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Inspection on 25/11/09 for Holly Close

Also see our care home review for Holly Close for more information

This is the latest available inspection report for this service, carried out on 25th November 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: Holly Close 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?   No 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: Rajshree Mistry Date of this annual service review: 2 1 1 0 2 0 0 9 Annual Service Review Page 1 of 10 Information about the service Address of service: 6 Holly Close Brackley Northants NN13 6PF 01280840577 01280840049 ajones@livability.org.uk www.livability.org.uk Livability Telephone number: Fax number: Email address: Provider web address:   Name of registered provider(s): Name of registered manager (if applicable) Miss Jill Lammond Conditions of registration: Category(ies) : learning disability Number of places (if applicable): Under 65 Over 65 3 0 Have there been any changes in the ownership, management or the Yes 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 Holly Close is a care home, which is registered to provide personal care and accommodation for three people with a learning disability. Holly Close is one of six homes in the area that are owned by Grooms - Shaftesbury, which is also known as The Brackley Residential Project. 6 Holly Close is situated in a residential area of Brackley in Northamptonshire. The home is within walking distance of Brackley town centre. The local amenities include shops, pubs, restaurants, gymnasium and a swimming pool. The accommodation consists of three single bedrooms upstairs and a sleep-in rooms for staff, a kitchen/diner and lounge on the ground floor. There is a well-maintained Annual Service Review Page 2 of 10 New Registered Manager garden at the rear of the property. The Registered Manager is also Registered Manager for the sister homes: Hanover Drive, Remus Gate, Westmister Croft, Tudor Way and Hawkins Close; and has an office base on the first floor at Hanover Drive. The range of fees for 2009/10 are not known. People who are interested in using Holly Close should contact the Registered Manager or the home directly for the range of fees. Further information about Holly Close can be obtained from the home in the form of a Service User Guide and a Statement of Purpose. The latest Inspection Report is available at the home or can be accessed via the Care Quality Commission (CQC) website: www.cqc.org.uk Annual Service Review Page 3 of 10 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. This included the Annual Quality Assurance Assessment (AQAA) that was sent to us by the service. This AQAA is a self-assessment that focuses on how well outcomes are being met for the people using the service. It also gave us some numerical information about the service. We assessed the information we have about the service and how the complaints received have been managed. We looked at what the service told us with regards to the things that have happened in the service. These are called notifications and are a legal requirement. We looked at the last Key Inspection Report dated 23rd October 2007 and the last Annual Service Review dated 6th October 2008 and any other visits that we have made to the service in the last 12 months. We looked at the relevant information from other organisations and what other people have told us about the service. We sent out surveys to the people who use this service, which included surveys for their relatives. We sent out surveys to health and social care professionals. We also sent out staff surveys. What has this told us about the service? Holly Close sent us their Annual Quality Assurance Assessment (AQAA) when we asked for it. It was clear and gave us all the information we asked for. We looked at the information in the AQAA and our judgement is that the service is still providing a good service. Holly Close has demonstrated how it continues to maintain the standards to benefit the people who use the service. The AQAA was completed by the Assistant Manager, which provided us with details of what the service does well and the evidence to support the practice. There were details about the new developments and practice to improve the quality of service people experience. This showed the service recognises the need to continuously improve in response to concerns, changes in best practice and the legislation. The AQAA demonstrated that people considering using the service and their relatives are given information to help them decide whether the home can meet their needs and aspirations. This information people receive is the comprehensive Statement of Purpose and the Service User Guide, which are both available in written and picture format. This has information about the range of services offered to people who use the service to meet their needs and aspirations that promotes their independence and well- Annual Service Review Page 4 of 10 being. This is reviewed and updated annually, making sure the type of service provided promotes independence. The AQAA demonstrated that there is a comprehensive pre-admission assessment to ensure the service is able to meet individual needs. People considering using the service are encouraged to have several visits including overnight stays. This enables people to decide if this is the right place for them and ensures a planned move to the home. People who choose to move to Holly Close are given a contract that has the agreed fees, the terms and condition of stay. Holly Close uses a person centred approach to care planning that takes into account individual choices, interests, health and personal care needs. These are reviewed monthly with the individual and includes changes to their goals, developments and aspirations. People who use the service are supported by a key worker. Care plans are reflective of the risk assessments and the safety measures, which are agreed with the person. The new simplified staff rota is displayed and helps people to know which staff are working. The AQAA states people who use the service are encouraged to take control and make decisions. People choose their own furnishing and colour scheme for their bedroom. They also take an active role in keeping the home clean and tidy. Individual needs and choices are highlighted in their person centred care plans that includes contact with family, friends, social interest, activities and events. People who use the service are asked about the type of events and activities they would like to take part in before these are organised. The AQAA states people who use the service choose their own menus and help with the preparation of meals. Individual likes and dislikes of meals are recorded and known to the staff. They also have one day off a week with staff who support them to pursue their own interests, meet friends for coffee or lunch. The AQAA states people who use the service have at least one holiday a year with staff support. Individual holiday diaries are kept, which people can share with their family. People keep in contact with their family and friends. Some people invite their family or friends for meals and parties. People who use the service have the right to form personal relationships and supported if necessary by the staff. The people who use Holly Close all attend the local day centre for four days a week. They have the opportunity to take part in peer and cultural activities. The link worker from the day centre meets with the people who use the service and the staff to identify changes to support and needs. There have been some improvements made offering people more opportunities as they have access to two vehicles at the weekends and all now have a bus pass that enables the staff to travel free with them. The AQAA states people who use the service are supported to be as independent as possible with regards to receiving personal care support and meeting their health needs. Staff have a good understanding of individual needs and how to support them. People are registered with the local health surgery and have regular visits to the dentist, podiatrist, optician and have annual health checks. Individual health needs and Annual Service Review Page 5 of 10 treatment are met and ongoing monitoring and treatment ensures peoples health and well-being. The improvements made include the life skills assessment carried out by the Community Team with the individual with regards to promoting their independence. Holly Close has a good system for the management, storage and administration of medication. The staff have received accredited medication training, which includes the annual epilepsy training. Holly Close now records any medication errors as a safeguarding of vulnerable adults procedure (SOVA). This means the promotion and protection of vulnerable people from harm, risk or abuse. All sova alerts are investigated and recommendations made to avoid a repetition, which may include further staff training. The AQAA states the complaints procedure is provided to everyone using the service in the form of a booklet, how to make a complaint. This is provided in a format most suitable for individuals. The complaints procedures is also included in the service user guide and the statement of purpose, with details of the process and the timescales. The AQAA states there were no complaints received about Holly Close. The Care Quality Commission received no expressions of concerns or complaints about Holly Close. The AQAA states the staff receive safeguarding of vulnerable adults (SOVA) training. This means the promotion and protecting the well-being of people using the service from harm, risk and abuse. The service had two safeguarding investigations, in line with the multi-agency procedures to protect vulnerable people. The improvements made to the service includes staff receiving training in the Deprivation of Libertys and the Mental Capacity Act. This is to help staff have a better understanding of what is meant by liberty and capacity with regards to supporting the people living at Holly Close. The people who use the service also have the opportunity to comment and express their views and concerns through the annual quality questionnaires and surveys. The Care Quality Commission has received timely notifications with regards to events that have affected the well-being of individuals who use the service. These are known as Regs 37 notifications and are a legal requirement. The AQAA states Holly Close is a well maintained property that blends in with the other private residential properties in the area. People who use the service choose the decor and furnishings for their bedroom to reflect their personality and interest. They have a key to their bedroom and the front door, if they choose to use it. People are responsible for keeping their bedroom and the home tidy. Staff do not enter peoples bedrooms without their permission. The AQAA states there is a programme of routine maintenance of the home. Some areas of the home have recently been re-decorated. The garden is well-maintained and one person has taken an active role in maintaining the garden. The AQAA details a list of the systems, servicing and testing of appliances and equipment in the home. There are weekly, monthly and annual health and safety checks carried out on the home Annual Service Review Page 6 of 10 environment. The AQAA demonstrates the staff recruitment process is robust, whereby the people who use the service are involved in the recruitment of staff. Pre-employment checks are carried out and maintained on file such as two satisfactory references, criminal records bureau (CRB) check and protection of vulnerable adults (POVA) check. This is a check to assess the suitability of the applicant to work with vulnerable people. The service also uses agency staff who undergo the same pre-employment checks. The AQAA states all staff complete a six week induction programme and are expected to complete the Learning Disability Qualification (LDQ) within 6 months of starting employment. Agency staff are required to complete induction training before they can work alone. All staff receive mandatory training and updates. The service has two staff that have attained the National Vocational Qualification (NVQ) in care level 2 or above. All staff including agency staff receive supervision and an annual performance review, which is a form of appraisal. There are monthly staff meetings that includes agenda items such as adult protection, health and safety, care standards, care plans and sharing of information with regards to the things that have happened in the service. The AQAA states the Registered Manager is experienced in managing a care home and working with people with a learning disability. She has attained the NVQ level 4 and the Registered Managers Award. The management of the service currently meets the needs of the people who use the service through good recruitment procedures and staff deployment. Holly Close also recognises the changing needs of people and is considering other types of living arrangement that promotes peoples independence, such as supported living. The AQAA states that policies and procedure are in place, some were last updated in June 2009. It also identifies the need for some of the policies and procedures to be reflective of Holly Close and the people who use it. The AQAA states there is a range of quality assurance and monitoring systems in place. These include the monthly visits conducted by the Registered Person or their representatives, known as Regs 26 visits. There are monthly, house meetings whereby the people who use the service are consulted and given information about changes that may affect or influence the quality of life they experience. People who use the service are involved in the annual reviews with the stakeholders. This is the organisation that financially supports individual using the service such as the Local Authority. People also have the opportunity to express their views and opinions about Holly Close through the annual quality assurance questionnaires. We sent out 3 surveys to the people who use the service that included relatives surveys. We received 3 completed surveys from the people who use the service and 1 from a relative. Some people completed the surveys with the help of staff or their relative. The responses all indicated people were involved in choosing and moving to Holly Close. All responses indicated people got the care and support they need including medical support. All responses indicated they can do what they want in the day, evenings and at weekends. All responses indicated staff are available, listen and act on requests. All responses indicated people know who to speak with if they are unhappy or have a complaint. All responses indicated that the home is fresh and clean. The additional comments received in the surveys were: Annual Service Review Page 7 of 10 Cleaning, I help with hoovering I am happy Its all right Im fine Keeps ... safe re: medicine, food, warmth, clothing, social awareness, hygiene, aware of vulnerabilities and personal preferences They are pin-pointing every need, where ...... is concerned with regard to her health and overall lifestyle so that all aspects are being catered for and improved We sent out 3 surveys to the health and social care professionals who are involved in the care and well-being of the people who use Holly Close. We received 2 completed surveys, which generally indicated that Holly Close provided a consistent level of support and care to meet individual health, personal care and support needs. The responses indicated peoples dignity and privacy was respected including individual diverse and cultural needs. The additional comments received were: This service works very well with our team. We are often contacted for advice / support with any concerns they have. Staff in general show care and dedication to the service users. The only time this falls short is when agency staff have to be used - this is a reflection on the quality of some agency staff, not the home itself The service is open to advice / criticism and always take on board any suggestions made by our team. They actively work to make a difference / improve the lives of their service users I would describe Livability as one of the best service providers in our catchment area. When we provide group work they always support us by providing consistent support from staff who have a genuine interest in the needs of the group members I believe that they actively seek to improve the lives of their service users and know that other team members share my positive views It is a pleasure to be able to pass on my views about this service. I wish there were more like it We sent out 2 staff surveys and both were returned. Both responses indicated staff received up to date information about the people who use the service, the care and support they need, such as care plans. Both responses indicated staff recruitment was done fairly and thoroughly and pre-employment checks were carried out. Both responses indicated that staff received induction and training for the job. Both responses indicated staff receive support from the manager and communication and information sharing systems between staff is good. The additional comments received in the surveys were: Annual Service Review Page 8 of 10 Have regular meetings covering all care etc, with service user and staff Service user are very well cared for and have plenty of say in what ever they want to do or go All staff get on well with all service users The home is a clean, friendly environment that allow the service user to live in a relaxed atmosphere and gives choices such as decoration of room, menu choice, how they spend their day off and with whom Transport is difficult due to rural location so getting places can be difficult - but this is improving with transport available for weekend activities if the residents choose to participate Staff have a lot of paperwork and this needs to be simplified so that staff can spend the maximum time with service users We concluded that the information in the AQAA was supported by the responses and comments received in the surveys. This demonstrated the practice within Holly Close and the experiences of the people who use it is consistent and promotes individual well-being and independence. Holly Close continue to let us know about the things that have happened including changes in the management of the service, since the last Key Inspection. They have shown that they have managed issues. They work well with us and have shown that the service continues to provide good outcomes for the people who use it. What are we going to do as a result of this annual service review? We are not going to change our inspection plans and will do a key inspection by 22nd October 2010. However, we can inspect the service at any time if we have concerns about the quality of service or the safety of the people using the service. 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