Inspection on 18/09/08 for Baytrees

This inspection was carried out on 18th September 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Baytrees 21/02/07

Baytrees 17/11/05

Baytrees 29/06/05

Baytrees 30/12/04

Baytrees 18/06/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Baytrees 246 Old Worting Road Basingstoke Hampshire RG22 6PD three star excellent service The quality rating for this care home is: 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: Kathryn Emmons 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. 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 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. Internet address www.csci.org.uk Information about the care home Name of care home: Address: Baytrees 246 Old Worting Road Basingstoke Hampshire RG22 6PD 01256466274 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Liaise Loddon Ltd Name of registered manager (if applicable) Mrs Sarah Trievnor-Long Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 4 0 care home 4 learning disability Additional conditions: The registered person may provide the following category/ies of service only: Care home only - (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 (LD). The maximum number of service users to be accommodated is 4. Date of last inspection A bit about the care home Baytrees is a care home providing personal care and accommodation for 4 young adults with a learning disability. It is owned and managed by Liaise Loddon. The home is a four bedroom detached house located in the heart of Basingstoke and is within access to local shops and services as well as to shops and leisure amenities within the main town. The home has a large private enclosed garden with areas for growing vegetables as well as ample space for service users to relax. Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home How we did our inspection: This is what the inspector did when they were at the care home The visit to the service was undertaken by one inspector who spent four hours at the home. The care received by three service users was looked at in detail. This is a method called case tracking. This included looking at their personal records a range of general records and staff details. This forms part of a key inspection and focused on the standards in the key areas that most effect the quality of life for the service users. Information already held such as a service history and the providers self -audit which is called an AQAA (Annual Quality Assessment Audit) were used to plan the visit. During the visit the inspector spoke to the responsible individual and three staff and observed service users interacting with staff. We also sent comment cards for staff and residents to complete and we also considered the comments these contained when writing the report. The current weekly fees for the service start from 2500 pounds per week. What the care home does well Service users are enabled to be as independent as possible by being provided with a wide range of recreational activities and learning opportunities. Staff are recruited safely and well trained to carry out their job roles. The service ethos is very clear on enabling service users to be as independent as possible and to be able to make as many of their own decisions as is possible. Quality assurance systems in place provide the manager and responsible individual with information to assist them with continually improving the service. What has got better from the last inspection What the care home could do better The responsible individual, manager and staff continue to improve the service to provide an ever increasing quality service for the service users. 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 Kathryn Emmons 33 Greycoat Street London SW1P 2QF 02079792000 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 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 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 can be confident that their needs will be comprehensively assessed before an offer of placement is made. Contracts and service user guides enable service users and their relatives to be confident about the services they can expect. Evidence: Since the last inspection no new service users have been admitted to the service. We could see the statement of purpose and service user guide , which provide information about the house and service ,had been personalized for each service user. The service user guide is kept in each service users bedroom and is in symbol format to enable the service users to understand what services they can expect from the service if they choose to live at the house. We could see that contracts are in place and these had been signed by the relatives of the service user,or the contracting authority. We looked at the admission details for two service users and could see how admissions take place and that an in depth assessment is undertaken before an offer of placement is made. 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 . Written records provide residents with confidence that their needs are known are that they are able to be kept safe. Regular reviews of needs provide staff with detailed information to provide the correct level of support and enable them to make choices. Evidence: We saw care files for two service users. Both of these contained written assessments, care plans and risk assessments. It was clear what service users needs and abilities were and how support was to be delivered. We could see that reviews took place and that care plans were reviewed regularly. We could see that progress notes were completed every two hours so staff could see what activities service users had been involved in and how they had responded to these. We spent time with service users during the afternoon to see how they were enabled and supported to make choices. We could see that staff had a very good understanding of each individual service users method of communication. There were also symbols and , pictures which service users were using to assist them with communicating their choices. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Service users live in an environment which enables them to learn new skills and increase their independence. Different cultural needs are acknowledged and promoted. Dietary needs and preferences are catered for. Evidence: Staff were able to explain to us the individual lifestyle choices service users made. There was a lot of written information about the lifestyle activities each service user enjoyed such as going shopping, cinema, eating out and doing sport activities. We could also see that service users were able to be involved in gaining ASDAN (Award Scheme Development Accreditation Network) awards which enable them to learn new skills and continually be able to move towards becoming more independent in their daily lives. Staff understood the differing cultural needs of each of the service users, examples of this were supporting one service user ,who follows the Muslim faith , to ensure only Halal meat was provided to them. The service celebrated various festivals such as Christmas, Easter and Chinese New Year and ensures that whatever faith or religion service users follow this is understood by the staff so they can support appropriately. During the day service users have a timetable of activities to ensure they are provided with a variety of opportunities to engage in community activities as well as one to one time in the service. We could see that since the last inspection visit new circle of support plans have been introduced to enable service users and staff to be aware of who are relevant people to provide support. This could be staff or family members or Evidence: other people who attend the service to provide support. During our visit a music and movement session took place at the service and we could see that the service users were expressing their enjoyment. There are also records for staff to complete to gain feedback from service users after activity sessions so they can assess if the activity was positive for the service user. We could see from the visitor book and from daily notes that the service users had regular visits from family and friends. Staff were aware of the service users right to have visits and to form friendships with each other and people outside of the service. Service users were able to chose their own snack during the afternoon and we could see that there were lots of fresh fruit and vegetables available for service users. A menu is in place and we could see that this was varied and nutritional. Service users will be supported by staff to do some of the shopping and other items are ordered on line and delivered to the service. Staff prepare the meals with the service users support where they are able and will take their meals with the service users to provide a more relaxed and family atmosphere. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Service users personal support is given in their preferred way. Staff are able to deliver very good emotional and personal support to service users. Medication arrangements keep service users safe. Access to heath care professionals enable service users to stay well. Evidence: We spent time with service users and could see that their support was being delivered in a valuing and sensitive way . There are a team of staff who interact extremely well with the service users. Very in depth care plans support the skills the team show in delivering the support.Service users looked relaxed and were smiling and interacting well with the staff. One of the service users responded by nodding their head when we asked if the staff were kind and helpful. Another service user was seen smiling , laughing and hugging one of the staff. We looked at the medication arrangements for the service users and found that all records were in good order. There was a clear record of all medication received into the service and records of returned medication. Where there was medication that was prescribed to be given when necessary there were directions on when this medication could be given. We could see from staff records that staff had received training in the administration of medication. We could see from service users files that a full medical history had been obtained and when needed service users accessed Doctors and other medical professionals. One service user attended an osteopath and we could see that appointments had taken place with opticians and chiropodists and dentists. Service users are supported to attend any hospital appointments with their named support workers. Staff understood that any medical interventions or appointments may be a source of anxiety for the service users and gave examples of how they managed this. We could see from the Evidence: interactions we saw and from what staff told us that they understood the emotional needs of the service users and had the skills to calm service users and understand the emotion that the service user was expressing through their behaviour. We could see from the AQAA that since the last inspection more exercise activities have been included in the programme for service users such as, walks,swimming ,bowling trampolining and bike riding. This means that service users have more opportunities to be physically fit and healthy. 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 . Service users can be confident that their concerns will be listened to and acted upon. Staff are trained in safeguarding adult procedures and service users are protected from harm by staff having received the necessary training in relation to holding techniques for calming service users. Evidence: We saw a copy of the services complaints procedure this was in symbol format and we could see that staff would assess any concerns service users may have and address these promptly. We were told by the service representative that any concerns will be investigated and responded to. No complaints or concerns have been raised since the last inspection. Staff told us that they had a right to raise concerns and knew these would be taken seriously. Staff had received recent training in safeguarding adults and we saw certificates for this on staff files and staff told us they had received this training when we spoke with them. On occasion one of the service users requires support by having their arms held by their side so they do not self harm. We could see from staff files that staff had received a lot of training in these techniques to ensure that if they had to carry the technique out they understood why they were doing it and how to carry it out correctly to ensure the service user was not placed at harm. 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 . Service users live in safe, clean and comfortable surroundings which they have been able to personalise. Evidence: The house is similar to other residential houses in the area. A large driveway at the front of the house provides space for the house vehicle and staff and visitor parking. The house was clean and tidy and well decorated and smelt fresh. Each service user had their own room and these have been personalised with their chosen colour scheme and furniture. We briefly looked at one service users room with their agreement and could see that furniture was all in good repair and that the service user had been able to personalise their room with photos and personal possessions. The communal areas were homely and comfortable and service users could move freely around the home. The kitchen was clean and tidy and we could see that good infection control measures were in place. There is a large garden at the back of the house and service users had been growing their own vegetables. The garden had areas for service users to sit with others or be by themselves. Recently a Bar-B-que was held at the service and service users from other houses belonging to the service were invited to attend. Bathrooms were clean and tidy and we saw gloves and aprons were available if needed to be used by care staff. Service users are kept safe by staff monitoring who is entering the house. Security for the home was good and a maintenance person was available to make any repairs that may be needed. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Service users needs are met by a well trained and competent team. Robust recruitment procedures including interview systems ensure the right people are employed to support service users. Staff receive supervision sessions which enable them to identify any training needs and to discuss ways to improve how they work to improve the service they provide. Evidence: We looked at the recruitment records for three of the staff . One of these staff was the last person to be recruited. We saw that all the necessary paperwork was in place including references and criminal record bureau checks. This means that service users can be confident that the right people are supporting them. We talked to the responsible individual who said that service users were involved in the interview process as they were present when prospective staff visited the service. This means that the organisation understands that service users should be making as many decisions as possible regarding how their care is delivered. We also saw evidence of the organisations commitment to equalities and diversities. These include supporting a member of staff with adaptation aids so they could continue to work with the service users. Staff told us that they worked in a non discriminatory environment and any discrimination would never be tolerated to wards service users and staff. The organisation has a policy on anti discrimination behaviour and equal opportunities. We were told by staff that there are sufficient staff on each shift. We saw that there are two teams of staff who generally work opposite each other except for one day a week when the team all work the same day.We were also told ,that to enhance team building and staff morale,at each shift change there is a fifteen minute debrief meeting where staff can talk about any issues they had during the shift. This is to enable staff to be able to go home and not be concerned about the challenges they had dealt with at work. Evidence: We looked at training records and saw that staff received an in depth induction programme and were also required to attend ongoing training sessions which were relevant to the support they provided. A high number of staff had obtained the NVQ (National Vocational Qualification) in Health and social care. This means that they may have more skills and knowledge and be able to provide an improved quality of support. We could see that regular supervision seasons take place and staff are able to raise any issues they have and discuss training and development needs. Staff told us we receive a lot of updates and training which is really good, and, I find supervision helpful as it gives you time to discuss any issue and talk about learning new skills. Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The service is managed by a competent, trained and experienced manager. Service users benefit from the quality assurance systems which are in place and are kept safe by the updated polices and procedures and heath and safety arrangements. Evidence: The registered manager has been working at the service for eight years and has NVQ Four in Management and has now completed the Registered Managers Award. The manager was not present on the day of the field work visit. We could however, see from the AQAA, the improvements the manager has made since the last inspection visit. Staff we spoke with said they had a good relationship with the manager and comments included I get on well with her, she is very approachable and We have a good rapport and will come up with solutions together. Staff said they felt confident to discuss any issues with the manager and look at ways of providing a constantly evolving and improving service. Quality assurance systems are in place and these include questionnaires for service users , their families relatives and other relevant stakeholders such as social workers and health care professionals. The AQAA records that all polices and procedures have been recently updated. This means that staff are working to current care practices and service users benefit from this. Health and safety arrangements were good and staff confirmed they were involved in checking heath and safety arrangements such as testing the fire alarm weekly. 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 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 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 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. - 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. 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