Inspection on 20/02/09 for 165 Point Clear Rd

This inspection was carried out on 20th February 2009.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

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

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 165 Point Clear Rd St Osyth Clacton on Sea Essex CO16 8JB The quality rating for this care home is: One star Adequate 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: Neal Cranmer Date: 2 0 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. 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 Inspection report CSCI Page 2 of 31 Care Homes for Adults (18-65 years) Audience Further copies from Copyright 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 31 Information about the care home Name of care home: Address: 165 Point Clear Rd St Osyth Clacton on Sea Essex CO16 8JB 01255823172 01787479406 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): TLC Care Homes Limited Name of registered manager (if applicable) Miss Regina Green Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 4 0 care home 4 learning disability Additional conditions: 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 categories: Learning Disability - Code LD The maximum number of service users who can be accommodated is: 4 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 31 A bit about the care home 165 point Clear Road is a chalet style bungalow situated in the pleasant village of Point Clear, just outside of St Osyth. The home offers service users spacious accommodation. All have their own bedrooms with en-suite facilities. Communal living areas are also large and spacious and offer service users space to go off and spend time in isolation if they choose. The home has a large garden area to the rear of the property, with a patio area where service users may chose to sit during clement weather. The home is situated on a bus route, which provides easy access to either Clacton-On-Sea, there nearest seaside resort or the historic town of Colchester some twelve miles away. Care Homes for Adults (18-65 years) Page 5 of 31 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: One star adequate 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 Care Homes for Adults (18-65 years) Page 6 of 31 How we did our inspection: This is what the inspector did when they were at the care home This was the homes first inspection visit since it opened in August 2008. The inspection was carried out on the 20th February 2009 with assistance from the deputy manager. The inspection was carried out between the hours of 9:00am and 3:00 pm. The inspection involved a tour of the home, looking at records and documents, and talking with service users, the deputy manager and three members of staff. The Annual Quality Assurance Assessment (AQAA) a self audit tool that the home uses to tell us what they do well, and identify any areas of further improvement) was used to help inform this report, it was good, well laid out and contributed positively to the overall inspection visit report. Care Homes for Adults (18-65 years) Page 7 of 31 What the care home does well Care plans were written in a person centered way (this means that they reflected peoples wants and wishes). staff working in the home know and understand the needs of the people they support well. Interactions seen were good, and staff displayed a lot of patience. Service users were supported in a pleasant environment, which was comfortable and well equipped. Care Homes for Adults (18-65 years) Page 8 of 31 staff are provided with a good level of training, which enables them to meet peoples needs. What has got better from the last inspection What the care home could do better The home needs to develop a Quality Assurance process that is based upon the views of the service users living in the home and other people interested in the running of the home (we call these people stakeholders). Care Homes for Adults (18-65 years) Page 9 of 31 The Registered Provider must ensure that the home is visited on a Monthly basis for the purpose of carrying out a Regulation 26 Visit. (this is a visit to the home which the provider is expected to make by law) 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 Neal Cranmer CPC1 Capital Business Park Fulbourn Cambridge CB21 5XE 01223 771350 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. Care Homes for Adults (18-65 years) Page 10 of 31 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 11 of 31 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 12 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People who may use the service and their representatives are provided with the necessary information to enable them to reach a decision about the homes ability to meet their assessed needs. Evidence: The home opened for the first time in August 2008. The home has a Statement of Purpose and Service Users Guide (these are documents that set out what services the service can provide). Both documents provided detailed information about the way in which the service was structured, the qualifications and experience of the senior management team and staff, and the facilities provided. The documents also included information about the homes complaints and admission procedures. The documents provided prospective service users and their representatives with a sufficient level of detail to enable them to make an informed decision as to whether or not the home would be able to meet their needs. Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: Service users have only been living in the home since last year, however a number of them were previously residing in one of the homes sister homes. Service users admitted to the home by local Authorities arrive with a Community Care Assessment (COM 5) This is an assessment that is undertaken by a representative of the placing authority. From the information contained in the files examined, it was evident that upon admission to the home a further assessment was undertaken by the home. This assessment focused on service users skills and identified areas where additional support maybe required. The manager reported that the assessments are reviewed on an annual basis. Care Homes for Adults (18-65 years) Page 14 of 31 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 . Individuals are supported to be involved in decisions about their lives, and play an active role in planning the care and support they receive. Evidence: Three care plans were examined, and all were found to include all aspects of peoples personal, social and healthcare needs. Care plans were in place to support people with their personal care, independent living skills and communication. In respect of communication one person’s care plan recorded that when communicating with me it is best to only use short sentences, with a limited number of key words, do not use any lengthy drawn out explanations, and please use open and encouraging body language. All of the remaining care plans were written in the same style, showing a good awareness of peoples needs, and recognition of the way in which people liked and needed to be supported. The homes Annual Quality Assurance Assessment (AQAA) states that service users are encouraged to partake in writing their care plans (where possible). And where appropriate care plans are provided in a pictorial format. The AQAA goes on to state that service users are actively encouraged to take part in the reviewing of their care Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: plans. All of the service users residing in the home may at times have behaviors that may be difficult to handle and manage and may pose a risk to themselves or others. To manage these episodes risk assessments had been carried out, these included management strategies to enable the identified risks to be managed. A key worker system operates in the home. Observation of interactions between key workers and service users showed that they encouraged service users to make decisions, this at times proved difficult for the service users, but key workers were seen to display patience, and remained engaged entirely with the service user until the issue was resolved. Care Homes for Adults (18-65 years) Page 16 of 31 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People who may use the service are able to make choices about their life styles, and are supported to develop their life skills. Evidence: At the time of the inspection visit the manager reported that none of the service users were engaged in any form of adult education, they went on to explain that the subject had recently been discussed with the service users during a meeting, where the service users had chosen not to engage in adult education. The manager went on to explain that activities are based upon individual likes and dislikes. Because of the complex needs of the service users, over time staff have discovered that it is best not to be to prescriptive about activities. The service users tend to choose what activity they wish to engage in day by day. However there were a range of activities provided, these included listening to music, Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: spending time chatting with staff, drives out, going for walks. On the day of the inspection service users were seen to be supported by staff to go out shopping. The homes AQAA states that service users are encouraged to help develop daily routines for their home and to participate in the day to day running of it. The home has an open door policy on the receiving of visitors; the homes visitor’s book showed that relatives were regularly visiting the home. Service users are supported to maintain links with their families and friends by their key workers. The care plans examined were seen to contain contact details of the people who were important in the lives of the service users. The homes AQAA states that service users are encouraged and supported to assist in the preparation of well balanced menus, which encourage personal choice, preferences and healthy eating. On the day of the inspection service users were heard being consulted with by staff about what they wanted for lunch. On the day of the inspection service users were seen to have their meal at varying times, due to them being engaged in different activities either in-house or in the community. Care Homes for Adults (18-65 years) Page 18 of 31 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 health and personal care that people receive is based on their individual needs, and the principles of respect, dignity and privacy are put into practice. Evidence: Information relating to how service users were supported with their personal hygiene was noted in their individual care plans. Continuity and consistency of support for service users was provided through the key worker system. Service users care plans examined provided evidence that appropriate healthcare services were available, accessed, and fully recorded following any referrals made. Records showed that service users had access to a range of healthcare professionals including: Community Nurses, and Chiropodists. All of the service users have Health Action Plans (HAPs), these are small booklets which contain health related information about the service users) which they take with them whenever they have a need to visit their General Practitioner. The management of medication was found to be of a good standard with appropriate records in place regarding the ordering, administration and recording of medicines given by staff. Medication storage in the home was appropriate. Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: The home operates a Monitored Dosage System (MDS).The manager reported that staff administering medicines had all received training on this system provided by the dispensing chemist; in addition to this training all staff are required to complete the Essex County Councils medication workbook. Care Homes for Adults (18-65 years) Page 20 of 31 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 who use the service are supported to express their concerns, and have access to a robust, effective complaints procedure. Evidence: The home had a complaints policy and procedure in place, which was clearly set out and openly available to service users, visitors and staff. The procedure was also available in pictorial format for those service users who were less able. At the time of the inspection no complaints had been received by either the home or the Commission. As mentioned elsewhere in this report information regarding the homes complaints procedure is contained in the homes Statement of Purpose and Service Users Guide. Safeguarding policies and procedures were in place for staff guidance and were available to individuals living in the home should they wish to access the information. Staff spoken with during the inspection confirmed that they had received training and further discussion indicated that they had a good level of understanding. Care Homes for Adults (18-65 years) Page 21 of 31 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 physical design and layout of the home enables service users to live in an environment that is safe and well-maintained, and in which they can develop their independence. Evidence: The home had been designed to meet the individual needs and life styles of the people accommodated. It was found to be clean, well furnished, comfortable and suitable for its stated purpose. The home provided service users with a good sized garden and patio area where people could sit during clement weather. The home was situated on a bus route and was quite close to local facilities. Service users rooms visited were seen to provide evidence of individuality and personal possessions. The home has a very large lounge which houses a snooker table which all service users are free to use whenever they wish. Discussion with service users indicated that they were happy and contented in their environment. The atmosphere in the home was generally homely and inviting. The laundry facility was domestic in nature, and was equipped with the necessary facilities to meet the needs of the service users in residence. Policies and procedures were in place and appropriate records were kept regarding cleaning materials. Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: Staff training records sampled showed that staff had received training in infection control, and other health and safety related areas. Care Homes for Adults (18-65 years) Page 23 of 31 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 in the home are trained and skilled, and are available in sufficient numbers to support the needs of the people in residence. Evidence: The manager reported that the home employs twelve care staff, of these ten hold a National Vocational Qualification (N.V.Q) at level 2 or above. This information was confirmed in the homes AQAA. The recruitment files of four members of staff were examined and contained evidence of all of the required information and checks necessary being carried out before they commenced working in the home. These checks included references, proof of identity and protection of Vulnerable Adults (POVA ) and Criminal Records Bureau (CRB) clearance. Staff files also included evidence of any relevant training Staff spoken with and personal development files seen confirmed that they had undertaken relevant training to meet the diverse needs of the people using the service, this training included: moving and handling, Mental Capacity Act, Safeguarding, and Health and safety, including fire awareness. Discussion with staff during the course of the inspection indicated that access to Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: training was good. Care Homes for Adults (18-65 years) Page 25 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The management and administration of the home is based on openness and respect, and their are systems in place for reviewing the quality of the homes service provision. Evidence: The homes registered manager has significant previous experience of working and managing in the care sector, and holds the Registered Managers Award. The manager is responsible for two services, although they are supported by a deputy manager in the second of the two services. Feedback from the manager indicated that they were well supported by the registered provider. Discussion with the manager indicated that there was not a specific Quality Assurance process in the home, which was based upon the views of service users and other interested stakeholders. The home does carry out periodic service reviews during which they focus on a number of practice areas, these included: care planning, medication administration, staff training and health and Safety. Team meetings are held on a Monthly basis, minutes of which were presented. Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: Discussion took place with the manager regarding Regulation 26 visits (these are visits that the provider is expected to make to the home on a Monthly basis, these are visits which are required under legislation). The manager reported that at the time of the inspection visit Regulation 26 visits to the home were not being carried out. The homes safe working practices were looked into by the viewing of a range of safety certificates, these included records relating to gas and electrical installation, fire drills and emergency lighting tests, all of which were current and up to date. Staff training and development files showed that staff had received training in health and safety. The records looked at indicated that the home was providing safe working practices. Care Homes for Adults (18-65 years) Page 27 of 31 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 Care Homes for Adults (18-65 years) Page 28 of 31 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 1 39 24 The registered person must 31/08/2009 establish a system for reviewing and keeping under review the quality of the care provided at the care home. This is to ensure that the quality of the care provided is kept under review. 2 39 26 The registered person must ensure that Monthly visits are made to the home in accordance with Regulation 26. 31/08/2009 This is to ensure that the service is kept under review. 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 Care Homes for Adults (18-65 years) Page 29 of 31 Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 03000 616161 or Textphone : or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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