Inspection on 26/01/10 for Time-to-Care

This is the latest available inspection report for this service, carried out on 26th January 2010.

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.

Extracts from inspection reports are licensed from CQC, this page was updated on 11/04/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: Time-to-Care Chatton Sandyfords Chathill Northd NE67 5JD     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: Anne UrwinBrown     Date: 2 6 0 1 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 27 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 27 Information about the care home Name of care home: Address: Time-to-Care Chatton Sandyfords Chathill Northd NE67 5JD 0 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Stephen Clark, Claire Clark Name of registered manager (if applicable) Mr Colin William Lee Type of registration: Number of places registered: care home 1 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users that can be accommodated is: 1 The registered persons may provide the following category of service only: Care Home - Code PC To service users of the following gender: Either Whose primary care needs on admission are within the following category: Learning Disability, not falling within any other category - Code LD, maximum number of places: 1 Date of last inspection Brief description of the care home Time to Care is a service providing residential care for one person with learning disabilities. The home is situated in a quiet rural area about seven miles north west of Alnwick in Northumberland. Accommodation is provided in a former farmhouse set in a large garden. The house has very attractive views and provides spacious homely accommodation for one person on two floors. Transport is provided to ensure that the person living at Time to Care is able to access the local community and Newcastle when he wishes. Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 1 Brief description of the care home The charges are £4009.00 per week. Care Homes for Adults (18-65 years) Page 5 of 27 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 registration. The Visit: An unannounced visit was made on 26 January, 2010. The visits lasted a Care Homes for Adults (18-65 years) Page 6 of 27 total of five hours. During the visit we: Talked with the person who uses the service, staff and the manager. Looked at information about the person who uses the service & how well his 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 person they care for. Looked around the building to make sure it was clean, safe & comfortable. We told the manager what we found. Care Homes for Adults (18-65 years) Page 7 of 27 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 27 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 27 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. The service uses good assessment tools to ensure that they have enough information about a person before they are admitted. This ensures that they are able to effectively meet the needs of the person. Evidence: There is an up to date Statement of Purpose that clearly sets out the aims and objectives of the service. This provides good information about the service offered, the facilities, staffing arrangements and qualifications of staff and the complaints procedures. A comprehensive needs assessment is undertaken before admission by senior staff. The home obtains a care management assessment and care plan before admission. These were available in the home. Individuals are supported and encouraged to take part in the admission process. Information is collected from a range of sources including the person identified, professionals working with the person and relatives if appropriate. 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 10 of 27 Evidence: Care Homes for Adults (18-65 years) Page 11 of 27 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. The person living in the home receives good quality care that is organised to suit his individual needs in a way that respects his privacy and dignity. Evidence: The person living at Chatton Sandyfords has a care plan that covers all aspects of his care and this is based on the initial assessment and is added to as the placement goes on. There is evidence of the plan developing to take account of the changing needs of the person. Plans include reference to equality and diversity issues relevant to each person. There is information about limitations on freedom and choice and there is work going on that to ensure compliance with the Mental Capacity Act that involves other professionals working with this person. Information about health care needs is clearly recorded. The plan included comprehensive risk assessments that were up to date and clear. The service has a positive view towards risk assessments that focuses on supporting Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: 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 the persons best interests and these are well documented and agreed with the persons representatives. An assessment is ongoing to take account of Deprivation of Liberty legislation. Care Homes for Adults (18-65 years) Page 13 of 27 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 person living at the home is encouraged and supported to make choices about his routines and lifestyle. Social, emotional, cultural and recreational needs are met in a way that suits the individual. Evidence: The person living at Chatton Sandyfords is encouraged to live an ordinary, meaningful life that is suited to his individual needs. Staff recognise the importance of enabling people to follow and develop their own interests and to take an active part in life in the local community. Policies and procedures for staff at the home take account of the need to respect peoples rights and their equality and diversity. The person living at the home is able to enjoy a full and stimulating life that suits his abilities to participate in daily life. The person has in place a support plan that identifies the activities and there is a Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: pictorial summary of this so that he can be involved in the process. Outcomes for this person are very positive and he said that staff support him well. Staff were respectful towards him and had a good rapport. It was evident that this individuals preferences were well known to the staff. Staff said that they go out regularly and try to use community facilities and local services as much as possible. During discussions with the resident and with staff it was evident that music concerts, cinema and trips shopping were the activities preferred. Musical instruments were available at the home and these are well used. Menus show that meals are varied and are chosen to suit the preferences of the person living at the home. He is able to make choices about the food and staff try to encourage healthy eating. The resident is learning to cook and staff encourage him to prepare his own food on one or two nights every week. Care Homes for Adults (18-65 years) Page 15 of 27 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. The person living at Chatton Sandyfords receives appropriate personal and healthcare support to ensure that their needs are effectively met in the way that they prefer. Evidence: Good information was available to show that this person receives the care and support he needs in a way that respects his privacy and dignity. Records show that additional specialist support is available and advice is sought from health care professionals as necessary. His personal plan is very detailed and provides comprehensive information for staff about his daily needs and the actions to be taken. Healthcare information was well recorded and showed that good support is provided to ensure that all healthcare needs are met. The persons records showed that there is ongoing monitoring of his health care needs and any problems quickly identified and assistance sought where necessary. Good records are kept of contact with healthcare professionals and any recommendations are quickly added to the persons plan. Good arrangements are in place for reviewing the plan. Good systems are in place for the administration of medicines. Policies and procedures Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: are in place and are known to staff. Staff training has not yet been provided, but was being organised at the time of this inspection. Care Homes for Adults (18-65 years) Page 17 of 27 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. Good systems are in place at Time to Care for dealing with complaints and safeguarding. These protect the person living in the home. Evidence: Good procedures are in place for dealing with complaint. The person living at the home is aware of the complaints procedure and knows how to make a complaint. He said that he could talk to the manager or the staff if he had any concerns and he was satisfied that his concerns would be taken seriously. No complaints have been made. Safeguarding procedures are in place for dealing with any allegations of abuse. A copy of the local authority safeguarding procedures is available in the home. Staff are aware of the appropriate action to be taken in the event of an allegation being made. Staff training in adult safeguarding has been delayed due to the recent bad weather and has been rearranged for later this month. All staff have completed child protection training. Care Homes for Adults (18-65 years) Page 18 of 27 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. Time to Care provide comfortable, well maintained and decorated accommodation that suits the needs of the person living there. Evidence: Accommodation is provided in a farmhouse set in its own grounds in a rural area of Northumberland. The property provides spacious accommodation that includes sitting/dining room, kitchen, bathroom, 2 bedrooms and an office. There is a large garden to the side of the property. The house is comfortable and homely and the standard of decor is generally good, although the hall and staircase and bathroom would benefit from being redecorated. All areas of the home were clean. Furniture and fittings are appropriate and domestic in style. Good systems are in place for dealing with repairs and staff said that these are addressed quickly. The persons room is spacious and has been furnished and decorated to suit his requirements. He is also consulted about the decor and furnishings in other areas of the house. The bathroom on the first floor has an over bath shower. There was some evidence of Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: water damage from a leaking pipe that has now been repaired. The bathroom would benefit from redecoration. The house is run as a domestic style home and the washing machine is in the kitchen. The person living in the house is encouraged and supported to do his washing. Staff are aware of the need to follow good infection control measures. Care Homes for Adults (18-65 years) Page 20 of 27 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. There are sufficient appropriately skilled and trained staff to meet the needs of the person living in the home. Evidence: The rota shows that staffing levels are maintained at two staff on duty throughout the day and two staff sleeping in on the premises at night. This level of staffing has been agreed with the local authority placing the person living at the home. Staff have received appropriate training to equip them with the skills they need to provide good quality care. All except one new member of staff have completed national qualifications in care at Level 3 gained while this home was registered for children. The management of the home are trying to identify further training that will allow staff to convert their qualification to relate to adult care. There are regular staff meetings with minutes available showing good discussions among the team. Staff confirmed that there are appropriate training opportunities. All training relating to safe working practices is undertaken at regular intervals. Recruitment of staff follows good procedures and all appropriate checks are carried Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: out prior to appointment. Staff files were in good order and contained two written references and appropriate other checks required to safeguard the resident as well as the training records and supervision notes. Care Homes for Adults (18-65 years) Page 22 of 27 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 person living at Chatton Sandyfords benefits from living in a well managed home and is encouraged to put forward his views. Evidence: The manager is experienced and qualified to run the home. He has the skills and recognised the need to undertakes further training to meet the needs of the service. There is a clear sense of direction and leadership from the management of the home. An open and inclusive atmosphere is fostered and staff said that they felt able to raise issues about the operation of the service and be sure that these would be received positively. The management have a good understanding of current good practice guidance including equality and diversity issues and the requirements to assess for Deprivation of Liberty and relevant legislation in the Mental Capacity Act. Good systems are in place for assessing the quality of the service. Records were available to show that regular monitoring takes place and this ensures that any omissions are identified and rectified. The person using the service said he felt able to talk to the management about the service at any time and he said that they always Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: listen and try to help where possible. There was evidence that policies and procedures are developed or amended to take account of changing priorities and legislation. Good recording systems are in place to safeguard the person living at Chatton Sandyfords. The person living in the home has access to his records and a pictorial summary is available to ensure that he is fully able to understand what his plan means. Records showed that staff have completed training in safe working practices. Fire safety training and records of fire checks are kept in an appropriate form. Staff have received training in dealing with challenging behaviour and this is regularly updated. Good risk assessments are in place to protect the person living in the home and the staff. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 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 20 Staff must receive accredited training in the administration of medicines. This will protect the person living in the home. The planned safeguarding training should be completed to ensure that anyone living at the home is protected. The hall and stairs and the bathroom should be redecorated as part of the homes planned maintenance schedule. This will make the environment more attractive and homely. 2 3 23 24 Care Homes for Adults (18-65 years) Page 26 of 27 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. Care Homes for Adults (18-65 years) Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!