Inspection on 10/09/09 for Blackdown Polden House

This is the latest available inspection report for this service, carried out on 10th September 2009.

CQC found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Blackdown Polden House 22/11/06

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

Extracts from inspection reports are licensed from CQC, this page was updated on 25/11/2009.

Key inspection report Care homes for adults (18-65 years) Name: Address: Blackdown Polden House Somerset Court Harp Road Brent Knoll Highbridge Somerset TA9 4HQ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Jane Poole     Date: 1 0 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Blackdown Polden House Somerset Court Harp Road Brent Knoll Highbridge Somerset TA9 4HQ 01278760555 01278760747 yvonne.thomas@nas.org.uk Vanessahalfacre@nas.org.uk National Autistic Society care home 12 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: Date of last inspection Brief description of the care home As part of Somerset Courts Modernisation Programme each previous accommodation area that comprised of Somerset Court, has now become a separate registered service. Blackdown Polden House comprises of a large detached bungalow situated in the extensive grounds of Somerset Court. The home is registered as one service and currently has two distinct accommodation areas. Six people are accommodated in each living area with separate facilities. There current manager is not yet registered with the Care Quality Commission. The National Autistic Society remains as the Registered Providers. Each accommodation area has a lounge/dining room, kitchen and single bedrooms with wash hand basins. One person has a separate flatlet with full en-suite facilities. There are adequate bathing and toilet facilities. The home has some laundry facilities but the majority of the laundry is sent to the main on-site facility. The home has a fenced off garden area with areas laid to patio with garden furniture. Care Homes for Adults (18-65 years) Page 4 of 28 12 12 Over 65 0 0 Brief description of the care home Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience Good quality outcomes. The focus of this inspection visit was to inspect relevant key standards under the Commissions Inspecting for Better Lives 2 framework. This focuses on outcomes for people and measures the quality of the service under four general headings. These are:- excellent, good, adequate and poor. The inspection was carried out by one inspector over an afternoon and evening period. During this time We, The Commission, were able to speak with people living and working at the home, tour the building, observe care practises and view records. Many of the people living at the home are unable to express their views verbally but all appeared content and comfortable with the people who supported them. Care Homes for Adults (18-65 years) Page 6 of 28 Before the inspection the manager completed an Annual Quality Assurance Assessment (AQAA) This document was completed to a good standard and some of the information from it has been used in this report. Care Homes for Adults (18-65 years) Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Adults (18-65 years) Page 8 of 28 following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. In one instance the pre admission assessment did not give sufficient information to ensure that the home had the appropriate resources to care for the new person. Evidence: The home has a statement of purpose and service user guide. The service user guide is available in a pictorial format making it accessible to the people who use the service. Since the last inspection one new person has moved to the home. Assurances were given that a full pre admission assessment had been carried out before the person moved in although this was not available at the time of the inspection. Staff spoken with during the inspection said that the pre admission assessment had not given a clear picture of the persons needs and the staffing levels that they required. Staff stated that they had been able to visit the new person at their previous placement and the person had visited the home before moving in. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home uses a variety of communication methods to enable people to make choices about their day to day lives. People living at the home, and their representatives, are fully involved in care planning to ensure that they receive support in their chosen manner. Evidence: Everyone living at the home now has a person centred plan in place. Two were viewed in detail. Both were extremely personal to the individual. Pictures and photographs had been used to ensure that they were meaningful to the person. The plan of care also sets out measurable goals that have been set with the person. There are behavioural support plans and risk assessments in place. This ensures that people are able to take part in activities with minimum risk to themselves and others. One member of staff gave evidence that people living at the home are now fully Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: involved in their care plan to ensure that they are supported in their chosen manner. For example, as part of the care plan meeting, one person had said that they would prefer to eat on their own after other people had finished their meal. On the day of the inspection it was observed that this person ate in the dining room after everyone else had left. New staff stated that the care plans gave a good picture of the person and enabled them to support people in line with their wishes. The home use a variety of different communication methods to ensure that people are able to make choices. Staff receive training in various communication methods to ensure that they have the skills to communicate effectively.. People living at the home meet each week to make choices about the menu and the activities for the coming week. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have access to a wide range of social and leisure activities. People are able to make choices about the food they eat and the activities that they take part in. Evidence: Routines in the home are flexible in line with individual wishes and needs. All personal rooms are lockable and some people have keys according to their wishes and abilities. People are able to spend time in communal areas or the privacy of their room if they prefer. Everyone has access to on site day services. These include gardening, arts and crafts, communication, a gym and sensory room. One person attends college locally. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: Each person has an in house day once a week. This is a day when people are able to learn and develop independent living skills and take part in activities of their choosing. People also have opportunities to help with household chores on a day to day basis. Some people help to prepare and cook meals, take part in shopping trips and general cleaning and tidying around the home. Due to the rural location of the home transport is provided to enable people to access local amenities and facilities. People said that they go swimming, walking, shopping and out for meals. There are photographs around the home that show days out and holidays that people have taken part in. Since the last inspection the home has introduced weekly planners for meals and activities. At the beginning of each week people living at the home have a meeting to decide the menu and activities for the coming week. From this a menu and activity plan is made which includes choices from everyone. Staff spoken with said that times of weekend shifts have been adjusted to ensure that there are adequate staff on duty to enable people to have more outings, and access community facilities, at weekends. People are assisted to keep in touch with friends and family and some people have holidays away with family members. The manager stated that some holidays have been arranged near to relatives so that people can spend quality time with families, supported by staff from the home. On the evening of the inspection it was noted that people moved freely around the home and many people accessed the Somerset Court grounds or visited people in other houses on the site. Some people went out to a club in the nearby town. When people are attending day services they eat lunch in the main dining room, which is used by people across Somerset Court. This is a refectory style service with everyone making choices about their food. The main meal of the day is in the evening when everyone is at home. As previously stated people are able to make choices about the weeks menu. For some people who are unable to express themselves verbally pictures and photographs are used to assist them to express their preference. People are able to choose to eat with other people or on their own if they prefer. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assisted with personal care in a manner that is appropriate to their needs and respects their privacy. People have access to healthcare professionals according to their individual needs. Evidence: Care plans seen gave details of the level of support people require with personal care. Staff spoken with during the inspection demonstrated a good knowledge of the needs of people living at the home and gave evidence that everyone is respected as an individual and their different needs accommodated. The home employs both male and female staff to ensure that people have a choice about the gender of the person who assists them with intimate personal care. One person has an en suite bathroom and others share bathrooms, toilets and showers. All facilities are lockable to allow privacy. It was noted that staff knocked on bedroom doors before entering and privacy was respected. Everyone is registered with a local GP and other healthcare professionals according to their individual needs. Since the last inspection the home have developed health Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: action plans for everyone that clearly set out their healthcare needs and the specialist input that they require. All staff receive training in the Mental Capacity Act and the manager gave evidence that the implications of this are considered for anyone who requires medical intervention. All appointments with healthcare professionals are recorded and the staff assist people to attend appointments outside the home. The home uses a monitored dosage system for medication and staff receive training in this area. Medication Administration Records (MARs) showed that all medicines are signed for when they are received by the home and when administered or refused. This gives a clear audit trail. Medication is administered by one member of staff and witnessed by another. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has taken appropriate steps to minimise the risks of abuse to people living at the home. Evidence: The home has policies and procedures in respect of making a complaint, recognising and reporting abuse and whistle blowing. The complaints procedure has been made available in symbol format to make it accessible to as many people as possible. No complaints have been received since the last inspection. Some people living at the home are unable to express themselves verbally. Staff spoken with were confident that they would recognise any changes in mood or behaviour that may indicate that the person was unhappy. All staff receive training in the protection of vulnerable adults as part of their induction. Staff spoken with were aware of what to do if an allegation of abuse was made and all were familiar with the whistle blowing policy. The local safeguarding procedure has been made available to all staff. One person has a small flatlet in the home which was locked by an electronic keypad. Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: This keypad is now only locked when requested by the person living in the flatlet. At the time of the inspection the door was not locked giving the person unrestricted access to the communal areas of the home. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Some areas of the home are shabby and require redecoration but the home is due to be totally refurbished within the next two years. Evidence: Blackdown Polden is a single storey building divided into two distinct accommodation areas. It is set in the extensive grounds of Somerset Court where there are a further 4 registered care homes. The home is not within walking distance of shops or other local amenities and is not on a public transport route. All areas of the home are fitted with a fire detection system. Each part of the home has its own communal lounge, dining area and kitchen. There are small enclosed gardens with seating and people have access to the grounds of Somerset Court. All bedrooms are for single occupancy and one has en suite facilities. Bedrooms seen had been personalised to reflect the tastes and needs of the individual. There are shared bathing and showering facilities available. Since the last inspection some bathrooms have been redecorated. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: Each kitchen has a domestic style washing machine and there is also a commercial type laundry on the site. The AQAA states that people living at the home now carry out personal laundry in the home rather than use the on site laundry. All areas seen were reasonably clean and fresh. One lounge and dining room is sparse and unhomely. Decor is shabby and would benefit from redecoration. However the home is due to undergo a major refurbishment within the next two years. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are supported by a well qualified and motivated staff team. Recruitment practises minimise the risk of abuse to people. Evidence: The home employs 22 care staff, 14 (64 ) have a National Vocational Qualification (NVQ) in care at level 2 or above. (Figures taken from AQAA) All new staff undertake an induction programme before they begin work in the home. New staff said that the induction was very comprehensive and gave them an understanding of the job. Staff were very happy with the ongoing training opportunities which include health and safety issues and training relevant to the needs of the people at the home. Staff asked stated that there was usually enough staff on duty to support the people living at the home. In addition to permanent staff the home also has a pool of relief staff who are able to cover when full time staff are away. Three staff recruitment records were viewed. These gave evidence of a robust recruitment process which minimises the risks of abuse to people living at the home. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: Written references are obtained for all new staff and appropriate checks are undertaken. Since the last inspection the home has introduced trial shifts for prospective employees. After interview people are asked to work a shift before a position is offered. This gives them an opportunity to spend time in the home and a chance for people living at the home to voice their opinions about prospective employees. Staff spoken with, and observed, were very enthusiastic about their jobs and had a commitment to providing a high quality service that was personal to each individual. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager has the skills and experience to manage the home. There are systems in place to monitor quality and seek the views of people who live and work at the home. Evidence: The manager at the home is currently in the process of applying to the CQC to be registered. The manager is well qualified and experienced in working with people who have a learning difficulty and autism. In addition to the manager there are two senior members of staff who offer day to day guidance and supervision to less experienced staff. People working at the home stated that the management team were supportive and approachable. Prior to the inspection the manager completed an Annual Quality Assurance Assessment (AQAA) which gave details about the home, their achievements in the past year and plans for the future. This completed document demonstrated that the Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: home is committed to providing a person centred approach to care and ensuring that people are consulted on the running of the home. To monitor the quality of the service and facilities offered there are weekly audits in place, regular meetings for people living and working at the home and a suggestion box where anyone can post their ideas and views. This can be done anonymously if preferred. All staff have regular supervision sessions to monitor their practise and highlight areas that they may require further training in. A sample of personal supervision records showed that this is an opportunity to share ideas and views with their supervisor. Staff have access to the National Autistic Society intranet where all policies and procedures are available. To ensure that staff keep up to date the home has begun to discuss specific policies at staff meetings. The home has taken reasonable steps to ensure the health and safety of people living and working in the home. The AQAA demonstrated that equipment in the home is regularly tested and serviced to ensure that it is in good working order. Staff receive training in subjects such as first aid, food hygiene, manual handling and fire safety. A fire risk assessment is in place but in one part of the home is was noted that not all staff had received training in fire safety in line with the requirements of the risk assessment. Up to date certificates of registration and insurance are displayed in the home. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 2 14 The registered person must 30/11/2009 ensure that pre admission assessments give clear details of the persons needs. To ensure that staffing levels and skills are appropriate to support any new person moving in. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 42 Staff should receive training in fire safety at the frequency required by the homes fire risk assessment. Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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