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Inspection on 20/01/09 for 29 Albion Hill [Normanlea Society]

Also see our care home review for 29 Albion Hill [Normanlea Society] for more information

This inspection was carried out on 20th January 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: 29 Albion Hill [Normanlea Society] 29 Albion Hill Exmouth Devon EX8 1JS     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: Teresa Anderson     Date: 2 0 0 1 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 27 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.csci.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: 29 Albion Hill [Normanlea Society] 29 Albion Hill Exmouth Devon EX8 1JS 01395276323 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): linda@normanlea.co.uk Normanlea Society Name of registered manager (if applicable) Mrs Linda Williams Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home This service was last inspected in November 2006. 29 Albion Hill provides small, family type accommodation and personal care for up to 8 younger adults with learning disabilities who are physically able. The property is a four storey detached house with small gardens to the rear. It is situated in a residential area of Exmouth and is within easy walking distance of the town and the local facilities. The town has a train and bus services, and has numerous pubs, eateries and entertainment venues. Bedroom accommodation is in single rooms and all but one have washbasin facilities. There is an open lounge/dining/kitchen facility on the ground floor. There is also a staff sleeping in room/office, a small laundry room, and a further office all situated on the ground floor. On road parking is available. The current level of fees charged per week is available direct from the home. 8 Over 65 0 care home 8 Care Homes for Adults (18-65 years) Page 4 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: 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: This unannounced inspection took place as part of the normal programme of inspection. The site visit took place over one day. During the inspection we (the commission) spoke with 5 of the 6 people whose home this is. Some of whom have communication difficulties. Because the people we spoke with would be easy to identify, we have not used their quotes in full but have summarised what they have said. We looked in depth at the care and services offered to 2 people living here. This helps us to understand the experiences of people who live here. We spent time observing the interactions between staff and the people living here. We spoke with three members of Care Homes for Adults (18-65 years) Page 5 of 27 the staff and with the administrator. Records in relation to care planning, medication, monies, staff recruitment and fire safety were inspected. Before the site visit comment cards were sent to all the people who live here and all were returned and to staff and 3 were returned. No surveys were returned by health and social care professionals who have contact with the home. In addition to the above the project manager provided the commission with information in the Annual Quality Assurance Assessment (AQAA). What the care home does well: What has improved since the last inspection? Care Homes for Adults (18-65 years) Page 7 of 27 Since the last inspection the home have worked hard to continue to develop person centred care planning which is enhancing the lives of the people living here. People have developed new skills and this is opening up new opportunities for them. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.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. People who come to live here can be assured that staff will have a good understanding of them and what their needs and desires are. Evidence: People living here have lived here for a very long time and there have been no changes to the occupancy since the last inspection. However, staff describe the process that helps people to make a decision about where they live before they come to live here. This includes giving them information in a format they can use and explaining this information at a pace that suits each person. In depth assessments are carried out and each person visits the home to meet with other people living here and with staff on numerous occasions. Care Homes for Adults (18-65 years) Page 10 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. Improvements in the way that care is planned and the way that decision-making and managing risks are recorded means that people are enabled to live active and fulfilled lives. Evidence: Each person living here has a plan of care and a key worker who helps them to develop their care plan and identify their aspirations, goals and related risks. Since the last inspection the project manager reports that further work has been undertaken in care planning and in sourcing opportunities that would help people to enhance their lifestyles. A member of staff told us that some senior staff had received additional training in care planning and that this had influenced the way care is planned and is benefiting people living here. We looked at some care plans and saw that people living here have differing abilities. Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: Staff work with each person to help meet their potential and to ensure that they are supported to explore what opportunities might make their lives more meaningful and fulfilled and what might help them to develop new skills. Care plans show that associated risks are identified and where needed managed. People we spoke with say they are very happy with their lives and like the things they do and how staff support them to do this. We saw that people living at this home have freedom throughout the home and are encouraged to be independent and to use their skills. Throughout the site visit staff were heard offering choices to the people living here, for example whether to help with making tea, what to eat and what to do with the day. Regular meetings are held and some people talked to the inspector about what is discussed during these. Staff and the project manager are helping people to further develop their skills so that they can run their own meetings. The administrator acts as appointee for handling residents finances. All monies are kept safely and securely. The home has an internal auditing system carried out by the Treasurer of the Normanlea Society. All accounts are kept separate and two members of staff check monies at least once daily. We checked an account with the administrator and this was accurate and up to date and showed that receipts are kept for all expenditures. Care plans and discussions with staff and one person living here demonstrate that people are being assisted to manage their own monies to a level that suits their abilities. Where potential to improve that ability has been identified, work is ongoing to develop this skill. Care Homes for Adults (18-65 years) Page 12 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. People who live here have their rights protected and experience a lifestyle that enhances their quality of life. This includes enjoying a varied and nutritious diet of their choosing. Evidence: In surveys people told us that there are always activities arranged by the home that they can take part in. People who like to go out are supported to do so, and many people living here live very independent lives. This includes going out when they please and working at jobs they enjoy. People join in activities that include karaoke, discos, art classes, skittles, going out for lunch, going shopping and going into Exmouth. Some people are attending an intensive course which is helping them to develop life skills. In addition people told us Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: and showed us photographs of their holidays, outings and events they have attended. Photographs show that people are supported to take part in signigicant life events, such as birthdays, with family and friends both in and out of the home. Some people belong to local churches and attend these if they wish. In addition staff demonstrate how they celebrate cultural events significant to people living here and their families. Staff work hard to find other opportunities for people to participate in. This includes helping people to widen their social networks and to integrate into the local community. Links with the local community are good and there are a number of local clubs that people living here belong to. People are also supported to maintain relationships with family and friends and there are no restrictions on visiting. On the day of the site visit when we arrived only one person was at home. This person had made this choice because they were not feeling well. Other people were out, some at work, some playing skittles. During the day people came back to the home. Some got on with their chores for example washing clothes, others went to their bedrooms, whilst others prepared to go out again that evening. People told us that where group activities take place, this is a positive choice. Staff were seen to maintain residents privacy and dignity by knocking on bedroom doors before they enter and one member of staff talked of the importance of not talking about residents in front of others. Everyone we spoke with or who completed a survey said how much they enjoy the food. People talked about the things they like and what they eat. Some people would prefer a much less healthy diet and staff do a good job ensuring there is a balance between choice and nutrition. People living here are involved in shopping, menu planning and cooking depending on their abilities. Although more recently the home has chosen to try internet shopping, so there are less opportunities for impromptu visits to the local supermarket. However, staff showed us that opportunities do exist for this for people who enjoy this activity and as part of one persons communication plan. Photographic and symbolised menus are available to help people make choices about what to eat. Bowls of fresh fruit are available. Care Homes for Adults (18-65 years) Page 14 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. People are helped to stay healthy and the management of medications ensures their safety. Personal support is offered in a way that offers choice and promotes independence. Evidence: In surveys people say that they always receive the medical support that they need. Each person is registered with a local GP and records indicate that regular visits are made to (for example) the dentist and opticians. Additional medical support is obtained as and when it is required. People living here remain well and healthy. Records and conversations with people show that people receive personal support in the way they prefer and require. Gender choices are recognised regarding the delivery of personal care. Records also show that physical and emotional healthcare needs are monitored on a regular basis through the use of an holistic healthcare chart. Staff demonstrate a good understanding of each persons needs and of signs or symptoms of distress or pain and deal with this appropriately. Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: The home uses a monitored dosage system of medication issued by the local pharmacy. Staff manage most peoples medication although work is ongoing to support some people to manage their own. Records were seen and they indicate that medication is being administered appropriately and that records are kept up to date and are accurate. Some hand written entries had not been signed for by two people as they should be and this was bought to the attention of the person in charge. Care Homes for Adults (18-65 years) Page 16 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. People are listened to and are protected from harm. Evidence: No complaints have been received about this service by either the service itself or by the commission. In surveys people told us that staff listen and act on what they say and that they always know who to speak with if they are not happy. During the site visit people told us they have no complaints and really enjoy living here, although some are looking at options to live more independently. People were observed being really comfortable in the company of staff and having relaxed and mutually respectful interactions. Records show that staff receive training in safeguarding adults and demonstrate an excellent understanding of what abuse is and a zero tolerance to it. They watch a video produced by the Department of Health and some have attended training sessions organised by the local authority. Some training is directly related to supporting residents to know about their right to be protected and not to be harmed in any way. The Normalea Society has an in house trainer who is trained to train other people by Devon County Council. Care Homes for Adults (18-65 years) Page 17 of 27 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. People enjoy living in an attractive, clean, safe and homely environment. Evidence: In surveys people told us the home is always clean and fresh. This is a shared activity and responsibility amongst the people living here and staff. On the day of the site visit the home was clean and as tidy as a home with an active family living there is expected to be. Records show there is a maintenance and repair system in place. People told us they are involved in helping to choose furnishings and the decor. We saw staff washing their hands and using alcohol gel rub, as is good practice. This home is not suitable for people who have mobility problems, as the building has many stairs and no lift. However, staff are aware peoples additional sensory needs and try to ensure that these are met. For example by leaving lights on at darker times for those people with impaired sight. Care Homes for Adults (18-65 years) Page 19 of 27 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. Recruitment, training of staff and staffing levels ensure that the people who live here are well supported and are safe. Evidence: Normal staffing levels at this home are one member of staff in the morning, two in the afternoon, one in the evening and one member of staff sleeping at night. During this inspection there were two members of staff at the home. The home has its own bank of relief staff who work to help cover sickness and holidays and who work flexibly and with the permanent staff group to help the home respond to residents needs. People say that staff respond to their needs, are brilliant and really good. In surveys staff say they know who to contact in an emergency and that they get the support they need. During discussions with the inspector staff demonstrate an excellent understanding of the client group and a real commitment to best practice and care. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: The duty rota shows who is on duty in pictorial form so that people living here have a clear understanding of this. The project manager reports in the Annual Quality Assurance Assessment (AQQA) that staff receive a variety of training including care planning, safeguarding adults, introduction to autism, age discrimination and supervision skills for line managers. National Vocational Qualification (NVQ) is ongoing and two members of staff are currently undertaking NVQ level 4. We looked at two staff recruitment files which contained all the checks necessary to ensure the protection of people from unsuitable staff. This includes police checks and two references. The manager reports that people living here are actively involved in the recruitment procedures. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that is well managed, is safe and is run in their best interests. The style of management ensures that continuous improvement and best practice enhance the lives of the people living here. Evidence: This service is managed by a project manager who is registered with the commission and who has successfully completed the Registered Managers Award. She has many years experience working in social care with people with a learning disability and demonstrates an excellent understanding of best practice and the needs of the individuals living here. In additions she understands the strengths and training needs of individual staff and of how this service can contribute to enhancing potentially vulnerable peoples lives. She is supported by senior staff in the home who provide support to people living here and have designated responsibilities which helps them to continually develop their skills. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: In the AQAA the manager reports that appropriate maintenance checks and contracts are in place for systems such as heating and electrics. Appropriate fire checks take place and staff demonstrate a good understanding of this. They also demonstrate a good understanding of peoples limitations in understanding fire drills and they know what to do to compensate for this. All staff receive mandatory training including First Aid, food hygiene and health and safety. Records and outcomes for people living here show that the management team conducts itself in an atmosphere of openness and respect, in which people living here, their families, friends and staff feel valued. This has consistently been seen during successive inspections. More recently the Trustees have employed the services of a consultant to review the service provided within this home. The people living here, their families, shareholders, staff members and significant agencies were informed of the consultation and are currently being advised of the outcome of the report. Frequent meetings, open days, coffee mornings and social events are organised, which families are encouraged to attend. 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 All hand written entries on medicine charts should be checked and signed by a second person. Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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 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!