Inspection on 27/04/09 for The Stables

This is the latest available inspection report for this service, carried out on 27th April 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

The Stables 14/07/06

The Stables 25/10/05

The Stables 25/05/05

The Stables 27/09/04

The Stables 05/05/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 09/06/2011.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Stables The Stables Bisterne Ringwood Hampshire BH24 3BN two star good service The quality rating for this care home is: 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: Craig Willis Date: 2 7 0 4 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. They reflect the things that people have said are important to them: 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. 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. Internet address www.cqc.org.uk Information about the care home Name of care home: Address: The Stables The Stables Bisterne Ringwood Hampshire BH24 3BN 01425478043 01425461076 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) : The Stable Family Home Trust care home 8 Number of places (if applicable): Under 65 Over 65 8 0 learning disability Additional conditions: The registered person may provide the following category of service only: Care home only ( PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category : Learning disability (LD) The maximum number of service users to be accommodated is 8 Date of last inspection A bit about the care home The Stables is a registered care home owned and managed by The Stable Family Home Trust. The home is registered to provide care and accommodation for eight adults with learning disabilities. It is located in four acres of agricultural land in Bisterne, three miles outside of Ringwood. The home is on the first floor of a large two storey building which also provides a day, employment, training and leisure service for up to seventy people each day. These services do not form part of this inspection. The fee for a place in the home is 519.48 pounds per week. 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 How we did our inspection: This is what the inspector did when they were at the care home We visited the home on 27 April 2009. During the visit we spoke to two people who live in the home and the manager. We spoke to two staff on the phone after the visit. We received surveys from six people who live in the home and six staff. We looked at all the information we have received about the home since our last visit. What the care home does well Peoples needs are set out in clear support plans. People are involved in making decisions about their lives and the plans help staff provide the support that people need. People are supported to take part in a range of activities they enjoy and to keep in contact with family and friends. Staff support people to safely store their medication and take it when they need to. The home is well maintained and provides a clean, comfortable and safe environment for people. Staff are well trained and there are good systems to check them before they work in the home. This helps to keep people safe and ensure staff can meet their needs. What has got better from the last inspection What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Craig Willis The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 01622 724 950 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 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 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 . There are good systems to assess peoples needs before they move into the home. This reassures people that the home will be able to meet their needs. Evidence: The manager reported in the annual quality assurance assessment that potential new residents have a needs assessment and are able to visit the home, including an overnight stay. The records of three people who live in the home were inspected during the visit, including one person who moved in since the last inspection. Each person had a comprehensive needs assessment that was completed before they moved into the home. For the most recent person to move in, the home had consulted with the persons previous placement, health professionals and relatives. The assessment covered eating, drinking, personal care, health, medication, mobility, social relationships, difficult / disruptive behaviours, independent living skills and community activities. There is a guide to the services provided by the home, although this was not inspected during this visit. 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 . There are good care planning and risk assessment systems, which involve people in making decisions about their lives and helps staff to provide the support that people need. Evidence: We inspected the records of three people who live in the home during the visit. Each person had a person centred support plan, which set out how their assessed needs should be met. The plans seen contained detailed information about how staff should provide support to meet peoples needs and aspirations. Plans are regularly reviewed and there was evidence that plans have been amended where peoples needs have changed. People who live in the home are involved in the process of developing and reviewing their plans and they are able to invite other people to planning meetings for support. Six staff completed a survey for us. Five said they were always given up to date information about the needs of the people they support and one said they usually received this information. Details of how people should be supported to make decisions are set out in the support plans. Six people who live in the home completed a survey for us. Four said they always make decisions about what they do each day and two said they sometimes make decisions. The plans inspected contained information about the way people communicate their decisions. Risk assessments have been completed for people who live in the home and contain clear information about how to manage the identified hazards. The assessments have been regularly reviewed and amended where assessed as necessary. Two staff were spoken with by phone following the visit. Both demonstrated a good understanding of peoples needs and the importance of supporting people to make decisions about their Evidence: lives. 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 . The home provides good support for people to take part in a range of activities, to maintain contact with family and friends and to follow a healthy diet. Evidence: Each person has an individual programme of activities that are organised in conjunction with the day service that operates from the same site. Examples of activities include swimming, trampolining, keep fit, horse riding, bowling, snooker, woodwork and life skills. Two people who live in the home were spoken with during the visit and both said they enjoyed the activities they participated in. One person works in a local pub and said he enjoys this a lot and gets on well with colleagues. The manager reported that he has regular meetings with the pub manager to ensure the person is receiving the support they need. The home has a minibus that is used to support people to travel to their activities. People are supported to maintain contact with family and friends, with staff providing support to visit family where necessary. The home has a menu that people are supported to plan. People make choices about the food they eat each day, with staff providing support to maintain a balanced diet. Mealtimes are flexible to fit round activities and snacks are available at any time. 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 personal care and health is well met by staff who know their needs and there good systems to safely store and administer peoples medication. Evidence: The support plans we inspected contained details of the support people need with their personal care and how it should be provided. Six people who live in the home completed a survey for us. All said staff always treat them well. Five said staff always listen to them and act on what they say and one person said staff sometimes do this. People are supported to attend a range of health services including GP, dentist, audiologist, psychologist and psychiatrist. Detailed information is recorded about appointments and kept in peoples records. Medication is stored in a locked cabinet in an area of the dining room that will be used to create a new office. A record is kept of medication coming into the home and administered to people. These records were checked for two people and the balance recorded matched the medication held. None of the people living in the home are currently prescribed any controlled drugs however the manager is aware of the need for a specific controlled drugs cabinet and recording systems if this is needed in the future. Staff administering medication have received training and are assessed each year to ensure they are following the homes procedures. The manager completes regular medication audits to assess whether the procedures are being consistently followed. 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 . There are good systems for dealing with complaints and responding to allegations of abuse. This gives people confidence that any complaints will be taken seriously and responded to. Evidence: There is a complaints procedure which is provided to all people living in the home in a pictorial format to make it more accessible. Six people who live in the home completed a survey for us and all said they know who to speak to if they are not happy and how to make a complaint. Two people spoken with during the visit said they were confident that any complaint they made would be taken seriously and investigated. The home has received one complaint in the last year from someone who lives in the home about the way another person was behaving. A meeting was held with the people concerned and it was agreed how to resolve the problem. The manager has also responded to a complaint about the support a person received whilst at the day service. We have not received any complaints about the home in the last year. Staff have completed training in keeping people safe from abuse. Staff spoken with demonstrated a good understanding of the action they should take if abuse is witnessed, reported or suspected. There is a policy and procedure on safeguarding adults and the prevention of abuse. The home has reported incidents involving one person who lives in the home hitting others to the local adult services department under the safeguarding procedures. There is a record of all the appointments and meetings regarding this person and the manager is working with adult services, the health team and the persons care manager to resolve the problems. Staff spoken with said they have sufficient information about the persons needs to be able to respond to incidents of aggression and information is regularly updated. The home holds money for most of the people who live in the home for safekeeping. There was clear information about the money held in the home, with records of expenditure, receipts and regular checks of the money. The money is individually stored in a locked cupboard and the balance recorded matched the cash held for the two records we checked. Bank statements for the two records checked matched the withdrawals recorded. 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 well maintained and provides a clean, comfortable and safe environment for people. The planned improvements will provide suitable bedroom space for everyone. Evidence: The home was being prepared for a refurbishment, which was due to start in the week following the visit. The refurbishment will include the creation of an additional bedroom so two people will no longer have to share. A new bathroom is being created and additional staff facilities. All of the homes communal areas were viewed during the visit. All areas were clean and well maintained, with good quality domestic furniture and fittings. Six people who live in the home completed a survey for us. Five said the home was always fresh and clean and one said it sometimes was. The home has a domestic utility room with washing machine and drier. This is situated by the kitchen and there are procedures to prevent laundry being taken through the kitchen when food is being prepared or eaten. The home was clean throughout with hand washing sinks and soap in the kitchen, toilets and bathrooms. There are infection control procedures in place and staff have completed infection control training. 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 . Staff are well trained and there are good systems to check staff before they work in the home. This helps to keep people safe and ensure staff can meet their needs. Evidence: The manager reported that three of the seven permanent and bank staff have completed the National Vocational Qualification at level 2 or above and three staff are currently working towards the award. The manager reported in the annual quality assurance assessment that all staff who have worked in the home over the last year have had satisfactory pre-employment checks. The records of three staff members were checked and all contained evidence that the home had obtained an enhanced Criminal Records Bureau disclosure in respect of them, had confirmation that the person was not on the protection of vulnerable adults list as unsuitable to work in a care home, had obtained two written references for the person and had a full employment history. The home has a on-going training programme and staff reported they received good training that helps them to meet peoples needs. Training records indicated staff have completed an induction and courses including manual handling, health and safety, infection control, medication, first aid, challenging behaviour, fire safety, risk assessment, Makaton sign language, loss and bereavement, oral health, safeguarding people from abuse, food safety and epilepsy. All six staff who completed a survey for us said they received training which is relevant to their role, helps them meet peoples individual needs and keeps them up to date with new ways of working. 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 home has a qualified and skilled manager in post who supports staff to do their jobs effectively. There are some quality assurance systems in place and a strong emphasis on gaining the views of people who use the service, however, the systems would be improved by a more structured approach to planning improvements. Evidence: The manager has been in post for a number of years and has completed the Registered Managers Award. Staff spoken with said they thought the manager was supportive. All six staff who completed a survey for us said they regularly meet with the manager to receive support and discuss how they are working. The chief executive of the organisation visits the home each month and assesses the quality of the service that is being provided. Reports of these visits are made and sent to the manager and contain a list of actions that are needed. There are regular service user meetings with the manager, where people living in the home can say how things are going and what changes they feel are necessary. The manager completed the annual quality assurance assessment for us before the visit and highlighted his plans for improvements over the next year. The home has a quality audit system that produces an action plan, however, the manager reported this has not been completed for this year. The manager said that the quality assurance systems were discussed at a recent management meeting and it was recognised that they need to be improved. Records of the servicing and testing of the fire alarm, emergency lighting and portable electrical appliances were inspected and were up to date. The manager reported that a new boiler is being installed as part of the refurbishment programme, as the home currently shares a boiler with the rest of the buildings on the site. There are workplace risk assessments in place, which include actions to minimise the identified hazards. Are there any outstanding requirements from the last inspection? Yes  No  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 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 Description 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 Description 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 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). 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. 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