Key inspection report
Care homes for adults (18-65 years)
Name: Address: Healey House 1 Oakenshaw Avenue Healey Whitworth Lancashire OL12 8ST The quality rating for this care home is:
three star excellent 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: Marie Dickinson
Date: 3 0 0 3 2 0 1 0 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 33 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 33 Information about the care home
Name of care home: Address: Healey House 1 Oakenshaw Avenue Healey Whitworth Lancashire OL12 8ST 01706759692 01706759692 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Anna Geraldine Ellis Name of registered manager (if applicable) Miss Marie-Louise Bennion Type of registration: Number of places registered: care home 10 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The registered person may provide the following categories of service only: Care home only - Code PC, to people of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Learning Disability - Code LD The maximum number of people who can be accommodated is: 10 Date of last inspection Brief description of the care home Healey House is registered with the Commission for Social Care Inspection to provide care and accommodation to eight younger adults who have a learning disability. Healey House is situated close to the boundary that divides Rossendale and Rochdale. The home is situated on a main bus route and residents can use public transport with staff support. Transport provided by Healey House is also available for residents to access facilities in both areas. 10 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 33 Brief description of the care home The home is an end terraced Victorian building that provides homely spacious accommodation on two levels. Access to the first floor is via a passenger lift. The first and second floor can be accessed via a staircase. There are large single bedrooms, bathing and toilet facilities on the ground and first floor. The ground floor consists of two lounges a dining area and a kitchen. Confidential information and medication are both stored securely in separate rooms. The home is decorated, equipped and furnished to a good standard. Furnishings are domestic in character. There are enclosed garden areas surrounding the property. Prospective residents can have a copy of the statement of purpose and a service user guide. Fees at the home are subject to service user need. Additional charges are made for clothing, hairdressing, toiletries, holiday spending, meals out, admission to places of interest and gifts for families. Care Homes for Adults (18-65 years) Page 5 of 33 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: three star excellent 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: A key unannounced inspection was conducted in respect of Healey House on the 30th March 2010. The process of this inspection involved getting information from an Annual Quality Assurance Assessment completed by the manager, staff records, care records and policies and procedures. Staff and residents returned surveys giving their view on how well the home was managed and of the care, and facilities provided. The inspection also involved making observations and talking to residents, staff on duty, and the manager. The premises were inspected as part of the process. There had been two annual service reviews completed since the last key inspection. There were no issues identified that required improvement, and the findings were the Care Homes for Adults (18-65 years)
Page 6 of 33 home continues to provide excellent outcomes for residents living there. The home was assessed against the National Minimum standards for Younger Adults. Care Homes for Adults (18-65 years) Page 7 of 33 What the care home does well: Staff who provided written comments said, Access to both assessment and provision is fair and consistent. There is no discrimination on the grounds of race, disability, gender, age, and sexual orientation, religion or belief. How people are admitted to Healey House is very well managed. People had their needs assessed by professionals and could visit and stay for a while to meet the other residents and staff. Staff at the home, relatives, and other people who were helping them, talked to them about their stay and were involved in making sure their choice to stay was the right one. Residents benefited from good care planning. This was because they were person centred which meant residents decided how they wished their care to be managed, and they made decisions about their everyday lives. Good communication methods were used in helping people understand as much as possible and residents knew information about them was kept confidential, and staff respected this. Activities were varied and personal to everyone. This supported residents to live a fulfilling life in the home and in the community. Residents lived their lives to the full. They were happy in the home. Written comments included, It gives me activities I want to do, and involves me in all aspects of things. And Supports me getting new clothes when needed and take me to the pub. Staff considered the home did well, The home is very good at being person centred. Every individual is treated as an individual and their needs are met to the best of staffs ability. And The home caters for the service users needs very well and does its best to meet all the service users wishes and needs. Family links were encouraged and they were made very welcome in the home. The level and type of training given to staff was very good which meant residents were cared for by people who had the right skills and knowledge. This provided the necessary support residents may require in any given situation. Meal times in the home were relaxed and enjoyable. Residents were involved with the day to day running of the home with tasks like cooking, cleaning and food shopping. Special diets were managed very well and residents given additional support where needed. The high standard of residents health care plan helped them to receive the correct support from medical professionals and understand what was happening. People were registered with a General Practitioner and had regular routine health screening. Medication was managed safely. Health and social care professionals considered, Management and staff have engaged in all aspects of training and awareness to ensure the best possible interventions and outcomes for the service user. The complaints procedure and the way the home was managed made it very easy for residents and other people to raise any issues or concerns they had. There were up to date policies and procedures for staff reference and training provided in Safeguarding Vulnerable Adults. Staff were also trained to respond appropriately to physical and Care Homes for Adults (18-65 years)
Page 8 of 33 verbal aggression. Health and social care professionals considered the home did well as Flexible and transparent approaches to behavioral support has resulted in the successful placement of individuals who challenge services. The home was very nicely decorated. Furniture provided for residents was of a very good quality. Observations made during inspection found the standard of hygiene in the home was excellent. The home was well maintained, safe, clean, and tidy, and provided a homely and pleasant environment for residents, visitors, and staff. The level of staffing, training provided and good recruitment practice meant residents were cared for by qualified and competent staff. Staff who provided written comments for this inspection said they were given training they needed to help them understand and meet the needs of the people they cared for. Additional comments regarding what the home did well included, The staff are well trained, providing training and development opportunities for its workers. And I am very proud to be working for Healey Care. I especially like our in house training. Training is very appropriate to the people we support. Management responsibilities were clear and the home was very well managed. There was some evidence to show the management approach in the home allowed for residents to have a positive impact on how they would like the home to run, the care they receive and facilities they enjoy. Confidence was expressed in how the home was managed. Staff written comments included, We have excellent management and a good team spirit. Our manager encourages to go that extra mile to reach out to someone with a problem. Healey House has been a very good place to work. Its been to me one of the most rewarding jobs Ive had. And The homes manager is proactive and has good communication and listening skills. Record keeping was very good and all records were organised and kept up to date. Residents were involved in keeping safe. They had regular fire drills and knew what to do should this occur. The home had a good range of policies and procedures and practice aimed at keeping everyone safe. Staff were given essential health and safety training in topics such as first aid and fire prevention. What has improved since the last inspection? One recommendation made at the last key inspection relating to medication had been implemented. The home has continued to improve and informed us of their continuing commitment to provide an excellent service. Examples of these improvements included: Provided training from outside agencies in Mental Capacity Act (MCA), and Deprivation Of Liberty Safeguard (DOLS) for staff in addition to ongoing in house training, such as person centred planning, and training for National Vocational Qualification in care. They have developed a new format for recording personal daily notes to include an acknowledgment of when they may have worked in residents best interest. Daily life and social activities have improved with further activity opportunities like Bounce trampolining, monthly disco/social held at their day service premises, more Care Homes for Adults (18-65 years)
Page 9 of 33 wide ranging holiday destinations.etc. They said they have continued positive presence in our community, and also developed group sessions to include cook and eat sessions, light room availability, art and reminiscence group, arts and crafts, drumming workshops and visiting session facilitators. Improvements have been made to the complaints procedure and staff were trained in safeguarding vulnerable adults. There continues to be investment made to improve standards within the home. These improvements had included building work to the extension, the main lounge had been redecorated and new carpet fitted, also in the dining room. A wider choice of dining arrangements was provided. One bedroom had been decorated and new flooring fitted. Homely items and electrical goods were replaced when needed. The manager has undertaken the role of Manual Handling Trainer for the service after completing an extensive 5 day course. They have revised and renewed their Staff Handbook in consultation with support staff, this was released last summer. What they could do better: The home has exceeded in most outcome areas. There were a number of recommendations made as purely good practice issues. To further improve on records maintained for admission, the views of the new resident and the people living at the home should be recorded. This information will support the new resident to express themselves when a meeting is held with everyone involved in their care, such as family and social worker, to discuss how the trial period went and whether living at the home meets with their approval, and they are confident their needs can be met. Residents should have a copy of their care plan made available to them in a format they understand unless there are clear recorded reasons why this is not possible. To make sure residents really are consulted at all levels, they should discuss regularly, policies and procedures that directly affects them and essential house rules for group living they agree themselves, such as being respectful to each other. Residents should have written expectations of social living in the home to refer to. It is important residents are aware of what is acceptable and what was not, such as respecting each others privacy of space or how they speak to each other. When residents move into the home it would be useful for them to be given information on how to keep safe. This will help them to be clear what abuse means and what safeguards are in place to protect them. It will help them to identify institutional abuse, and alert them to other forms of abuse and abusive issues in the wider community. A more structured approach to enabling residents to be fully involved in staff selection should be made. Care should be taken to make sure any reference accepted is hand signed by the Care Homes for Adults (18-65 years)
Page 10 of 33 referee. This will validate the authenticity of the reference. Better records of full induction should be made. This will help to keep track of learning and competencies achieved. Notes taken during interviews should demonstrate equal opportunities, with structured questions and show care has been taken to ensure the information provided is accurate, such as exploring and confirming gaps in employment. Consideration should be given to introducing systems of quality monitoring for residents that are structured. This will ensure good quality assurance control, designed to evaluate and monitor performance, and look at staff support processes effectively. For example, resident representation at staff and management meetings and business planning, staff recruitment and training and accessing service users networks in the wider community. If you want to know what action the person responsible for this care home is taking 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 11 of 33 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 12 of 33 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good information available, and admission processes followed, helped to make sure the facilities and care services provided would meet the assessed needs, requirements and preferences of individuals. Evidence: Residents who provided written comments for this inspection all indicated they were asked if they wanted to move into the home. And the information about the home helped them decide it was the right place for them. There was evidence to show that admissions are planned for. All new residents receive a full comprehensive needs assessment before an admission. This includes an assessment from a health and or social care professional and from the home. They are given the opportunity for introductory visits including an over night stay when they meet with staff who will support them and they can join in everyday activity in the home. They can also get to know other residents and staff can observe how well everyone gets on. To further improve on records maintained the views of the new resident and the people living at the home should be recorded. This information will
Care Homes for Adults (18-65 years) Page 13 of 33 Evidence: support the new resident to express themselves when a meeting is held with everyone involved in their care such as family and social worker to discuss how the trial period went and whether living at the home meets with their approval, and they are confident their needs can be met. Records maintained showed that following admission, assessment of need continues and care is taken to reassure the resident and provide good support during this time. It is an opportunity to help staff gather information required to know the residents likes dislikes, and what they want from the service. This can also help to identify if staff require any specialist skills and knowledge to meet the residents needs. Staff training records show that staff are very well trained to care for people with a learning disability and associated needs. Care Homes for Adults (18-65 years) Page 14 of 33 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good person centred care planning meant residents could have personal goals that staff knew about and helped them achieve safely and their right to independence promoted and respected. Evidence: There was good evidence seen in residents care plans to show the service respected residents right to take control over their own life and make their own decisions and choices. The standard of residents care records was very good, and included an up to date assessment of their needs. Care plans were person centred. They linked very well to assessed needs, and placed residents central to any activity. The plans took into account what was important to residents, what they wanted, what they needed, and what support people would give them. Care plans were seen to be updated and reviewed. Residents should have a copy of their care plan made available to them in a format they understand unless there are clear recorded reasons why this is not possible.
Care Homes for Adults (18-65 years) Page 15 of 33 Evidence: Risk assessments were completed and took into account responsible risk taking as residents right, and part of daily living we all experience. Any limitation that may be required was agreed and included in care planning. There was evidence of key worker involvement to support residents for example manage their own finances, live as they wished, and to make good choices. To support residents understand and have their say with care planning, different methods to engage residents were used. For example, illustrations, discussions and staff observations, key worker and knowledge of current needs of residents. Good communication methods were used to support residents with limited vocabulary, for example residents own language dictionary. There was some evidence residents had involvement with the running of the home. They had meetings and were involved informally in staff selection. Information received at the Commission informed us they have a range of policies which shapes how they respond to personal needs and choices. Examples of this included, Admission policy, Complaints and compliments, Consent and Capacity, Confidentiality and disclosure of information, Equal opportunity and race equality, Individual planning and review, Key worker role, Rights and risk taking, Person centered service user plans, service users monies, Sexuality and relationships and Statement of purpose. This could be improved by making sure residents have copies of, and discuss regularly, policies and procedures that directly affects them and essential house rules for group living they agree themselves, such as being respectful to each other. Care Homes for Adults (18-65 years) Page 16 of 33 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The scope of opportunities for personal development, family contact, and social activities was excellent. Residents were treated with respect and lived a fulfilling lifestyle in the home and in the wider community. Evidence: People were out and about during the day when the inspection took place. The manager said residents were helped to develop skills that included social, emotional, communication, and independent living skills, and they were encouraged and supported to use community resources. Good care planning and key worker involvement provided residents with the required support for every day living activities. Residents were supported to access education, work skills, and leisure activities according to their interests, and capabilities. Within the home residents could use weekly planners to help them remember what to do and
Care Homes for Adults (18-65 years) Page 17 of 33 Evidence: where to go, and they usually did something different every day. For example they knew when they would probably clean their room with support, and attend different venues they enjoyed. Residents who provided written comments for this inspection considered the home did well with activities. And it gives me activities I want to do, and involves me in all aspects of things. Residents discussed the various types of social activities they enjoyed. For example they went to town, went to the pub, went swimming, went to clubs etc. Transport was provided by the home and two residents enjoyed the benefits of their own car to support them to get about. As part of the basic contract price, residents had the option of a minimum seven-day holiday outside the home they helped to choose. Where residents were at risk or vulnerable in the community, this had been managed properly through discussions with residents to help them make good choices and give support, for example managing money. There were no agreed house rules, or written guidelines to support living together residents could refer to. This was discussed with the manager as it is important residents have clear boundaries and are aware of what is acceptable and what was not, such as respecting each others privacy of space or how they speak to each other. Difficulties in relationships between residents however were identified and management strategies in place to deal with these situations. Family links were encouraged and residents could have visitors at any reasonable time. Relatives and friends were made welcome to the home, and there was good evidence residents were supported to maintain family relationships. Significance of family relationships was included in care planning, to ensure staff knew what was required of them to support residents maintain contact. The home was managed in a manner to avoid any institutional routines. Observations of staff at work showed they treated individuals with respect. Staff who provided written comments for this inspection thought the home did well as they respected peoples wishes with thought and understanding. Residents preferred name was recorded on their plan. Residents had had locks on their doors and could manage their own keys. Staff who provided written comments for this inspection said, Its a great feeling when we sit and compare notes and see how much someone we support has changed for the better, grown in confidence, and you can see that it is because we have broken down barriers that have confined them. And I love the knowledge that care and Care Homes for Adults (18-65 years) Page 18 of 33 Evidence: support within the community really works. Meals provided met with resident tastes and choice. They said the food was good and they had what they wanted. Meal times were flexible and likes and dislikes and special support needed was recorded for staff reference. Residents who provided written comments said they feed me well. Care Homes for Adults (18-65 years) Page 19 of 33 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care of residents is monitored and they are supported according to their need. Individual preferred routines, likes and dislikes allowed them to enjoy personal care in a dignified way. Evidence: Comments from residents living in the home indicated staff treated them well. Records showed residents had a key worker they were happy with to help them. Care planning was very person centred and took into account residents ability for self care and health care needs. Records showed the focus was on independence, and help with personal care was given according to need and individual wishes. For example able to wash independently, but may require verbal prompts and encouragement. Staff giving support for more intimate care such as continence management were generally instructed how best to provide this. Staff who provided written comments for this inspection considered they always received up to date information about the needs of residents. Additional comments included The home is very good at being person centred. Every individual is treated as an individual and their needs are met to the best of staffs abilities. Health and
Care Homes for Adults (18-65 years) Page 20 of 33 Evidence: social care professionals considered, Healey care has always promoted multi disciplinary involvement. Management and staff have engaged in all aspects of training and awareness to ensure the best possible interventions and outcomes for the service user. Records showed residents living in the home were registered with a General Practitioner. Appointments for routine health screening were made and staff support offered where needed. Health action plans were written to ensure all health care needs were properly monitored There was also evidence of other professionals being involved in residents personal and healthcare needs for example, care coordinators, consultants, and community health services as required. Information received from the home stated, Each service user has an up to date Health Action Plan and a hospital grab pack. We support individuals to their primary health appointments. All staff were very well trained to care for people with a learning disability and in other related topics. This meant that basic core values such as residents rights and choice and basic principles of care such as dignity, respect was included in staffs approach to their work. Records of medication were kept for each resident that included information staff should be aware of if someone was not well. Health action plans gave staff signs and symptoms to recognise for example if a resident was in pain and how they communicated this. Residents capacity to self medicate safely was assessed. Medication storage was secure and tidy. Medication administration records were up to date, and all staff responsible for this task had been trained. Care Homes for Adults (18-65 years) Page 21 of 33 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints procedure supported residents to raise any issue of concern they may have. There were policies and procedures, and appropriate training for staff in professional conduct and adult protection issues to support residents rights, safety, and welfare being promoted. Evidence: The manager said there were two formats of the complaints procedure making it more accessible and more user friendly for the people who use the service and visitors to the home. To offer a non judgmental service and encourage people to understand and use the procedure if and when they need to, time is spent time discussing the complaints procedure with residents, both in a group meeting and in one to one sessions with key workers. No complaints had been received at the Commission and no complaints recorded in the home. Residents who provided written responses for this inspection said they knew who to speak to if they had any concerns and knew how to make a complaint. They appeared to be satisfied with how they were treated as staff always listened and acted on what they said. Staff also said they knew what to do if someone had concerns about the home. Residents at home during inspection said they were happy in the home. There were up to date policies and procedures for staff reference and training provided
Care Homes for Adults (18-65 years) Page 22 of 33 Evidence: in Safeguarding Vulnerable Adults. Staff were also trained to respond appropriately to physical and verbal aggression and fully understand the use of physical intervention as a last resort. They had attended further training on The Mental Capacity Act and Deprivation of Liberties Safeguard. Health and social care professionals who gave their view on how well the home performed said, Management and staff have engaged in all aspects of training and awareness to ensure the best possible interventions and outcomes for the service users. And Flexible and transparent approaches to behavioral support has resulted in the successful placement of individuals who challenge services When residents move into the home it would be useful for them to be given information on how to keep safe. This will help them to be clear what abuse means and what safeguards are in place to protect them. It will help them to identify institutional abuse, and know what is not acceptable behavior toward them in the course of daily living, and alert them to other forms of abuse and abusive issues in the wider community. Care Homes for Adults (18-65 years) Page 23 of 33 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was well maintained, safe, clean, and tidy, and provided a homely and pleasant environment for residents, visitors, and staff. Evidence: Healey House is a large Victorian Style building situated close to the boundary that divides Rossendale and Rochdale. There is also a bungalow close by that is part of the registration providing accommodation for two people. In the main house accommodation is provided in single rooms and the upper floor can be accessed by stairs or passenger lift. There are enclosed garden areas surrounding the property. Information received at the Commission showed there continues to be investment made to improve standards within the home. These improvements had included building work to the extension, the main lounge had been redecorated and new carpet fitted, also in the dining room. A wider choice of dining arrangements was provided. One bedroom had been decorated and new flooring fitted. Homely items and electrical goods were replaced when needed. Plans were in place to continue with this and include for example redecoration of the hall, stairs and landing. The home was decorated to a very good standard and furnishings and fittings were homelike in style and of a good quality. The home was very clean and residents were
Care Homes for Adults (18-65 years) Page 24 of 33 Evidence: very much at home and happy with their accommodation. All residents have a single large sized bedroom in close proximity to bathrooms and toilets. The doors were fitted with suitable locks to enable residents to maintain their privacy of space. Bedrooms seen were comfortable, personalised and furnished and fitted to a very good standard. Information received at the Commission from the manager showed relevant health and safety maintenance of equipment and appliances had been carried out. Observations made throughout the home was, the overall standard of hygiene in the home was exceptionally high. Care Homes for Adults (18-65 years) Page 25 of 33 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. The level of staffing, training provided and good recruitment practice meant residents were cared for by qualified and competent staff. Evidence: Information received at the Commission indicated there were sufficient numbers of staff employed to meet the needs of residents. The manager said staffing levels in the home allowed for staff to meet the needs of the residents, and supported a person centred approach to care. Rotas were available to look at and they gave an indication of the numbers of staff on duty at any given time to cover essential duties such as keeping the home clean and give residents one to one support. Residents who provided written comments for this inspection considered staff were always available when needed. Staff records showed recruitment checks to be complete and met with legislative requirements for Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) register check, being applied for prior to employment. On appointment staff were issued with a job description and contract of terms and conditions of employment. The manager said residents can be involved in selecting new staff. This was discussed
Care Homes for Adults (18-65 years) Page 26 of 33 Evidence: as there is potential to develop this further to ensure residents are cared for by staff they helped to choose. There is also potential to further develop the interview process. Notes taken during interviews should demonstrate equal opportunities, with structured questions and show care has been taken to ensure the information provided is accurate, such as exploring and confirming gaps in employment. References accepted should always be signed. Any verbal reference taken should be recorded to indicate who it was from, date, and time. This will validate them being from the right source. On appointment staff were issued with a job description and contract of terms and conditions of employment. Records showed new staff had been given initial one day induction training. Staff who provided written comments for this inspection said their induction had covered everything they needed to know to do the job when they started work. A full induction program however needs to be evidenced better showing very robust, detailed and service specific training. Staff also commented they were given training they needed to help them understand and meet the needs of the people they cared for. Additional comments regarding what the home did well included, The staff are well trained, providing training and development opportunities for its workers. And I am very proud to be working for Healey Care. I especially like our in house training. Training is very appropriate to the people we support. Information received at the Commission indicated that staff were trained in National Vocational Qualification in Care (NVQ) level 2 and above. A wide range of other training was provided that included specialist topics that care staff need to know about. This included for example among many, learning disability and associated needs such as epilepsy and autism. Records, and report writing, Mental Capacity Act, person centered planning, risk assessment and challenging behavior. They also provide training in infection control, equality and diversity, an annual abuse refresher, moving and handling and best interest. Care Homes for Adults (18-65 years) Page 27 of 33 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run in the best interests of the residents. Evidence: The registered manager is qualified in management and care, and has many years experience in managing a care home. Information received at the Commission show the scope of her responsibilities includes for example responsibility for staff, resident welfare, policies and procedures, health and safety, and training. There appears to be clear lines of accountability and good support from the provider. From observations made, records looked at, and comments from residents and staff, there was evidence to show the management approach in the home allowed for residents to have some say on the way the home was run, the care they receive and facilities they enjoy. To provide residents with a more consistent approach to this, consideration should be given to introducing systems of quality monitoring for residents that are structured. This will ensure good quality assurance control, designed to evaluate and monitor performance, and look at staff support processes effectively. For example, representation at staff and management meetings and
Care Homes for Adults (18-65 years) Page 28 of 33 Evidence: business planning, staff recruitment and training and accessing service users networks in the wider community. Written comments from staff sent to the Commission included, We have excellent management and a good team spirit. Our manager encourages to go that extra mile to reach out to someone with a problem. Healey House has been a very good place to work. Its been to me one of the most rewarding jobs Ive had. And The homes manager is proactive and has good communication and listening skills. Residents who provided written comments said, I am more happier now I am at Healy House, and they considered staff always treat them well. The home made sure everyone who could managed their own money as far as they were able. Proper records were kept and audited at regular intervals. Record keeping was very good, and confidential records were stored securely. Staff were made aware of the requirements of the Data Protection Act, and compliance was included in their terms and conditions of employment. Staff had the opportunity to discuss work issues with the owners and manager on a day-to-day basis and in supervision. Relationships between staff and those living there were observed as positive. Staff spoke about people with respect, who in turn described staff as good. The home has Investors In People award (IIP). Professional people considered the home did well in all areas they monitored, such as assessment, meeting health and social care needs, respect of privacy and dignity and supported people to live the life they chose. They also considered managers and staff had the right skills and experience to support people and they considered and responded to diverse needs of individuals. Information received at the Commission showed regular maintenance of the homes fixtures, fitting and equipment and the review of policies and procedures. The manager complies with statutory reporting requirements and other relevant legislation. Safe working practices in the home were evidenced with safe working practice monitoring and risk assessments. Staff were trained in health and safety topics such as first aid and fire prevention. The manager said the residents and staff had fire drills. Care Homes for Adults (18-65 years) Page 29 of 33 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 30 of 33 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 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 2 To further improve on records maintained for admission, the views of the new resident and the people living at the home should be recorded. This information will support the new resident to express themselves when a meeting is held with everyone involved in their care such as family and social worker to discuss how the trial period went and whether living at the home meets with their approval, and they are confident their needs can be met. Residents should have a copy of their care plan made available to them in a format they understand unless there are clear recorded reasons why this is not possible. To make sure residents really are consulted at all levels, they should discuss regularly, policies and procedures that directly affects them and essential house rules for group living they agree themselves, such as being respectful to each other. Residents should have written guidelines to support social living in the home to refer to. It is important residents have clear boundaries are aware of what is acceptable and what was not, such as respecting each others privacy of space or how they speak to each other.
Page 31 of 33 2 6 3 8 4 16 Care Homes for Adults (18-65 years) 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 5 23 When residents move into the home it would be useful for them to be given information on how to keep safe. This will help them to be clear what abuse means and what safeguards are in place to protect them. It will help them to identify institutional abuse, and know what is not acceptable behavior toward them in the course of daily living, and alert them to other forms of abuse and abusive issues in the wider community. Notes taken during interviews should demonstrate equal opportunities, with structured questions and show care has been taken to ensure the information provided is accurate, such as exploring and confirming gaps in employment. Care should be taken to make sure any reference accepted is signed by the referee. This will validate the authenticity of the reference. Better records of full induction should be made. This will help to keep track of learning and competencies achieved. Consideration should be given to introducing systems of quality monitoring for residents that are structured. This will ensure good quality assurance control, designed to evaluate and monitor performance, and look at staff support processes effectively. For example, resident representation at staff and management meetings and business planning, staff recruitment and training and accessing service users networks in the wider community. 6 34 7 34 8 9 35 39 Care Homes for Adults (18-65 years) Page 32 of 33 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Adults (18-65 years) Page 33 of 33 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
