Inspection on 22/01/09 for 3 Herrick Road

This inspection was carried out on 22nd January 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

3 Herrick Road 17/01/07

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Pemdale

Extracts from inspection reports are licensed from CQC, this page was updated on 08/06/2011.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 3 Herrick Road 3 Herrick Road Taverham Norwich Norfolk NR8 6SQ The quality rating for this care home is: two star good 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: Lella Hudson Date: 2 2 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. 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 33 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.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 33 Information about the care home Name of care home: Address: 3 Herrick Road 3 Herrick Road Taverham Norwich Norfolk NR8 6SQ 01603861076 01603869713 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): New Boundaries Community Services Ltd Name of registered manager (if applicable) Mrs Sally Cumbers Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 3 0 care home 3 learning disability Additional conditions: The registered person may provide the following category/ies 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: 3 Date of last inspection A bit about the care home Care Homes for Adults (18-65 years) Page 4 of 33 3 Herrick Road is a three bed roomed bungalow in Taverham providing care to three people with learning disabilities. The Home is located approximately four miles outside the city of Norwich in a quiet residential area with access to local facilities and shops. There is a small garden at the rear of the Home and shingle parking to the front. There is a communal bathroom, kitchen and lounge/diner. Care Homes for Adults (18-65 years) Page 5 of 33 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Staffing Conduct and management of the home Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Care Homes for Adults (18-65 years) Page 6 of 33 How we did our inspection: This is what the inspector did when they were at the care home This report contains information gathered about the Home since the last Key Inspection (January 2007). The Annual Quality Assurance Assessment was completed in a detailed way and this provides us with the organisations view of the service that they provide. The report includes information gathered during a visit to the Home which was carried out on the 22nd January 2009. During this visit we spoke to the Care Homes for Adults (18-65 years) Page 8 of 33 Manager and Team Leader, looked around the Home and looked at records. We observed staff supporting residents but due to communication difficulties it was not possible to gain the views of the residents about the service that they receive. What the care home does well The Home provides accommodation in a homely, comfortable bungalow located in a residential area close to the Care Homes for Adults (18-65 years) Page 9 of 33 city of Norwich. The Home is well managed by an experienced Manager who provides good leadership and puts the needs of the residents first. The staff receive good training and support to enable them to carry out their roles effectively. The residents receive attractive, healthy meals. Care Homes for Adults (18-65 years) Page 10 of 33 What has got better from the last inspection There has been an increase in staffing levels so that there is usually two staff on duty every day. This has meant that the residents are now able to be supported to take part in a greater range of meaningful activities. It also means that residents can choose to remain at Home if they do not wish to go out with the other residents. Care Homes for Adults (18-65 years) Page 11 of 33 The information about the Home and the service provided has been reviewed and updated so that it provides more accurate information. Some of the procedures have also been reviewed and updated to reflect changes in practice. There is a lot less reliance on agency staff in the Home as the Manager has recruited two more permanent members of staff. This means that the staff get to know the residents and their needs well. Care Homes for Adults (18-65 years) Page 12 of 33 More work has been carried out with regard to communication to enable the staff to better communicate with the residents. Further training is planned with regard to this. The care plans are more detailed and contain good guidance about how to meet the residents needs. These are written in a way which includes the individual residents preferences about how they receive support. Care Homes for Adults (18-65 years) Page 13 of 33 What the care home could do better Due to the increasing physical needs of two of the residents the bathroom no longer meets their needs. An assessment has been carried out by the Occupational Therapist and the recommended work needs to be carried out very soon if the residents are to be able to remain living at the Home. The residents need to have an individual contract which clearly states the service that they receive for the fees that are paid on their behalf. Care Homes for Adults (18-65 years) Page 14 of 33 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 Lella Hudson CSCI CPC1 Capital Park Fulbourn Cambridge CB21 5XE 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 15 of 33 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 16 of 33 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The Home has an effective admissions procedure. The Home provides written information about the service provided there. The residents do not have an individual contract which details the services they can expect. Evidence: There have not been any new admissions to the Home since the last Inspection, however the Home does have an appropriate admission procedure. We saw the revised Statement of Purpose and Service User Guide. These have been reviewed and updated. There is still a need for the residents to have individual contracts which include the details about their fees and what is covered by this. Care Homes for Adults (18-65 years) Page 17 of 33 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The needs of the residents are clearly recorded in the care plans which provide guidance for staff about how to meet their needs. Risks are recognised and appropriately assessed. Evidence: We looked at two of the care plans. The organisation has started to use a new format for these. The information within the care plans is detailed and provides good information for staff about how to meet the residents needs. In addition to this the Team Leader has written a very detailed guide as to how each of the residents likes to have their care provided from when they get up to when they go to bed. This is very individual and focuses on the residents preferences and wishes as well as ensuring that their needs are met. The care plans are currently handwritten and this means that it can be difficult to find information easily as the review notes have to be read in addition to the care plan. Also the format means that sometimes a lot of information is being written into a very small space. Care Homes for Adults (18-65 years) Page 18 of 33 Evidence: The care plans contain risk assessments which include guidance to staff about how best to manage the risks. The requirement made at the last Inspection for a risk assessment for the use of bedsides has been met but this would benefit from being more detailed. The residents all have communication difficulties and the Manager has applied for one of the staff to undertake the Communication Co-ordinators course so that they can ensure that they are using the most effective forms of communication with each resident. The Team Leader has worked with the residents for two years and has a good understanding of the way in which the residents communicate. He has written a very clear guide to this in each of the care plans. The staff are responsible for looking after residents money. There are clear records kept of this and we were able to check one against the cash held. Care Homes for Adults (18-65 years) Page 19 of 33 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The residents are now being supported to take part in a range of meaningful activities. The residents dietary needs are met. Evidence: The staffing levels have been increased since the last Inspection so that there are nearly always two staff on duty during the week and at weekends. This has meant a big improvement to the quantity and quality of activities that the residents can be supported to take part in. There is also improved communication between the staff at the Home and the staff at the Day Centre where all three residents used to regularly go. The activities that the residents were taking part in have all been reviewed so that only one of the residents goes to the Day Centre on a daily basis now. Discussions with staff and a look at the daily notes show that the residents are being supported to access a lot more community facilities. They are regularly going swimming, bowling, horseriding, sailing Care Homes for Adults (18-65 years) Page 20 of 33 Evidence: and using local shops. They also take part in groups that are run by staff, such as art and craft groups. The organisation has replaced the Homes vehicle and so they now have a more reliable vehicle. Only the Team Leader is able to drive the transport at present. The care plans contain information about the dietary needs of the residents. Residents and staff eat together. Copies of the menus are kept. Care Homes for Adults (18-65 years) Page 21 of 33 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 personal and healthcare needs of the residents are met by the staff team. The bathroom needs to be adapted for the Home to be able to continue to meet the needs of the residents. Medication is managed in a safe way. Evidence: The care plans contain information relating to how the residents personal and healthcare needs should be met. All three of the residents need assistance with all aspects of their personal care and the care plans are written in a respectful manner which includes the residents preferences about how their care is provided. There is evidence that residents are supported to attend healthcare appointments. Two of the residents are becoming less mobile and as a result are having problems with getting in and out of the bath. The Occupational Therapist is involved and providing advice about adaptations to the bathroom. The staff all receive training with regard to the administration of medication before they are able to administer medication alone. The Team Leader said that they are shortly going to change the way that they receive medication and will be using a Care Homes for Adults (18-65 years) Page 22 of 33 Evidence: monitored dosage system. The staff will have training about how to use this system. New storage will need to be found as the current cupboard will not be suitable. We looked at the medication system and saw that appropriate recording takes place and that there are records of medication received at the Home and that which is sent back to the pharmacy. There is also guidance available about the use of PRN (as required) medication. Care Homes for Adults (18-65 years) Page 23 of 33 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 . Procedures and staff training are in place to provide protection to the residents from abuse. Complaints are taken seriously and action taken to address them. Evidence: The Manager confirmed that there have not been any complaints made to her since the last Inspection. The Commission have not received any complaints about the Home. The Home has a complaints procedure but it would be difficult for the residents to use this due to their communication difficulties. The staff receive training with regard to the Safeguarding of vulnerable adults. The procedure has been updated since the last Inspection but it is still not clear as to who should be notified within the local authority and so the Manager has put the Norfolk Social Services procedure in the policies and procedures file so that the two procedures can be read together. Care Homes for Adults (18-65 years) Page 24 of 33 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Due to the increasing physical needs of the residents the Home no longer meets the needs of two of the residents. Evidence: We had a look around the bungalow and discussed the accommodation with the Manager and Team Leader. In general, the bungalow provides comfortable and homely accommodation although the presence of the staff sleep in bed in the lounge rather detracts from this. The physical needs of two of the residents have increased since the last Inspection and the bathroom no longer meets their needs. The Occupational Therapist has carried out an assessment and has made recommendations to the organisation about the work that needs to be carried out in order for the residents to remain living at the Home. A new carpet has been fitted to the lounge since the last Inspection. Care Homes for Adults (18-65 years) Page 25 of 33 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 . Appropriate recruitment procedures are followed prior to staff starting work at the Home. Staff receive regular supervision and training to enable them to carry out their roles effectively. Evidence: The staffing levels have been increased and this has meant improvements to the lives of the residents. They are now able to be supported to take part in a greater range of meaningful activities on a more regular basis. It also means that residents can choose to stay at Home rather than all have to go out together. The Manager of this Home also manages two other Homes within the organisation. This Home has a Team Leader and two full time permanent members of staff. This is also an improvement as at the time of the last Inspection there was only one permanent member of staff. This means that there is less reliance on agency staff. There was an agency staff on duty during our visit but she had worked at the Home before and knows the residents. The Manager receives confirmation of training and experience of agency staff prior to them working at the Home. This also includes confirmation of them having had a suitable Criminal Records Bureau check. Care Homes for Adults (18-65 years) Page 26 of 33 Evidence: We looked at a selection of staff files and these show that the organisation follows appropriate recruitment procedures and that staff receive induction when they first start work at the Home. The two care staff have only recently completed their induction and so have attended the mandatory training as part of this. The Team Leader has attended a greater range of training, which has included training relevant to being a team leader. The organisation used to have a dedicated Training Manager but this role is currently vacant. We were told that there are plans to recruit a new Training Manager. The Team Leader provides supervision to the two care staff. He receives regular formal supervision from the Manager. Care Homes for Adults (18-65 years) Page 27 of 33 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The Home is well managed in a way which puts the needs of the residents first. The quality of the service is regularly monitored. Health and safety needs of the residents and staff are given a high priority. Evidence: The Manager of this Home also manages two other Homes within the organisation. She has suitable experience and qualifications to manage this Home. The Home has a Team Leader who oversees the Home on a day to day basis. We were told that the Manager has good communication skills and that she provides good leadership and motivation. The Manager has recently been provided with a work mobile phone and a laptop with internet access. This has improved communication within the organisation and means that the Manager is able to carry out a lot more administrative tasks rather than having to wait while they are done at the Head Office. The Home does not have access to a computer and the telephone is still a pay phone with a pot of money next to it. The organisation has several different ways in which the quality of the service is Care Homes for Adults (18-65 years) Page 28 of 33 Evidence: measured on a regular basis. For example, the care plans are regularly reviewed and updated, health and safety checks take place, monthly visits take place as per Regulation 26. The AQAA was also completed in a detailed way. Regular checks are carried out with regard to health and safety issues. The Team Leader has attended Health and Safety training. The Home has linked smoke detectors and a fire risk assessment was carried out in 2008. We saw that there are steps from the patio doors leading from one of the residents rooms. As this may be used as an exit during a fire it would benefit from having a ramp rather than steps. As previously mentioned in this report there is a health and safety issue about the bathroom due to the increasing needs of the residents. Care Homes for Adults (18-65 years) Page 29 of 33 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 30 of 33 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 5 5 It is required that the residents have their own individual contract which details the service they can expect for the fees 31/03/2009 To ensure that it is clear as to the services provided within the fees 2 27 23 It is required that the 28/02/2009 adaptations to the bathroom take place to ensure that the needs of the residents are met To ensure that the needs of the residents can be met at the Home 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. Care Homes for Adults (18-65 years) Page 31 of 33 No Refer to Standard Good Practice Recommendations 1 6 It is recommended that there is a computer at the Home so that care plans and risk assessments can be printed so that they are easier to read. This would also mean that they can be more easily reviewed and updated. Care Homes for Adults (18-65 years) Page 32 of 33 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 33 of 33 - 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!