Inspection on 29/04/09 for CHAD Limited

This inspection was carried out on 29th April 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

CHAD Limited 10/05/07

CHAD Limited 05/06/06

CHAD Limited 01/12/05

Extracts from inspection reports are licensed from CQC, this page was updated on 06/08/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: CHAD Limited Cordingley House 22 Linden Terrace Whitley Bay Tyne & Wear NE26 2AA     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: Mary Blake     Date: 2 9 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.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: CHAD Limited 22 Linden Terrace Cordingley House Whitley Bay Tyne & Wear NE26 2AA 01912893621 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : michelle@chadhomes.co.uk Care Homes for Adults with Disabilities Limited care home 4 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 4 The maximum number of service users who can be accommodated is: 4 The registered person may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD, maximum number of places 4 Date of last inspection Brief description of the care home CHAD Limited is located at Cordingley House in Whitley Bay close to the town centre and seafront. The home is an Edwardian terraced house close to local amenities such as a library, swimming pool, shops and local transport. The home has two large rooms for lounging and activities and a large kitchenette used for dining and activities. There are four bedrooms, two bathrooms with showers and toilets and a separate toilet. The home can provide accommodation for four people with a learning disability. CHAD Limited cannot provide nursing care. The range of fees charged is agreed with the local authority and are dependent on individual needs. Information about the home is readily available to interested people. Care Homes for Adults (18-65 years) Page 4 of 26 Care Homes for Adults (18-65 years) Page 5 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: The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. An unannounced visit was made on the 30th April 2009. The Pharmacy inspector will visit during May 2009. The Provider and manager was present throughout the inspection. Before the visit we looked at information we have received since the last inspection in April 2007, how the service dealt with any complaints and concerns, any changes to how the home is run, the providers view of how well they care for people, the views of people who use the service and their relatives, staff and other professionals, including Care Homes for Adults (18-65 years) Page 6 of 26 surveys, the Annual Quality Assurance Assessment (AQAA), which is a self assessment document, was sent to the home for their completion, was completed well and returned to CQC. Have your say questionnaires were sent out to people who have used or had interest in the home, eight of which were returned to us. During the visits we talked with people who use the service, staff and the provider, looked at information about the people who use the service and how well their needs are met, looked at other records which must be kept, checked that staff had the knowledge, skills and training to meet the needs of the people they care for, looked around the building/parts of the building to make sure it was clean, safe and comfortable, checked what improvements had been made since the last visit A CQC Pharmacist will be making an inspection of the service in May. We told the provider what we found. What the care home does well: What has improved since the last inspection? What they could do better: The service user plans could be developed to provide a holistic person centred plan to reflect the holistic care that is provided. A review and update of risk assessments would provide current guidance and support to staff when working with service users. Care Homes for Adults (18-65 years) Page 8 of 26 A review of the restraint procedure to include record keeping, management overview and staff debriefing would provide additional staff support and guidance to manage and support service users. A review of accident recording and management overview could help to develop accident prevention for service users. 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 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 10 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. Admissions to the home are appropriately managed and people who use the service know how their needs will be met. Evidence: There have been no new admissions. The home has a detailed pre-admission process involving multi agencies, service user and their families Care Homes for Adults (18-65 years) Page 11 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 system of care planning adopted by the home was person centred but did not reflect the holistic care provided. People who use the service are fully consulted and enabled to participate in decisions about their lives. The arrangements in place for assessing the risks posed to people as they lived their daily lives were not adequate. Evidence: The current service user plans are problem based rather than holistic and goal centred and did not reflect the quality of the holistic care provided. The quality of the information was consistent. The manager had ensured that all recorded information was reviewed and summarised on a monthly basis. Risk assessments were in place but had not been consistently reviewed and updated. Staff were observed interacting well with service users and offering them choices. Staff had a good knowledge of individual needs and choices commenting, we meet Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: individual needs of service users, service users are given choices wherever possible/appropriate. Health professional commented, the service supports the needs of the individual including health, activity, education, social links, family, multi professional working. Care Homes for Adults (18-65 years) Page 13 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 opportunities for people to develop and maintain social, emotional, communication and independent living skills, were good, this meant that people have positive opportunities to enjoy a full and stimulating lifestyle. People living at the home are provided with a good healthy diet. Evidence: People who use the service are offered the opportunity to join in an extensive range of social and leisure activities. They have the opportunity to use community facilities for leisure activities e.g. sport, pub, meals On the day of inspection service users had been to college, shopping and walking. Staff commented, support and money is always available to do things. Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: People who use the service are offered the opportunity to experience a wide range of activities and leisure pursuits as well as supported where necessary to continue with hobbies and interests. Staff assist and encourage people to maintain family links as agreed and previous friendships, respecting the individual wishes of people who use the service. Staff commented, There are regular and varied holidays or short breaks service users families are encouraged to play a full and active part in their lives Chad keeps good relationships with service users families People who use the service were observed having a leisurely breakfast, coffee and lunch in a relaxed and social setting with good staff support evident. Cultural needs are supported with planning of menus and purchasing of food. Care Homes for Adults (18-65 years) Page 15 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. The people who use the service receive personal support the way they prefer and their personal and health care needs are met. Evidence: People who use the service are given personal choice and support in areas such as getting up, personal care and how they spend their time. People who use the service individual health needs are identified and they are supported to access community health services such as doctor, district nurse, dentist and optician. They have access to psychiatry and psychology health support. Staff training has been undertaken to provide awareness and additional support for health related needs. No person who uses the service currently self medicate. There were no medication Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: issues but an additional pharmacy inspection will be undertaken in May to clarify prescribing. Staff receive training that helps them to make sure that everyone is treated with respect, and as an individual. Staff help people make their own decisions and provided information and assistance when it is needed. Staff were friendly toward the people who use the service and were engaging them in conversation. They have a good knowledge of the needs of the people living in the home. Staff commented, we work well as a team giving each other support, delivering the best care possible to our service users. Health professional commented, care is provided in line with multi-professional goal plans. Communication between care team is excellent. Care Homes for Adults (18-65 years) Page 17 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. People who use the service are able to express their concerns have access to an effective complaints procedure and have their safety and rights protected. Evidence: The complaints procedure provided staff with guidance about how to handle complaints. Neither the home, nor the Commission, had received any complaints since the last inspection. Staff commented,Chad has an open door policy regarding complaints and concerns. All are recorded as well as details of any investigation. There is also a list of external contacts. The safeguarding policy provided staff with guidance about how to handle adult protection concerns. There had been no concerns raised with either the home, or the Commission, since the last inspection. All staff had received or were about to have training in the protection of vulnerable adults. Staff confirmed that they had training in this area and gave clear statements on their understanding of protecting vulnerable people. Care Homes for Adults (18-65 years) Page 18 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 facilities meet the needs of the people who use the service and is homely, safe, well maintained and clean. Evidence: Previous requirements had been met. The home was well furnished and decorated with personalistion throughout. The home was very clean. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are adequate numbers of appropriately skilled and experienced staff to care for the people who use the service and the recruitment processes in place protect them. Evidence: Staffing records showed that there are enough staff on duty to meet the necessary staffing levels. There has been minimal staff turnover. Staff commented,I have worked here for three years with the same service users, which has enabled me to develop an understanding and knowledge of their needs Chad has retained most of the staff it employed when first opened which contributes to a consistent environment which I feel benefits its residents. Recruitment procedures within the home are safe. Records confirm that appropriate checks are carried out for all staff. The home has an induction programme and the manager is currently developing the training programme for all staff working in the home. Staff spoke knowledgeably about the individual needs of people who use the service. Staff had undertaken refreshers in mandatory training. Staff had completed National Vocational Qualification in Care level 2 (NVQ) or over, with all but one of the staff having NVQ level 3 and five staff having completed or are undertaking NVQ level 4 . Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: Staff commented,staff are encouraged and supported to undertake training and gain qualifications appropriate to their professional development train staff to excellent standard. Staff were observed interacting well with service users and managing behaviour as detailed within the service user plan. 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 management of the home is consistent and effective and offers leadership to the staff; this improves the life of the people living in the home and protects them from harm. Evidence: The home has a registered manager but a lot of the managerial responsibilities are met by the provider. It was agreed that a review of management be undertaken and consideration given to the management role of the provider. The providers and the manager provide a good management team. The providers quality assurance and audit systems are comprehensive Staff supervisions and staff meeting are held. Staff commented, I see management on a daily basis and can approach them for support at any time I have regular supervisions to discuss working practices as well as monthly staff meeting. Records, policies and procedures were established, clear, concise and appropriately recorded and stored. Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: Accidents are recorded but not within the data protection guidelines and did not have evidence of management review. Restraint records are in place but are not consistently completed or have management overview or evidence of debriefing. Fire and other system testing had been undertaken at the recommended timescales and systems established for maintenance to be undertaken when necessary. Care Homes for Adults (18-65 years) Page 23 of 26 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 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 1 6 15 To provide a service user plan that is holistic and person centred To provide a plan that accurately reflects the holistic care that is provided 27/08/2009 2 9 13 To update individual risk assessments To provide staff with updated risk assessments to protect service users 27/07/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 42 42 Review restraint procedure to ensure records completed, management overview recorded and staff debriefing held. Review accident record to meet data protection and provide record of management overview Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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