Inspection on 18/09/08 for Amberleigh

This inspection was carried out on 18th September 2008.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Amberleigh 14/11/06

Amberleigh 10/01/06

Amberleigh 05/07/05

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Amberleigh 24 Isaacs Close Street Somerset BA16 0LS     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: Justine Button     Date: 1 8 0 9 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 26 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 26 Information about the care home Name of care home: Address: Amberleigh 24 Isaacs Close Street Somerset BA16 0LS 01458840865 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Somerset County Council (LD Services) care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Service Users may be admitted who have concurrent sensory and or physical impairment Service users are admitted for a maximum of three months Date of last inspection Brief description of the care home Amberleigh is a service for residential short breaks which caters for service users in the Younger Adult Category. Two of the six beds are used for emergency or assessment purposes. All the rooms are for single occupancy. There are a number of communal areas including sitting and dining space. In addition there is a conservatory, which is used for quiet time. The service has a very small garden area to the rear this is accessible to the people who live at the service. There are an adequate number of adapted bathrooms. The current scale of charges is between #50.00 and #94.00 per week. 6 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 26 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: This unannounced Key Inspection was conducted over one day (6.5hrs) On the morning of the inspection two care support workers, one care support assistant and one manager were on duty and during the afternoon there were one care support worker, two care support assistants. The registered manager Mrs. Molland was available to assist the inspector during the unannounced visit. On the day of the inspection one service user was at home. The atmosphere was relaxed and informal. Staff were seen to work professionally and demonstrated good rapport with the service users. Care Homes for Adults (18-65 years) Page 5 of 26 The inspector viewed all communal areas and also some service users rooms. The inspector met with one service user and three staff members. A selection of records was examined. These included two care plans and one staff recruitment files. CSCI sent out feedback cards for people who access the service. All of those returned were extremely positive about the services provided at the home. The home manager sent us the homes annual quality assurance document. This was completed fully when requested by us. The inspector would like to thank the people accessing the home , staff and manager for their time and hospitality shown to the inspector during her visit. The following is a summary of the inspection findings and should be read in conjunction with the whole of the report. 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 26 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 26 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 provides a statement of purpose, and service user guide that clearly sets out the objectives and philosophy of the service. Each prospective person is given the opportunity to spend time in the home prior to thier first admission. Each indivdual is provided with a clear statement of terms and conditions that sets out the terms and conditions of residency. people are provided with respite care in order to maximise their independence and prepare them for their return home. Evidence: Each person is provided with a written and pictorial statement of terms and condition of residency. There is a trial period of at least half a day followed by an overnight stay. Length of visit will be tailored and agreed to allow prospective service user the Care Homes for Adults (18-65 years) Page 9 of 26 Evidence: opportunity to find out if the home meets their needs. The indivdual is also provided with a Statement of Purpose and a Service Users Guide. The Service Users Guide is provided in Somerset Total Communication which uses pictorial symbols used within the Somerset County Council network services. The symbols are easy to understand and the guide explains what the prospective service user can expect from Amberleigh. This enables the service user to make an informed choice. The care plan sampled provided evidence of pre-admission assessments for recent admissions. The home also has a clear and concise flow chart detailing appropriate steps to take when conducting short-term emergency admission procedure. The home has received one complaint recently. Part of this complaint raised issues with regard to how information was up dated between people accessing the service. The home has now developed a form that is completed prior to each visit to ensure that the information that the home keeps on each individual is up to date and provides all necessary information for staff. Care Homes for Adults (18-65 years) Page 10 of 26 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 home has a detailed care plan for each individual. people are encouraged to exercise choice and participate in all aspects of life within the home. people are supported in taking risks. Records relating to individuals are stored securely and appropriately maintained. Evidence: Care plans are maintained for each individual. Two care plans were examined during this inspection. Those care plans seen were detailed and provided information regarding service users needs, daily routines and preferences. Care plans had been regularly reviewed and updated as required. people are encouraged to exercise choice, wherever possible. Staff have a good understanding of people needs and respond to choices that are expressed through verbal and non verbal communication. Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: Communication systems are widely used through out the service. Pictures and symbols are used to inform service users of such things as the menu for the day, where things are kept or activities that will be available on that day. Risk assessments had been completed for each individual. These are categorized and colour coded in relation to level of risk. This ensures that the information provided is clear and concise. Care plans included details of strategies to be used to manage challenging behaviour, where necessary. The care plans seen included specific manual handling risk assessment for each person, which is good practice. There is also a manual handling risk assessment file kept for residing service users in the bathroom. These files provide staff manual handling guidance and instruction for each service user. This is stored appropriately and locked away when the individual is not in residence. The care plans are stored in a secure manner. The care plans evidenced that the service users are supported in making decisions and exercising choice over their lives. Daily Living Skills objectives set by the home and service user provide structured goals. These were signed where possible. Care Homes for Adults (18-65 years) Page 12 of 26 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 home offers individuals opportunities to engage with peers, access appropriate leisure activities, and exercise choice. peoples rights and responsibilities are respected. Evidence: People are provided with a range of activities that are appropriate to their individual needs, and are supported in accessing the local community. On the day of the inspection, one person was at home and one person was attending the day Centerer for part of the day. The level of staffing at the home provides service users with the opportunity to participate in a range of activities. These include: day centre access, music & relaxation, gardening, flexicise, accessing the community, and social club at the Tor Leisure. There is a sensory room in the home, which provides soft mats, beanbags, Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: light projector, tactile toys, and water bubble display. The home has use of a minibus to access local facilities. The bathroom also has underwater spa lights for peoples enjoyment. The care plan included an interests checklist, which is used when a new person resides at the service. This helps establish their personal interest and leisure preferences and contribute to care planning if needed. The home provides support with equality and diversity needs such as appropriate skin care or dietary requirement for those in ethic minority. There is an activities reference book which includes photographs and total communication symbols listing a range of activity available. Staff have a communication passport, which people accessing the home can look at, and get to know the staff member. This is a helpful tool in developing rapport. This is to be commended. Staff supports individuals in maintaining contact with friends and family members. Visitors are welcomed at the home. Care Homes for Adults (18-65 years) Page 14 of 26 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 provided with appropriate assistance to meet their personal care needs. The home supports individuals in accessing healthcare services. The home has a medication policy, which provide staff with clear guidance. Medication records are managed safely. Evidence: All bedrooms rooms are single occupancy and have sink en suite facilities. Care plans provide details of the level and type of assistance each person requires to meet their personal care needs. people visit the GP with staff support if and when required. individuals are also supported to attend any pre-arranged healthcare visits. All visits to health and medical services are well documented in the service user plan. The Manager had ensured that staff receive training in relation to individuals specific Care Homes for Adults (18-65 years) Page 15 of 26 Evidence: health and personal care needs. The manager has arranged comprehensive health and medical training for the staff such as peg feeding, bolus feeding, epilepsy, mental health, dementia and medication. All medications were stored securely. The medication records were examined. Each person has a medication file which is detailed. This includes photograph of the individual, and written records of phone contact with GP. A record had been maintained in relation to all medications entering and leaving the home. Two staff signatures further support this record. Medication stored were sampled and checked. These were checked daily by staff and fell within the correct date period. The service provides lockable cabinets in each room, should the service user wish to self-medicate. The care plan includes a section, which outlines persons end of life wishes where applicable. Care Homes for Adults (18-65 years) Page 16 of 26 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. Policies and procedures are in place for the protection of vulnerable adults from abuse. It is recommended that staff receive POVA training as good practice. The home has a complaints procedure and policy relating to the Protection of Vulnerable Adults. Evidence: The homes complaints procedure was included in all service users care plans and management confirmed that parents or guardians were issued a copy of the Councils complaints procedure. The information on how to complain is also available in pictorial form, or a video is available. This is commendable. Service users spoken to, where able, confirmed that they felt comfortable raising issues of concern to staff and management. Two complaints have been received since the last inspection. One complaint had been dealt with appropriately by the management team. Remedial action has been taken by the management at the home to learn from this complaint and to implement systems to ensure that the issues identified have been rectified. Staff are aware of the vulnerable adults and whistle blowing policies. In addition to this training there is in place a policy for the two areas. The policies complied with the Public Disclosure Act and the DOH Guidance No Secrets. Care Homes for Adults (18-65 years) Page 17 of 26 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 has been decorated and furnished to an adequate standard. The home has sufficient communal areas and bathrooms to meet peoples needs. Appropriate adaptations have been provided. The home was found to have a good standard of cleanliness. Evidence: The home is a purpose built unit and provides respite care. The home is adapted to a high standard to meet the range of disabilities that people using the service may have. A tour of the building was conducted during the inspection. All the bedrooms are for single occupancy with sink en suite facilities. One persons bedroom was viewed with permission. The bedrooms viewed were found to be personalized and comfortable. Some bedrooms were equipped with overhead hoist track to provide assistance with mobility if required. A number of the rooms have electric beds equipped with bed rails. The beds can be adjusted electronically to raise people into different positions. Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: The majority of bedrooms have built-in wardrobes There are three toilets in this home with adequate space for wheelchair users. There is one very large shared bathroom with a bath suitable for people with severe mobility impairment to access via an overhead hoist. The water temperature of the bath is displayed on a digital readout. There is also a shower trolley available, where adequate space is provided for its use in the bathroom. All washing and bathing facilities inspected were clean and tidy. Also, paper towels and liquid soap were available. Water temperatures records were checked and found up to date. Communal space at the home includes a large lounge and a separate dining area. The lounge is comfortable and homely. The home has a conservatory, which is used as a sensory room as well as additional communal space. The kitchen is spacious and provides good storage and cooking facilities. The kitchen units have Somerset Total Communication symbols displayed on the cupboard to inform a person of the content. The laundry provides good equipment for washing of clothes and machines enable programmes to heat to a degree to manage infection control measures. All chemicals are stored in a locked cupboard. Amberleigh has limited accessible outdoor space. The surrounding lawns are well maintained. Pictorial signs were evident throughout the home to signpost fire exit or toilets. The home was maintained in a clean and hygienic condition. Western Challenge currently manages the premises. Recent decorating and updating of the environment has been completed. Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are experienced and provide a good standard of care. Staffing levels are appropriate to meet peoples needs. Training updates in moving and handling are recommended. Staff receive appropriate support and supervision. . Evidence: The staffing structure at the home has recently been reviewed. Previously staff at Amberleigh provided staff support for other satellite homes. This practice has now all but ceased with the staff now only supporting one other small service in the local area. This was discussed with the manager who stated that this has eased the staffing requirements at the home. The needs of people who access the home however have increased over recent months. Despite this staffing levels appear to be acceptable but Somerset County Council needs to keep these under review. The manager stated that staff recruitment has improved over recent months however Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: the home continues to have some staffing vacancies. These vacancies are well managed and do not have an adverse effect on the people who access the home however robust recruitment needs to continue. The recruitment file for one staff member who had recently commenced employment was viewed and this demonstrated that satisfactory checks including written references and Criminal record Bureau checks had been completed. Newly employed staff are provided with a thorough Induction programme. Staff spoken with confirmed this. Staff are provided with regular opportunities to receive training, and have attended courses such as Health and Safety, Food Hygiene, First Aid, Fire, Autism, Equality & Diversity, Mental Health, and Epilepsy. It could not be conformed that all staff have received manual handling training in line with good practice guidelines Care Homes for Adults (18-65 years) Page 21 of 26 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 run. There is a relaxed and open atmosphere within the home. Staff endeavours to promote the rights and best interests of service users through person centred approach using total communication. Appropriate actions have been taken to promote the health and safety of staff and service users. Evidence: Mrs Pauline Molland is the Registered Manager. Mrs Molland has many years experience of providing care to a service users who have a learning disability. Staff at the home seek peoples views on an individual basis, taking account of behaviours, verbal and non-verbal communication. Staff spoken with confirmed that the Manager was approachable and that they would be able to raise any concerns. The home has appropriate policies and procedures in place to safeguard vulnerable Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: service users. All records relating to service users are stored securely in accordance with the Data Protection Act 1998. Staff spoken with confirmed that the management team were supportive and open. Staff informed the inspector that they have staff meetings every one or two months. Overhead hoists, Lifting Operations, Lifting Equipment Regulation (LOLER) were checked and found to be satisfactory. Fire safety records were examined. Fire equipments were tested regularly. There are notices displayed in throughout the home in Somerset Total Communication that provide details of the actions to be taken in the event of a fire. The inspector viewed records relating to medication, water, portable appliance testing (PAT), Control of Substance Hazardous to Health (COSHH), and manual handling assessment. Health and Safety checks are maintained and up to date. The home was generally found to be well organised and well run. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes R 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 1 24 23 It is required that the 31/01/2007 management clarify with Western Challenge when the refurbishment upgrade work will take place. Also, to forward to CSCI an action plan detailing plans for refurbishment. 2 34 Schedule 2 (5) It is required that the home updates all staff personnel records to evidence information required by Schedule 2, Care Homes Regulations 2001. 31/01/2007 3 42 13 4(a) It is required that broken or damaged furnishings be replaced. 18/12/2006 4 42 13 4(a) It is required that the manager completes an environmental risk assessment to include freestanding wardrobes and unrestricted window openings. 18/12/2006 Care Homes for Adults (18-65 years) Page 24 of 26 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 Care Homes for Adults (18-65 years) Page 25 of 26 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 26 of 26 - 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. 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