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Inspection on 07/12/09 for Church Street

Also see our care home review for Church Street for more information

This is the latest available inspection report for this service, carried out on 7th December 2009.

it is an annual review prepared by CQC after examining previous reports and information from the provider. At the time of this report, CQC judged the service to be Good.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Annual service review Name of Service: Church Street The quality rating for this care home is: The rating was made on: two star good service A quality rating is our assessment of how well a care home, agency or scheme 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 review a ‘key’ inspection We do an annual service review when there has been no key inspection of the service in the last 12 months. It does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection or annual service review.   Has this annual service review changed our opinion of the service?   Yes You should read the last key inspection report for this service to get a full picture of how well outcomes for the people using the service are being met. The date by which we will do a key inspection: Name of inspector: Linda Hirst Date of this annual service review: 0 5 1 1 2 0 0 9 Annual Service Review Page 1 of 6 Information about the service Address of service: 19 - 23 Church Street Market Warsop Nottinghamshire NG20 0AU 01623840000 Telephone number: Fax number: Email address: Provider web address:   www.voyagecare.com Milbury Care Services Ltd Name of registered provider(s): Conditions of registration: Category(ies) : learning disability Conditions of registration: Number of places (if applicable): Under 65 Over 65 10 0 The maximum number of service users who can be accommodated is 10. The registered persons may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission are within the following category: Learning disability - Code LD. Have there been any changes in the ownership, management or the No service’s registration details in the last 12 months? If yes, what have they been: Date of last key inspection: Date of last annual service review (if applicable): Brief description of the service Church St is a purpose built detached house situated in the centre of Market Worsop, which provides care and support for people with learning disabilities and physical health needs. There are eight bedrooms in the main house all with en-suite facilities. There are also two self-contained ground floor flats. The home is owned by, Milbury Care Ltd. The home is accessible for people with mobility difficulties and a passenger lift provides access to the first floor. The home has extensive gardens that are well maintained and easily accessible. There is ample car parking available. The home has its own accessible mini bus with hydraulic ramp as well as a car to Annual Service Review Page 2 of 6 enable people to travel for appointments and outings. The acting manager stated on 08/01/09 that the homes current charges range from £1,383.75 to £1,698.18, which excludes hairdressing, community activities and pampering days. Annual Service Review Page 3 of 6 Service update since the last key inspection or annual service review: What did we do for this annual service review? We looked at all the information that we have received, or asked for since the last key inspection or annual service review. This included: The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. Surveys returned to us by people using the service and from other people with an interest in the service. Information we have about how the service has managed any complaints. What the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. The previous key inspection and the results of any other visits that we have made to the service in the last 12 months. Relevant information from other organisations. What other people have told us about the service. What has this told us about the service? The service did not send us their annual quality assurance assessment (AQAA) when we asked for it, and we had to write to them again to remind them that the Law says it must be returned to us. The AQAA was completed well, and many of the plans for improvement were in areas where people who live at the service had raised concerns on their surveys (getting information in an understandable format before admission, people understanding how to complain, staffing levels and the range of activities.) That said, we found some of the statistical information in the AQAA about the number of safeguarding referrals is not accurate. The management of the service has been uncertain since the last registered manager left. An acting manager was appointed who was in the process of applying to become registered, but this person has now left the service and a new acting manager has been appointed. The service has told us in their AQAA that finding a manager with the right qualities and skills for the service is a priority. Given that we received a survey from a member of staff which told us there are problems with staffing levels (the person told us there are never enough), the efficacy of the arrangements for sharing information and understanding the diverse needs of people living at the service it is clear that this is an important area and one that is key in ensuring the service operates in the best interests of the people who live there. Annual Service Review Page 4 of 6 We sent out 6 surveys to people who live at the home, 8 surveys to staff, 4 to visiting professionals and 1 to a relative. 6 people who live at the service completed and returned surveys, four people told us they are very happy with the way staff care for them and listen to them, comments included, (they are good at) looking after me, nice dinners, making sure Im ready to go to my day centre in the week, or when Im going out. I get on well with my family and friends. Another person told us, people have happy faces, I like the people I live with, the meals are alright, I like pub visits/going out in the mini bus. In terms of improvements, people commented they would like more activities and staff, comments to us included, (we need) more activities, more male staff, and new and more staff, more outings. No complaints have been made directly to us since our last annual service review, though the service has told us they have investigated two complaints using their own internal processes. However, there have been a significant number of safeguarding issues at the home some of which have been investigated and some which are still being undertaken now. Where the providers have worked with the investigating authorities and have shown that they want to work with us to improve outcomes for the people living there, the number and pattern of incidents has given us concerns and we cannot be assured that the service continues to provide good outcomes for people living there. The service has continued to let us know about incidents which have happened and they have shown a committment to improving their service but we have concerns about how the home is being managed and how this is affecting outcomes for people living there. What are we going to do as a result of this annual service review? The next inspection of this service will be based on the Fees and Frequency Regulations 2007 and the assessment of risk of the service. Further clarity will become evident as the new registration and inspection system under the Health and Social Care Act 2008 is confirmed. However we can inspect the service at any time if we have concerns about the quality of the service or the safety of the people using the service. Annual Service Review Page 5 of 6 Reader Information Document Purpose: Author: Audience: Further copies from: Annual service review CQC General Public 0870 240 7535 (national contact centre) Our duty to regulate social care services is set out in the Care Standards Act 2000. The content of which can be found on our website. Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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