Inspection on 27/11/08 for Alder Close (20)

This inspection was carried out on 27th November 2008.

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

Alder Close (20) 15/05/06

Alder Close (20) 22/11/05

Alder Close (20) 05/07/05

Alder Close (20) 15/02/05

Alder Close (20) 10/08/04

Alder Close (20) 16/03/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 26/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Alder Close (20) 20 Alder Close March Cambridgeshire PE15 8PY     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: Andy Green     Date: 2 7 1 1 2 0 0 8 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. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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 25 Information about the care home Name of care home: Address: Alder Close (20) 20 Alder Close March Cambridgeshire PE15 8PY 01354654146 01354657905 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Cambridgeshire County Council care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Learning Disability - for 5 service users receiving respite care only between the ages of 18 - 65 years. Date of last inspection Brief description of the care home 20 Alder Close is a 5-bedded bungalow providing respite care for adults with a learning disability. The home was first registered in October 2003 and comprises five bedrooms, all with en suite facilities, a lounge, kitchen, two bathrooms, laundry and office. There are also extensive gardens around three sides of the bungalow incorporating seating and planted areas. The home is situated near to March town centre where service users have access to a variety of shops and facilities. 5 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: We the Commission for Social Care Inspection carried out a key unannounced inspection on 27th November 2008. We met with the manager and members of the staff team. A variety of records were inspected including care plans, staff files, fire safety records and medication records. A tour of the building was undertaken and we met one of the service users receiving respite care. The AQAA (Annual Quality Assurance Assessment) was completed by the manager of the service. This is a self assessment process that focuses on how outcomes are being met for people who live in this home. Comments and surveys were returned to the Commission completed by service users or others who have interest in the home. Care Homes for Adults (18-65 years) Page 5 of 25 Care Homes for Adults (18-65 years) Page 6 of 25 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.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 7 of 25 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users have access to good information, and can make an informed choice regarding the homes services. Evidence: All referrals are made through the local authority via the Contact Centre. A level 2 assessment is received from the service users care manager and visits are then made to the service which often includes relatives and carers where possible. The Operations Manager stated that both the Statement of Purpose and Service users Guide have been reviewed as part of an ongoing process throughout the year. However, it is recommended that versions of both documents be produced in a pictorial format to aid service users understanding of the services provided Service users, relatives and carers are given clear guidelines from the service regarding items to bring in during the respite period. These include; medication, personal money, clothing, mobility aids. Care Homes for Adults (18-65 years) Page 9 of 25 Evidence: There are approximately 35 service users who receive respite care from the service on a regular basis during the year. Care Homes for Adults (18-65 years) Page 10 of 25 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are appropriate care plans in place to ensure that service users assessed care and support needs are met and understood. Evidence: Four service user plans were inspected and they contained a variety of information detailing care and support needs. This included weekly activities, food preferences, health care, daily routines and personal care. Care plans are written in a person centred style including a pictorial version using a system called Widget to assist service users understanding and involvement. There are appropriate risk assessments in place to ensure that service users are safe both within the home and when accessing the community. Care plans are reviewed to ensure that any changes in the individuals care and support needs are monitored. Each service user has a body map document completed for each respite visit. Care Homes for Adults (18-65 years) Page 11 of 25 Evidence: Evidence of reviews were seen in individual care plans and there is a continual dialogue with relatives to ensure that any changing needs are discussed. Relatives continue to be involved in the review process if they and the service user wish them to be. Care Homes for Adults (18-65 years) Page 12 of 25 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users have access to activities in the community appropriate to their needs and abilities. Service users have a choice of meals, which are prepared and served in a homely manner. Evidence: The majority of service users receiving respite care are involved in programmes of organised day services during the week. Service users continue to have regular access to the community with staff assistance including regular visits to the local town and shops, garden centres, pubs and cinema. The home has access to their own transport, which enables day trips to the coastal resorts and nearby towns. A new vehicle is being purchased but conversations with staff indicated that it may not be accessible for some service users especially those using wheelchairs. It is Care Homes for Adults (18-65 years) Page 13 of 25 Evidence: recommended that the home researches the purchase or gain access to a more appropriate vehicle to suit wheelchair users. There continues to be organised in-house activities including board games, cookery and craft sessions. A new wall mounted television has been ordered and service users have access to video, DVD and music facilities. More in house craft and board games are due to be purchased with money raised from a recent fund raising event. One service user was present during the inspection and she was involved in meetings with her key worker and care manager. She was complimentary about the care and support received during her respite stays in the home. Three residents were involved in activity programmes at a local day service. Service users are also involved with menu planning and the preparation of meals with staff assistance where appropriate. Individual food preferences are reflected in the weekly menus to meet the likes and dislikes and dietary needs of the service users receiving respite care. Care Homes for Adults (18-65 years) Page 14 of 25 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users receive health and personal care to meet their assessed needs together with support in taking prescribed medication. Evidence: Service users have a variety of care and support needs including personal care with bathing and dressing where required. Care staff accompany service users to hospital appointments if necessary during their respite stay. The home has appropriate aids and equipment in place including overhead tracking in two bedrooms. If a service user is physically unwell they but would receive care from their own local GP and would not usually make use of their respite stay. A variety of health care specialists continue to be available when required including speech therapists, occupational therapists, psychiatrist, community nurses and care managers. Nursing care is not provided but the home continues to have an arrangement with a local GP practice to provide medical support to service users when necessary. Surveys received from service users and their relatives were positive and included the Care Homes for Adults (18-65 years) Page 15 of 25 Evidence: following comments; We have complete confidence in all the staff at Alder Close and we are very appreciative for all their hard work I would like to say that this has been a major turning point in ours nd our daughters lives as she has never been anywhere without us and Alder Close look after her so well they always ask us all what we want to do every day. We all have a great time and I enjoy my time here Our daughter is well looked after when she goes to Alder Close and she is happy there or she would not want to go The operational manager stated that outreach support is being provided to one service user who had been receiving respite care and two service users are also receiving occasional day care support. Records are kept of all medicines brought in by service users. A medication policy is in place. Records of medication administered were inspected and found to be satisfactory. Care Homes for Adults (18-65 years) Page 16 of 25 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home ensures that service users have their complaints or concerns listened to and acted upon properly. There are suitable arrangements for ensuring the protection of service users from neglect or harm. Evidence: There have been no changes made to the complaints procedure since the last inspection. The home has a satisfactory policy in place, which is in line with local authority policies, to ensure that service users are protected from abuse. Safeguarding adults training is being booked for all staff to update their knowledge. Care staff were observed to speak with service users in a friendly and social manner appropriate to the individuals needs. Comment cards received from service users and their relatives were positive regarding the care and support that is provided in the home. Care Homes for Adults (18-65 years) Page 17 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a comfortable environment to meet service users assessed needs. Evidence: The home is presented in a clean, homely and comfortable manner so that service users can enjoy their respite stay. Since the last inspection the home has been redecorated including all bedrooms and communal rooms. All bedrooms have been individually decorated in a variety of attractive colours Carpets in the lounge and hallway have been replaced and the flooring in one bedroom has been renewed. There is adequate equipment to meet the service users needs and individuals also bring their own aids and adaptations where required. Service users can personalise their bedrooms with personal possessions to make their respite stay more enjoyable. There are five well furnished single en-suite bedrooms two of which have overhead tracking in place. The gardens have been developed to incorporate more landscaped areas with a variety of attractive plants. A recent fund raising event has raised money to provide more planting and to provide further arts and crafts equipment for service users. The garden fences have also been painted since the last inspection. Care Homes for Adults (18-65 years) Page 18 of 25 Care Homes for Adults (18-65 years) Page 19 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes recruitment policy and processes makes sure that service users are protected from harm. Training must be improved to ensure that care staff deliver care competently to the service users they support. Evidence: Since the last inspection it was noted that frequency of staff training has deteriorated and needs to be refreshed to ensure that staff remain up to date with current care practices. The operational manager recognised that this is an area for improvement and stated that the training programme is being coordinated by one of the senior carers in conjunction with the homes manager and a copy of the training programme would be forwarded to the Commission as soon as possible. The senior carer showed evidence of a recent training audit which she has carried out to identify training gaps and she is booking appropriate sessions to improve this area. NVQ training continues to be undertaken by staff in the home. Care staff confirmed that they were well supported by the manager in the home and that they received an annual appraisal and regular recorded supervision sessions approximately every six to eight weeks. Care Homes for Adults (18-65 years) Page 20 of 25 Evidence: There is a thorough recruitment process to ensure that only appropriate people are employed. Three staff files were inspected and they contained appropriate recruitment checks including two references, photograph, Criminal Records Bureau checks and application forms. The Operations Manager stated that the home has care staff vacancies and regular relief staff are used via the local authority. Relief staff are well known to service users to ensure that there is adequate and consistent cover provided. There were three carers and one administrator on duty and there is one waking night staff and one staff member sleeping in each night. Care Homes for Adults (18-65 years) Page 21 of 25 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager provides support and guidance to staff to ensure that service users receive good quality care. Evidence: The registered manager has completed an NVQ level 4 in Management and Care to improve her skills. The staff were complimentary regarding the support they received from the management in the home. They stated that they continued to be encouraged to raise issues and actively participate in the continuing development of the service. Fire safety records were seen during the inspection and they were recorded satisfactorily. Care Homes for Adults (18-65 years) Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 35 18 Staff must receive regular 31/01/2009 mandatory and safeguarding adults training to ensure their safe practice. To ensure staffs safe working practices. 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 24 of 25 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 © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!