Inspection on 09/06/09 for Little Arches

This is the latest available inspection report for this service, carried out on 9th June 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Little Arches 07/11/05

Little Arches 05/01/05

Little Arches 10/08/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Key inspection report Care homes for adults (18-65 years) Name: Address: Little Arches 83 Cambridge Street Clifton Rotherham South Yorkshire S65 2ST     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: Christine Rolt     Date: 0 9 0 6 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 24 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 24 Information about the care home Name of care home: Address: Little Arches 83 Cambridge Street Clifton Rotherham South Yorkshire S65 2ST 01709839998 NONE NONE Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Andrea Briggs,Mr. David Lambert care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Little Arches is registered to care for four people with learning disabilities. It is owned by Mrs Andrea Briggs and Mr David Lambert. Mrs Andrea Briggs is also the registered manager and is in day to day charge of the home. Little Arches is a detached extended house in a residential area close to Rotherham town centre. The home has three bedrooms, staff sleeping facilities, bathroom, lounge, dining room, kitchen, conservatory and downstairs lavatory. There is also an annex for semi independent living within the secure back garden. This comprises a bedroom with spacious en-suite facilities, a lounge,and a kitchenette. The kitchenette in this annex has facilities for making a hot drink, washing up and washing laundry. Intercom facilities are provided. The weekly fees were from £650 to £800 per week. Hairdressing, chiropody, Care Homes for Adults (18-65 years) Page 4 of 24 Over 65 0 4 Brief description of the care home newspapers, magazines, toiletries and holidays were all charged extra. The manager supplied this information during the site visit on 9th June 2009. Care Homes for Adults (18-65 years) Page 5 of 24 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 stars. This means that the people who use this service experience good quality outcomes. To improve national consistency, we have reviewed our practice when making requirements. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. This was a key inspection and comprised information already received from or about the home and a site visit. The site visit was from 9:15 am to 3.15 pm on 9th June 2009. The registered owner who is also the manager of the home completed an Annual Quality Assurance Assessment (AQAA) before the site visit. This document gave her the opportunity to tell us what the home did well, what had improved and what they Care Homes for Adults (18-65 years) Page 6 of 24 were working on to improve. Various aspects of the service were then checked during the site visit. Care practices were observed, a sample of records was examined, a partial inspection of the building was carried out and service provision was discussed with the manager. Two of the people living at the home were seen and chatted to during the visit. The care provided for two people was checked against their records to determine if their individual needs were being met. Questionnaires for people living and working in the home were completed and returned. All information, opinions and comments were considered for inclusion in this report. The inspector wishes to thank people living in the home, the staff and the manager for their assistance and co-operation. Care Homes for Adults (18-65 years) Page 7 of 24 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 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 8 of 24 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 9 of 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People only moved into the home after their needs and aspirations were assessed to ensure that the home could meet their needs. Evidence: The files for two people living in the home were checked. These contained both the local authority assessments and the homes own assessment to verify that the home could meet each persons individual needs. The homes assessments covered aspects of physical, health, emotional, and social needs including leisure and work. Also included were peoples choices, preferences, likes and dislikes. People had copies of the service user guide that were in a format suitable to meet their individual needs. Care Homes for Adults (18-65 years) Page 10 of 24 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. Peoples assessed and changing needs and personal goals were reflected in their plans of care Evidence: Peoples files contained plans of care that showed what people could do for themselves and what help they required. The home promoted independence and this was reflected throughout the care plans. Also included were detailed risk assessments that were individual to each persons daily routines. Files also contained timetables and information of personal goals. People living in the home considered the staff to be Kind and Helpful. Care Homes for Adults (18-65 years) Page 11 of 24 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 were encouraged to participate in activities in the community within a risk management framework. Their rights were respected and choices were offered. Evidence: People living in this home had active and fulfilling lives. A member of staff said, If they would like to go on an outing or somewhere, we do our best to make it happen. On the day of the site visit one person had already left to do voluntary work in a charity shop and another was visiting her family. The two people who were at home were also going out and spoke about their work and social lives. One of them also did voluntary work in the community and their file contained a certificate naming them as Volunteer of the Month. Files also showed that one person was employed at a dress shop in the town centre, that people were involved in group activities in the community and that they also attended church services when they wanted to. One person spoke about life skills and keeping the home clean and tidy, helping staff with Care Homes for Adults (18-65 years) Page 12 of 24 Evidence: shopping and doing her own laundry and one person had commented in a questionnaire, I like to clean...with staff The manager and the member of staff spoke about how people were encouraged and supported to do these tasks. Detailed information in peoples files confirmed this. People going out for the day were encouraged and supported to make their own packed lunches. The main meal of the day was usually in the evening. The manager said that they did not have a set menu because people often changed their minds of what they wanted to eat. People living in the home could have whatever they wanted to eat but were encouraged to eat healthily. They helped staff to shop and either helped staff to prepare meals or cooked their own meals with staff support. Care Homes for Adults (18-65 years) Page 13 of 24 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. Peoples needs were met but some records can be improved. Evidence: Files contained detailed information of how peoples needs were to be met but this information was mixed in with assessed needs and preferences. Therefore the directions of how the persons needs were to be met were sometimes lost among other information. The result of this was that the daily records, whilst providing some good person centred information, did not always verify that needs had been met. The separation of the assessed needs and wishes from the action that staff needed to take and verification that the action had been taken was discussed with the manager. Peoples health needs were met. There were good records of appointments with health professionals, the reason for the appointment and the outcome. People said that staff always listened and acted on what they said and commented See my GP... staff take me. Staff said The needs of the residents are always met. Medication was stored safely and all staff had undertaken medication training. There were no gaps in the Medication Administration Record (MAR) charts. Medication in the Care Homes for Adults (18-65 years) Page 14 of 24 Evidence: Monitored Dosage System (MDS) tallied with the MAR charts. Medication receipt was not entered on the MAR charts but records were kept in a separate file. However, this did not provide a running total for medications that were not in the MDS i.e. packets or bottles of as and when medications for pain relief or short term courses of antibiotics. This meant that there was no up to date record for stock control. This was discussed with the manager who was also advised to obtain a copy of the Royal Pharmaceutical Guide relating to medication in social care settings. Care Homes for Adults (18-65 years) Page 15 of 24 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. People considered that they were listened to and protected from abuse. Evidence: The home had a complaints procedure and a complaints book. The complaints book was checked. There were no recent complaints but it was evident that past complaints made by people living in the home were taken seriously and dealt with appropriately. People seen on the day of the site visit said that they were happy living in the home and there was a good rapport between them and the staff. One of the questions in the questionnaires asked if they knew how to complain. All had responded that they would tell Andrea (the manager) or staff. A staff member commented Our clients feel comfortable enough to speak to us about any concerns they have or decisions they make. Staff had undertaken adult safeguarding training with the local authority Safeguarding Unit. The manager had dealt appropriately with an adult safeguarding issue related to an incident that occurred in the community. Care Homes for Adults (18-65 years) Page 16 of 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was clean and hygienic and people lived in a home that was comfortable and generally safe. Evidence: The home was pleasant and clean and domestic in character. Furnishings, furniture and decor were all in good condition. Bedrooms were clean and had been personalised by their occupants. People living in the home had keys to their bedrooms doors but did not have lockable facilities. It was recommended that mirrors and shelves be provided above or near to wash basins and the manager agreed to do this. Risk assessments had been carried out and were available on each persons file. A ramp was available from the French windows in the lounge and the home also had a stair-lift. A paving slab in the back garden was loose. The manager was aware of this and had stated in the Annual Quality Assurance Assessment (AQAA) that there were plans for the whole area to be resurfaced. Care Homes for Adults (18-65 years) Page 17 of 24 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 were supported and protected by competent and qualified staff. Evidence: There was at least one member of staff on duty at all times. The manager was on site during the day and was available by telephone at other times. Records showed that staff received induction training to a recognised standard. All staff had undertaken and achieved NVQ Level 2 and the manager said that a senior member of staff was to undertake NVQ Level 3. Information and certificates in staff files showed that staff undertook skills training suitable to meet the needs of the people living there. The recruitment files for two members of staff were checked. All the relevant documentation was available. People said that they liked the staff. One comment was, I like it here. People are nice to me. Care Homes for Adults (18-65 years) Page 18 of 24 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 promoted the welfare of people living in the home and it was run in their best interests. Evidence: The registered manager was also the registered owner. She had the relevant qualifications and experience and kept up to date with current practice. A member of staff praised the manager, Our manager is very hands on, she makes sure the clients have a good, healthy and happy life. The clients know she is always available to talk and is totally approachable. The home had a quality assurance system. Questionnaires were distributed to families, health and social care professionals and other people who came into contact with the home. There were also questionnaires for people living in the home and these were available in a suitable format. All of these questionnaires were seen during the site visit. The quality assurance system also included day to day informal chats with people living in the home to ensure that their needs and wishes were being met. Audits of systems and checks within the home verified that regular monitoring had Care Homes for Adults (18-65 years) Page 19 of 24 Evidence: taken place. These included checks of the environment, care plans, staff files, food and stock rotation, water temperatures, fridge and freezer temperatures, money held on behalf of people living in the home and medication audits. Staff files contained certificates of mandatory health and safety training. These covered moving and handling, emergency first aid, infection control, food hygiene, adult safeguarding, COSHH, fire awareness and medication. Mandatory health and safety training was updated regularly, which is good practice. Fire drills were held regularly. The home had recently been checked by the South Yorkshire Fire Service who were satisfied with the measures in place and no requirements were made. Certificates and records were available to verify that systems and equipment with the home had been service and maintained within the required timescales. Care Homes for Adults (18-65 years) Page 20 of 24 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 21 of 24 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 19 15 Daily records must show that peoples identified needs have been met. To verify that the care plan is being followed to meet peoples identified needs. 06/08/2009 2 20 13 An up to date record of medications must be available particularly where medications are carried forward at the end of the month. To ensure that medication is properly stock controlled. 18/06/2009 3 24 23 The loose paving slab must be made secure. To reduce the risk of tripping or falling. 23/07/2009 Care Homes for Adults (18-65 years) Page 22 of 24 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 19 Separating the assessed needs from the plans of care would make it easier for staff to see the actions they needed to take to meet peoples identified needs. The Royal Pharmaceutical Society of Great Britains publication The Handling of Medicines in Social Care would remind staff of the procedures for dealing with medication and would also answer any queries that might arise. Lockable facilities should be provided in bedrooms. Consideration should also be given to the provision of mirrors and shelves near to wash basins. 2 20 3 24 Care Homes for Adults (18-65 years) Page 23 of 24 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. 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