Inspection on 15/12/08 for Consterdyne

This inspection was carried out on 15th December 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

Consterdyne 06/12/06

Consterdyne 03/02/06

Consterdyne 10/09/05

Consterdyne 11/03/05

Consterdyne 17/12/04

Consterdyne 25/02/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 20/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Consterdyne 6 Mason Road Kidderminster Worcestershire DY11 6AF     The quality rating for this care home is:   three star excellent 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: Martin George     Date: 1 5 1 2 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. 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 28 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.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Consterdyne 6 Mason Road Kidderminster Worcestershire DY11 6AF 0156269525 01562748693 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) : Worcestershire County Council Home Care Services care home 10 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 10 The maximum number of service users who can be accommodated is: 10 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 (LD) 10 Date of last inspection Brief description of the care home Consterdyne is a large, detached, Victorian building situated in a mainly residential area near to the ring road, approximately one mile from Kidderminster town centre. The building stands in its own grounds and is accessed by a private drive. The home is owned and operated by Worcestershire County Council and managed on a day-to-day basis by a competent and experienced manager, Mrs Linda Harradine. The home provides long-term care for 10 adults, both men and women, who have a learning disability and some degree of physical disability. The main aim of Consterdyne is to provide a safe and comfortable home that, as far as possible, is a home for life, with staff endeavouring to meet the social, emotional, communication and health needs of all the people living there. An outreach service for people with learning disabilities Care Homes for Adults (18-65 years) Page 4 of 28 Brief description of the care home operates from an office adjoining the home. The office has its own separate access. The home and the outreach service have their own separate staff groups, although the outreach service is line managed by the manager of the home. The current fee for the service ranges from £65.20 to £102.90 per week. Charges which are additional to the fee include personal toiletries, clothing, electrical items such as TV and music centre, holidays, major extra outings and hairdressing. Care Homes for Adults (18-65 years) Page 5 of 28 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 peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced key inspection was carried out by a single inspector between 09:45 and 16:00. As part of the inspection all National Minimum Standards defined as key by the Commission for Social Care Inspection (CSCI) were considered. Information about the performance of the home was sought and collated in a number of ways. Prior to inspection we were provided with written information and data about the home through their annual quality assurance assessment (AQAA). Information from the last key inspection report and other information submitted to CSCI prior to inspection were analysed to formulate a plan for the visit and to help us in determining a judgement about the quality of care provided by the home. Care Homes for Adults (18-65 years) Page 6 of 28 On the day of the inspection we spoke to the manager, deputy manager, staff and people living at the home. We also undertook a tour of the premises and observed practice, which provided evidence in support of the records we also checked on the day. This approach allowed us to assess how well outcomes were being met for those receiving a service. 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 8 of 28 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 9 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The commitment to undertaking thorough pre-admission assessments ensures people living at the home are provided with safe care from the day of their arrival. Evidence: The home is committed to ensuring that people who may be suitable to live at the home have their needs fully assessed and are encouraged to visit before admission to help them understand what the home offers. The pre-admission assessment process is thorough and involves liaising with other professionals to help the home provide as safe a service as possible from the point of admission and develop a care plan that describes how outcomes will be met. The Annual Quality Assurance Assessment (AQAA), which is a self assessment document completed by the home each year, states that a referral and assessment form is required as part of the application process for a place at the home. Information about what the home offers is provided through a statement of purpose and welcome guide. The statement of purpose is in need of updating so that it includes Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: information about recent improvements made by the home. Information available for those living at the home is provided in formats that are suited to their needs. There is good use of pictures, symbols and photographs to help individuals understand information they need to know. People living at the home have a comprehensive agreement, detailing how the home will care for them. Care Homes for Adults (18-65 years) Page 11 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home can openly express their preferences and choose what to do with the support and encouragement of the staff. Evidence: People living at the home are encouraged and supported to take as much control of their own lives as they are capable of. Any risks arising from this are recognised, assessed and carefully managed, which is evidence of how the home adopts a can do approach with the people they care for. Throughout the day we saw staff supporting, motivating and praising people as they undertook everyday tasks, such as mopping the kitchen floor, laying the lunch table and hoovering the dining room carpet. The care plans looked at are very person centred, meaning that they involve the person concerned and focus on that persons strengths and preferences. The plans are based on the comprehensive pre-admission assessment and show how the home will try to meet outcomes. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: Communication preferences of people living at the home are known about by staff and this allows people to contribute as fully as their capabilities allow. The care plans are used very much as a working tool and recent development of the care planning file will improve this aspect of the service even more. The AQAA states that the new development will lead to each individual having two files. One file will primarily focus on physical healthcare needs, while the second file will contain more general information about the individual. The home is in the process of changing everyones files onto this new system. Vulnerabilities and risk linked to individuals are known about and assessed thoroughly. One member of staff is given lead responsibility with regard to risk assessments and a discussion with her showed a good understanding of how effective risk assessments can help outcomes to be achieved. Care Homes for Adults (18-65 years) Page 13 of 28 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 day to day life of the home revolves around the needs and preferences of those living there as much as possible. Evidence: A discussion with the activities organiser provided evidence of a good range of stimulating activities. People are brought in to run aromatherapy and music sessions and records we examined showed when these activities took place and who attended. It is a shame that records for activities arranged by staff at the home are not as fully completed as this would help to show how activity related outcomes for people living at the home are met. There is however a very good photgraphic record of activities and outings that have happened. It would be good to have these photographs dated so it is clear when the activities and outings took place. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: The Annual Quality Assurance Assessment states that people attend day centres and colleges suited to their needs and abilities and this was supported by our observations on the day of the visit. Families are always invited to parties and other kinds of activities. We were told that families generally come to significant parties, such as 60th birthdays. Discussions with staff satisfied us that links with the local community are quite good. The shops and other facilities near to the home are responsive to the particular needs of the people living at the home. People living at the home help with menu planning and dependent on ability and willingness contribute to food preparation. We saw charts showing what has actually been eaten, but not all of them are being completed consistently. This is a shortfall because this is a way of showing the nutritional value of what each person has eaten. Discussion with staff on duty showed a good level of understanding about the dietary and feeding needs of people living at the home. People are encouraged and supported to carry out simple everyday tasks. During our visit we observed tasks such as washing up, laying and clearing tables and hoovering being carried out by people living at the home. Care Homes for Adults (18-65 years) Page 15 of 28 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. People living at the home are supported by well informed and committed staff. Healthcare is well managed and personal support is responsive to peoples needs and capabilities. Evidence: The home is in the process of introducing a new care planning system, which has two seperate files. One is for personal care and the other is for health care (which it is felt is likely to change more frequently). Within both files any information that relates to the REACH standards (which define expected standards for disability and supported living) are identified with a red dot. Both files are very well indexed and structured providing staff with easy access to information that will help them provide consistent and effective care to the people living at the home. Not all of the files have yet been transferred to the new two file system but work toward this is well advanced. Records show that there are very good professional relationships with external healthcare services. All visits are documented with outcomes from those visits clearly recorded. Observation on the day of the visit showed staff being very responsive to Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: each persons particular needs. Medication records and practice are very good and the way they were explained to us showed a high level of awareness of how important this aspect of care is. Medication Administration Records and the medication system are being used effectively and this means that people living at the home are protected from potential errors. Controlled drugs (CDs) have not been required for over a year but a CD register is kept in case there is need to administer them in the future. Medication storage arrangements and processes for disposal meet requirements. Care Homes for Adults (18-65 years) Page 17 of 28 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 living at the home are protected by a staff team who are knowledgeable about adult protection. People know how to express any disatisfaction they may have about the home. Evidence: There have been no complaints made since the last inspection but while this may be an accurate reflection of levels of satisfaction it would be good to see the home recording all concerns, however insignificant they may appear, to show how they respond. This will provide evidence of how the home listens to people using the service and how they seek to improve what they do. Information regarding complaints is provided in formats that are suited to the needs of people living at the home. Two people we spoke to indicated that they knew about how to complain if they needed to. Knowledge of safeguarding is good and practice we observed during our visit confirmed this. Staff have attended all necessary safeguarding and adult protection to ensure they are competent to protect people from preventable harm. The home has a copy of Worcestershires adult protection procedures and the Department of Health No secrets document, both of which inform the homes own adult protection procedures. To further safeguard people from preventable harm there are risk assessments in place in relation to use of equipment. Staff are also expected to attend training to help them manage aggressive behaviour effectively. Care Homes for Adults (18-65 years) Page 18 of 28 Care Homes for Adults (18-65 years) Page 19 of 28 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. People living at the home are encouraged to be as independent as possible and the environment supports this ethos. Health and safety issues are managed well by staff to ensure people are kept safe as they develop their independence skills. Evidence: The interior of the home is a pleasant environment, reasonably well maintained. The home is well lit throughout and is kept at a comfortable temperature. Bathrooms and toilets have been upgraded to make them particularly user friendly for the people who live there. Some of the bedrooms have en-suite facilities and there is one shared room, which can be screened to ensure privacy and dignity are maintained for the people using it. The back garden is very unkempt, which is a shame given that some rooms look out onto it. The front garden too is a little shabby and uninteresting, although it is possible that recent bad weather may be a contributory factor. We would like to see some attention given to the garden areas so that people living at the home have a pleasant outdoor area to relax in when the weather allows. There is a good awareness of infection control and cross contamination risks and there Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: is a very useful guide for staff on ways to reduce risks. The laundry facilities are suitable for the number of people and there are sufficient sluicing facilities. The kitchen is open access and people living at the home who are capable of doing so use the area frequently, either to assist staff or prepare things independently. Staff are aware that the responsibility to maintain required health and safety standards in the laundry and kitchen rests with them. To eliminate potential risks of cross contamination with regard to food storage there needs to be vigilant monitoring of fridges as people living at the home do not always understand which shelf to use. Fly screens are in place to reduce the risk of cross contamination. Hygiene and temperature records are all up to date. Care Homes for Adults (18-65 years) Page 21 of 28 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. People living at the home are cared for by a competent, well trained and well supported staff team. Evidence: People living at the home are cared for by a team that receive a comprehensive range of training that equips them to meet their complex needs. Supervision of staff occurs within expected timescales so that managers can monitor the performance of individual staff to ensure their practice continues to meet the needs of those living at the home. Nearly all staff have provided evidence of competent practice through the achievement of a suitable qualification. Every member of staff also has an annual appraisal, which reviews their performance over the past year and sets targets for the forthcoming year, ensuring that people continue to be looked after by competent carers. Staff files are kept in good order and all necessary recruitment information is acquired and necessary checks carried out. This provides evidence that staff who are recruited are being properly vetted before allowing them to hold caring positions with vulnerable adults. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: There is a culture of delegation at the home which means staff are comfortable and confident about taking on their professional responsibility and accountability. This was evident by how easily information I requested was found, no matter who I asked. Staff I spoke to were also able to explain how administration systems worked, without referring me to managers. This level of awareness and confidence was also evidenced by our observation of staff interaction with people living at the home. Staff meeting minutes contained very useful information, which guided staff in how best to meet the needs of people. Generally we found the minutes were outcomes focussed showing how the home is trying to improve life chances for people. Rotas we looked at showed that there is a satisfactory level of staff cover throughout the 24 hour period. The Annual Quality Assurance Assessment states that relief staff are used to cover holidays and sickness of permanent staff. Care Homes for Adults (18-65 years) Page 23 of 28 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. A competent management leads a committed staff team that are skilled at encouraging and supporting people to be as independent as their capabilities allow. Evidence: The manager is very committed to developing the service and works hard to ensure her staff team are competent to carry out their roles effectively, so as to provide the people living at the home with the best possible standard of care. Both the manager and the deputy manager have achieved the Registered Manager and NVQ 4 awards. During the day our observations satisfied us that delegation skills were used very effectively, giving staff the confidence and responsibility they need to meet peoples needs. The Annual Quality Assurance Assessment completed prior to the inspection states that the manager monitors the budget to ensure the home provides good value for money. It also states that all financial records are updated and audited regularly to protect people living at the home from financial irregularities. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: Regulation 26 visits, which are part of the quality assurance process, are carried out by other Worcestershire County Council managers on a rota basis. Although we were told that all required visits have taken place the most recent report available to see was for April 2008. The quality of the reports we did see were good and dealt with issues that have a direct impact on the well being of people living at the home. Fire records are very comprehensive and are kept up to date by one of the seniors. Care of Substances Hazardous to Health (COSHH) records could not be found but we were given a categoric assurance that there is a COSHH file and that it is kept up to date. This is especially important in a home where independence skills are promoted and the risks of improper use of substances is increased. Records seen and discussions throughout the day satisfied us that the manager is effective in monitoring the health and safety procedures and practice in the home. Care Homes for Adults (18-65 years) Page 25 of 28 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 26 of 28 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 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!