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Inspection on 18/02/09 for 12 Linden Road

Also see our care home review for 12 Linden Road for more information

This inspection was carried out on 18th February 2009.

CSCI found this care home to be providing an Excellent 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 12 Linden Road 12 Linden Road Brotton Saltburn-by-Sea TS12 2RU     The quality rating for this care home is:   three star excellent 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: Susan Lowther     Date: 1 8 0 2 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 25 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 25 Information about the care home Name of care home: Address: 12 Linden Road 12 Linden Road Brotton Saltburn-by-Sea TS12 2RU 01287678489 F/P01287678489 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) : Real Life Options care home 6 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 6 The maximum number of service users who can be accommodated is: 6 The registered person may provide the following category of service only: Care home only - Code 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 Code LD, maximum number of places: 6 Date of last inspection Brief description of the care home Linden Road care home is a purpose-built two-storey property located in a housing estate on the outskirts of Brotton. The home provides long-term care for six residents with a learning disability. Accommodation is provided in single bedrooms. Care Homes for Adults (18-65 years) Page 4 of 25 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: three star excellent 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 3 star. This means the people who use this service experience excellent quality outcomes. This unannounced inspection took place on 18th February 2009. Time was spent reviewing records, speaking to members of staff, the people who live in the home and to the manager. The company supplied some information prior to the inspection on a form called an AQAA. This is an annual quality assurance assessment for the agency to provide information about their service. Information was also received from people who use the service and their relatives. Care Homes for Adults (18-65 years) Page 5 of 25 The inspection focussed on key standard outcomes for people using the service and to check whether the recommendations from the previous inspection had been met. The fees charged at the time of this inspection were between 888 pounds and 94 pence and 1055 pounds per week. This does not include the cost of hairdressing, clothing, chiropody, personal toiletries and costs relating to outside entertainment. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. 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 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 7 of 25 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 8 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are appropriately assessed before they are admitted to the home. Their individual needs and aspirations are considered. Evidence: The manager said that there have been no admissions to the home for several years because there have been no vacancies. Two sets of documentation were examined. These were of people who have lived in the home for sometime. The assessment is usually undertaken by the manager in consultation with other professionals. The records showed that a full assessment had been carried out prior to the person moving into the home. The assessment documentation covered areas such as preferred recreational activities, personal care, nutrition, dress management, mobility, continence, night time, sensory loss, emotional status, medication and health, independence/leisure, culture/religion and finance. Assessments are reviewed annually or more frequently should a need change. The manager said that one room within the home had recently become vacant. She Care Homes for Adults (18-65 years) Page 9 of 25 Evidence: said that before someone new is admitted to the home they would be invited to visit on several occassions. This is to make sure that the home can meet the needs of the person and that it is also the correct choice for the other people who live in the home. One person indicated that he/ she had been involved in the admission process and had chosen to go to live there. Care Homes for Adults (18-65 years) Page 10 of 25 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. All of the people who live in the home have care plans. These contain risk assessments and show how risks are managed. The files also include information about how people are supported and assisted with making decisions and living their lives as independently as possible, within their capabilities. Evidence: Each person who has an individual care plan, which showed involvement from the person, his or her key worker in the home and key worker in the day centre where appropriate. The manager said that these are now reviewed regularly to make sure they reflect any changing needs. All of the people now have goals that they can work towards. These were recommendations in the last inspection report. Two sets of documentation were examined. These were comprehensive and had been reviewed. There was evidence to confirm that the person, their relatives and other professionals were involved in that process. One health care professional had written to the home stating that he/she had always been impressed by the person centred approach Care Homes for Adults (18-65 years) Page 11 of 25 Evidence: operating within the home which had resulted in excellent collaborative care plans. There was evidence to show that people are consulted about how they wish to spend their leisure time. Within the plans there was also a personal profile of the person and a pen picture. Daily notes detailed how the person spent their days, for example a walk, a visit to the local pub, and overnight stay with family. Each person also has an essential lifestyle plan. The plans covered areas such as likes and dislikes of food, activities, how the person wants to be supported, routines, things that must not change and things that can be changed, hopes and dreams for the future. Risk assessments were in place for each person which cover financial management, medication, emotional exploitation and bathing. There was evidence to show that the risk assessments were reviewed. Care Homes for Adults (18-65 years) Page 12 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are offered their choice of daily activities and can live their lives as they wish. Staff care for people in the way they want. People are encouraged to have a healthy and varied diet. Evidence: Some people who use the service attend day centres during the week, where they have an individual programme of activities. At other times people take part in a variety of activities and enjoy walking, visiting the nearby seafront, going to the local pubs/restaurants, local cafes, shopping and trips out. Holidays are very popular. One person had recently been to Barcelona, the first time he/she had flown. The staff had kept a comprehensive diary of event which confirmed that this had been a very successful holiday. Staff are flexible in their working hours to enable people to have their holidays. Care Homes for Adults (18-65 years) Page 13 of 25 Evidence: Family and friends are welcome to visit at any time and some people also spend time out of the home with them. One person had recently been assisted by staff to attend a family wedding. Care Homes for Adults (18-65 years) Page 14 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care needs of people are met. There are suitable arrangements in place for dealing with medication. Evidence: Two care plans were examined which detailed the personal support given to the people who use the service. Each person has their own General Practitioner and they also consult with other health professionals when needed. People who use the service also have individual Health Action plans, which are completed by themselves, their family and key worker. Some of the plans had been personalised with pictures relating to a health need. Health needs are identified such as oral hygiene, weight management, eye sight, in the two plans examined there was evidence to show that they had been reviewed regularly. The plans had also been updated following any tests or appointments relating to a health need. Policies and procedures are in place for the ordering, receipt, storage, disposal and administration of medication. The manager said the all staff who administer medication Care Homes for Adults (18-65 years) Page 15 of 25 Evidence: have been trained to do so. The manager has completed an advanced course in the management of medication. This level of training in addition to the regular audits which take place should make sure that people are safe with regard to medication. Care Homes for Adults (18-65 years) Page 16 of 25 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 can be confident that their concerns and complaints are dealt with appropriately and that safeguards are in place to protect them from abuse. Evidence: The home has a complaints policy and procedure in place. However this should be updated to include the details of the relevant social services department so that people know how to contact the other agencies should they require help to resolve a complaint. There had been no complaints made to the home since the previous inspection. Staff are always available for people who use the service to come to if they have any concerns or are unhappy. The manager said that the people who live in the home usually display their dislike at issues by using body language and behaviours. Staff are usually able to track the triggers and rectify them. The manager said on the AQAA that she felt the home could improve by devising a system to evidence families understaning of their rights and responsibilities to voice their concerns. This would result in further improvements within the service. The home has a safeguarding policy and procedure in place. There was evidence in staff training files to show that training in the protection of vulnerable adults had been carried out. This was a recommendation in the last inspection report. Staff spoken with confirmed that they would have no hesitation in reporting anything if they suspected an incident of abuse had occurred. One member of staff said, I would not hesitate to Care Homes for Adults (18-65 years) Page 17 of 25 Evidence: go to the manager, the company or social services if I felt there was a need. Care Homes for Adults (18-65 years) Page 18 of 25 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 clean and well maintained. It is decorated and furnished to a good standard and provides a homely environment for the people who live there. Evidence: A tour of the home was carried out. All areas were very clean, tidy and well decorated. There were no offensive odours apparent on the day of the inspection. People who use the service are involved in choosing the decor and furnishings in their own rooms and also in the communal areas. Bedrooms were very individual containing personal possessions. There are appropriate aids and adaptations in place to support individuals to maintain as much independence as possible. The gardens surrounding the property are maintained fortnightly in the growing season by a garden landscaper. Care Homes for Adults (18-65 years) Page 19 of 25 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 appropriately recruited, trained and in sufficient numbers to meet the needs of the people who live in the home. Evidence: Staff receive appropriate training, which helps them with their work. Staff training files were examined which showed training had been carried out in Safeguarding People, Health and Safety Management, Health Level 2 in Food Safety, First Aid, Infection Control and IT. At the time of the inspection 75 of staff had achieved NVQ level 2 or above. The manager said she was working towards all the staff completing an NVQ qualification. The home has a formal supervision system in place with staff receiving supervision every eight weeks. Staff recruitment files are held at head office. Written evidence was available to confirm that staff are appropriately recruited. Two written references are received and Criminal Record Bureau checks are made before commencement of employment. Care Homes for Adults (18-65 years) Page 20 of 25 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. People can be assured that the home is well managed and they are given the opportunity to comment on how the home is run. Policies and procedures are in place to safeguard their health, safety and wellbeing. Evidence: The manager is qualified and competent to run the home. She has achieved the Registered Managers Award and several awards in care practice. Staff confirmed that she is approachable and is a good support. The home has an annual service plan in place and a quality assurance system. The quality manager visits the home monthly to carry out a quality audit. A health and safety audit is also carried out every three months. Reports on many aspects of the home, the building, care records, accidents, health and safety are made during these visits. An action plan is then formulated to address any issues identified or concerns raised. Meetings are held monthly for staff, and minutes are kept. The views of people who live in the home, where possible, stakeholders and other interested parties are Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: now collated and made available for others to read. This was recommended in the last report. The home has health and safety policies and procedures in place. The maintenance certificates checked were found to be in order. Training files showed that staff have received training in health and safety and fire safety. Care Homes for Adults (18-65 years) Page 22 of 25 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 23 of 25 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 22 The complaints procedure should be updated to include the contact details of the relevant social services department. This is to make sure that people know how to contact the other agencies should they require help to resolve a complaint. Care Homes for Adults (18-65 years) Page 24 of 25 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. 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. Care Homes for Adults (18-65 years) Page 25 of 25 - 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. 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