Inspection on 12/05/09 for Pengarth

This is the latest available inspection report for this service, carried out on 12th May 2009.

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

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.

Other inspections for this house

Pengarth 22/05/08

Pengarth 23/05/07

Pengarth 03/05/06

Pengarth 21/09/05

Pengarth 25/04/05

Pengarth 25/10/04

Pengarth 02/06/04

Pengarth 05/12/03

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Extracts from inspection reports are licensed from CQC, this page was updated on 10/07/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Pengarth Windmill Hill Ellington Morpeth Northumberland NE61 5HU     The quality rating for this care home is:   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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Anne UrwinBrown     Date: 1 2 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Pengarth Windmill Hill Ellington Morpeth Northumberland NE61 5HU 01670860475 01670860475 steveac@ukonline.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Flexible Support Options (UK North East) Limited care home 5 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 5 4 persons may also have a physical disability Date of last inspection Brief description of the care home Pengarth is a detached bungalow situated in the small village of Ellington and is home to five residents with severe learning and physical disabilities. A post office, shop and public house are situated nearby and a bus service is available to a nearby town centre. Off-street car parking is available at the front of the premises and there is a large garden to the rear. Disabled access is provided at both the front and rear of the building. The home is not registered to provide nursing care. The Statement of Purpose and User guide is available at the home together with a copy of the last inspection report. A fee of £769.79 per week is charged at Pengarth. 1 8 0 9 2 0 0 8 Care Homes for Adults (18-65 years) Page 4 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means that the people who use the service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use the service are not put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. How the inspection was carried out Before the visit: We looked at: Information we have received since the last visit. How the service dealt with any complaints & Care Homes for Adults (18-65 years) Page 5 of 28 concerns since the last visit. Any changes to how the home is run. The providers view of how well they care for people. The views of people who use the service & their relatives, staff & other professionals. The Visit: An unannounced visit was made on 12 May, 2009 and a further visit was made on 19 May, 2009. The visits lasted a total of eight hours. During the visit we: Talked with people who use the service, staff and the manager. Looked at information about the people who use the service & how well their needs are met. Looked at other records which must be kept. Checked that staff had the knowledge, skills & training to meet the needs of the people they care for. Looked around the building to make sure it was clean, safe & comfortable. Checked what improvements had been made since the last visit. We told the manager what we found. What the care home does well: What has improved since the last inspection? There are comprehensive care plans in place identifying peoples individual needs and how these are met. Plans are regularly reviewed to take account of peoples changing needs. Risk assessment are well recorded and are clear about how risks are minimised. This protects people living in the home. Good systems are in place for dealing with complaints that mean that records have information about the investigation and outcome. Staffing levels have been reviewed and are now at an appropriate level to ensure that peoples needs are met. All staff have received training in moving and handling to ensure that they are clear about the specific needs of the people living in Pengarth. There is an effective quality assurance system in place to ensure that a high quality of service is maintained. Care Homes for Adults (18-65 years) Page 7 of 28 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 set out 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 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are confident that the service can meet their needs because there are good assessment systems in place at Pengarth. Evidence: There are good systems in place for planning an admission to Pengarth that focuses on the personal needs of the individual. Records show that prospective residents and their families are fully involved and are central in making decisions about how the process of admission is managed. There is emphasis placed on responding to individual needs for information, reassurance and support. A comprehensive needs assessment is undertaken before admission by staff. The home obtains a care management assessment and care plan before admission. Individuals are supported and encouraged to take part in the admission process. Information is collected from a range of sources including professionals working with the person, relatives and from pre-visits to the service by the individual. Two relatives said that they had been involved in the admission process and were satisfied that they Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: had enough information at the time about the service. Before agreeing to an admission the service carefully considers the assessment information and the capacity of the home to provide a suitable service. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Pengarth get the care and support they need and their privacy and dignity is respected. Evidence: Each person has a care plan that is based on a central assessment. The assessment is added to during their placement and the plan is developed to suit the needs of the person concerned. Plans include reference to equality and diversity issues relevant to each person. There is clear information to show the development of plans and peoples changing needs. Information about peoples health care needs is clearly recorded. Care plans are up to date and there is evidence of good systems for reviewing plans. There is regular discussion about peoples care at staff meetings so that all staff are clear about any changes for individuals. One relative said that she was pleased with the quality of care and felt satisfied that her daughter received the support she needed. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: Each plan included comprehensive risk assessments that were up to date and clear. These plans are much improved since the last inspection. The service has a positive view towards risk assessments that focuses on supporting people to live the life they want to lead. Records show that assessments are regularly updated. Any limitations on freedom, choice or facilities are in peoples best interests and these are well documented and agreed with peoples representatives. People using the service have limited communication and staff are skilled at reading signs that show when they are content or distressed. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have a good quality of lifestyle and are assisted to become part of the local community. Family links are fostered and encouraged and good opportunities are provided for people to take part in appropriate leisure activities. Evidence: At Pengarth people are encouraged to live an ordinary, meaningful life that is suited to their individual needs. Staff recognise the importance of enabling people to follow their own interests and to take an active part in life in the local community. Policies and procedures for staff at Pengarth take account of the need to respect peoples rights and their equality and diversity. People living at the home are able to enjoy full and stimulating lives that suit their abilities to participate in daily life. Each person has a weekly planner that identifies his or her activities for the week and Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: staff support them with this. Outcomes for people are positive and relatives said in the questionnaires that staff support people well. People were relaxed and looked happy during the inspection. Staff were respectful towards people and it was evident that individuals preferences were well known to the staff. Staff said that service users are out regularly in the local community using local services and facilities including shops, swimming pool, local walks, shopping, leisure facilities and having meals out. People have regular holidays and two ladies had recently returned from a successful caravan holiday and other people had plans for their breaks. On the day of the inspection two people were swimming and others were enjoying music and videos in the home. Visitors are always welcome at any time and links with family and friends are supported and encouraged. Menus show that meals are well balanced and nutritious and are based on healthy eating principles. Alternatives are available for people so that there is a choice, although individual likes and dislikes are well known to staff. Staff provide assistance to those who have difficulty with feeding and special diets are provided. Mealtimes are relaxed and staff were aware of those who needed help and allowed plenty of time for them making the meal a pleasant social event. Particular dietary needs are identified within individual care plans. People having lunch appeared to enjoy the food served. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal and healthcare support is planned and delivered taking account of multi agency intervention to ensure that peoples privacy, dignity and independence is respected. Evidence: Individual plans provide good information about the personal and healthcare support provided to each person living at Pengarth. Staff demonstrated a good knowledge of the care and support needed by each person. Support is organised to suit the preferences of each individual for example rising and retiring times, bathing and other activities. Specific staff training has been provided to ensure that staff are able to effectively meet individual needs. One relative said that the care provided is fabulous and that she is very satisfied with the support provided by staff at Pengarth. Records show that health needs are identified and met. All service users are able to access specialist support from healthcare professionals as needed. Evidence was available that peoples health care needs are monitored and potential problems identified and treatment sought. Records show that there is ongoing support for Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: individuals from healthcare professionals. Staff training to ensure that staff have appropriate skills to support individuals is given. Privacy and dignity is respected at all times. The home fully respects the rights of people living at Pengarth in the area of healthcare and medication. Staff are alert to changes in mood, behaviour or general well-being and understand how they should respond and take action. One relative said that the family are kept well informed about the persons needs and any changes in their care. There are good procedures and policies in place to protect service users receiving medication. Arrangements for the administration of medicines protect people living in the home. Records are well maintained and arrangements for the storage of medicines are satisfactory. Staff training in administration of medicines has been provided for all staff. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected by the good systems in place for dealing with complaints and safeguarding at Pengarth. Evidence: A good complaints procedure is in place that is clearly written and easy to understand. People living in the home are not able to verbally express concerns and copies of the procedure are given to their relatives and representatives. At every persons review meeting staff discuss the complaints procedure to ensure that everyone is reminded about how to express concerns or complaints. There has been one complaint since the last inspection and appropriate action was taken to investigate this. There is a good system in place to ensure any complaints, the investigation and outcome are well recorded. One relative said that she would speak to the staff if she had any concerns and was satisfied that they would take her concerns seriously. There have been no safeguarding referrals have been made since the last inspection. Clear policies and procedures are in place for safeguarding adults. Staff at the home demonstrated that they are aware of what the procedure is and how to respond. They have received appropriate training and staff records confirm this. Individual risk assessments protect residents from potential self-harm. People are also protected by good staff recruitment procedures and practice. Care Homes for Adults (18-65 years) Page 18 of 28 Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is comfortable, warm and clean so people have a pleasant place to live. The standard of the accommodation, decor and furniture and fittings was good. Evidence: This detached bungalow provides comfortable accommodation and has been adapted to suit the specialist needs of the people living there. The house is situated in a pleasant residential area with bus links nearby to Ashington and Morpeth. It has a large attractive garden, which is becoming overgrown and the manager said that the gardener had not visited recently. The home was clean, tidy and homely and is easily accessible with ramps at the front and rear doors. There is a good sized sitting area, a conservatory and a dining kitchen, all of which are used by the people living in the home. The furniture and fittings are of a good standard and are organised to suit clear access for people in wheelchairs and those with mobility problems. Maintenance is carried out as necessary and staff had reported the leaking washer for repair at the time of the inspection. Redecoration is carried out at regular intervals and the sitting room had recently been completed. The decor throughout the building is good. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: All accommodation is on the ground floor and bedrooms are personalised and very attractive. People have music systems and televisions in their rooms as well as ornaments and pictures to suit their taste. Equipment including bed rails, air mattresses and hoists are available in bedrooms to suit the identified needs of residents. Records show that equipment is regularly checked and serviced. One relative said that her daughters room is well decorated and clean. She said the room is very nice. The bathroom and shower room are fitted with overhead tracking so that people can be moved safely from their wheelchair to the bath or shower. A Parker bath that is height adjustable is available in the bathroom. The radiator cover was marked and damaged and the toilet frame in the bathroom is rusty and paint has flaked off. No odours were evident during the inspection. Cleaning materials and other potentially hazardous substances were safely stored. Policies and procedures were in place relating to the Control of Hazardous Substances and Infection Control and other Health and Safety matters. Training is provided in Health and Safety and Food Hygiene. The laundry is beside the boiler in a small room off the main hall. The floor has been painted since the last inspection to provide an impermeable surface. There is a washer with sluice facility and a dryer provided. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good staffing arrangements mean that people get good quality care from appropriately qualified and experienced staff. Good recruitment practices protect people living at Pengarth. Evidence: Staffing is sufficient to meet the needs of the people living at Pengarth. Records show that individual support is provided to ensure peoples needs, aspirations and activities are met. Staff demonstrate a good rapport with residents. The culture in the home is positive and staff said they enjoy working there. There is a good atmosphere in the home and residents appear well cared for with their individual needs met. Good recruitment procedures are in place and records show that these are followed. Staff records contained appropriate information. This included two references and criminal records checks. A comprehensive induction takes place for new staff that includes reference to equality and diversity issues. Staff said that new staff members are well supported and they given enough information about the service and the people living there to be able to help them understand their role and responsibilities. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: Records show that staff have appropriate training opportunities to help them with their work. All have received statutory training that relates to health and safety. Training has been provided in infection control, health and safety, first aid, moving and handling, protection of vulnerable adults, foot care, and medication administration. Staff said that they get plenty of training opportunities. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Good management systems are in place to ensure that the health and safety of people living at Pengarth and staff is protected. Evidence: The manager is experienced and qualified to run the home and meet its stated aims and objectives. She is aware of the need to undertake regular training and has had appropriate training opportunities in the past year. She is well supported by the organisation and has a good knowledge of the organisations strategic and financial planning systems. She says that she is well supported by the senior management of the organisation. She communicates a clear sense of direction and has a good understanding of the need for continuous improvement and quality assurance. She understands the importance of equality and diversity and person centred planning in planning the services development. There is a good system of quality assurance in place that takes account of the views of people involved with those using the service as they are unable to verbally Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: communicate their views. Staff said that the manager is open and responds positively to suggestions from staff. Relatives questionnaires are used as part of the quality assurance process. Good records of any money held on behalf of people living in the home are kept and appropriate procedures are in place for staff handling money. All transactions are recorded individually and money checked during the inspection balanced with the individual records. All working practices are regularly reviewed. Good systems are in place for checking on health and safety in Pengarth. Records are kept in good order to show regular checks or tests of equipment. Appropriate training is provided for staff and regularly updated. Risk assessments for the premises and for fire are in place. Fire alarm tests are carried out weekly and records were available to confirm this. Accident records are kept in an appropriate form. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 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 27 The radiator cover and toilet seat frame need replaced to ensure that a safe and pleasant environment is provided for people living in the home. The gardens should be regularly maintained to ensure that people have access to an attractive, safe outside space. 2 28 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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