Inspection on 20/01/09 for Foxglove Care

This inspection was carried out on 20th January 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

Pennine Camphill

Muston Road (70)

Grayling

The Cornerstone

John Street Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Foxglove Care 82 Willowdale Sutton Park Hull East Yorkshire HU7 6DW     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: Christina Bettison     Date: 2 0 0 1 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 29 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 29 Information about the care home Name of care home: Address: Foxglove Care 82 Willowdale Sutton Park Hull East Yorkshire HU7 6DW 01482826937 01482826937 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Foxglove Care Ltd Name of registered manager (if applicable) Johanna Leigh-Thompson Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 2 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 category: Learning Disability, Code LD manximum number of places 2 Date of last inspection Brief description of the care home The service at 82 Willowdale is owned and managed by Foxglove care. It is one of a small number of similar services that Foxglove care provides. 82 Willowdale is registered to provide care and accommodation for two adults with a learning disability. The home is on Sutton Park in Hull. 82 Willowdale is a house with three bedrooms. There is a sitting room, dining room kitchen, two bedrooms and the third small bedroom has been utilised as an office. There is a small garden to the front and rear. Care Homes for Adults (18-65 years) Page 4 of 29 care home 2 Over 65 0 2 Brief description of the care home There are shops, public houses, a medical centre and a post office all within walking distance. Public transport to various parts of the city is easily accessible. Care Homes for Adults (18-65 years) Page 5 of 29 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 stars. This means that the people who use the service experiences good quality outcomes. This visit was announced the day before by telephone to ensure that the people and staff would be at home on the day of the visit and took place over 5 hours on 20th January 2009. This home was last inspected on 30th November 2006 and an annual service review was completed on 20th December 2007. During the visit we observed how staff interacted with the people who live in the home Care Homes for Adults (18-65 years) Page 6 of 29 to find out what it was like for them living at this service. We spoke to the managers and staff members on duty on the day of the visit, we also met the people who live there. We received a survey back from a relative who did not make any negative comments about the home. We checked documents that related to peoples care and safety. These included care plans, daily records, risk assessments, staff supervision and training records. We looked at the environment and checked maintenance records to make sure the house was safe and well maintained for the people who live there. Before the site visit we also looked at a range of other information we had received about the service since the previous inspection. This was a key inspection and was carried out by Regulation Inspector Tina Bettison, we would like to thank the people who live at the service and the staff for their co operation during our visit. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the care home does well: What has improved since the last inspection? What they could do better: Service user plans need to be further developed to ensure that they cover all of peoples needs, care files need to be tidy and easy to follow so that new staff are helped to know what peoples needs are and are able to meet them. Plans for the management of peoples difficult behaviours need to be more detailed and specific. Care reviews need to be held every six months to ensure that peoples changing needs continue to be met. Care Homes for Adults (18-65 years) Page 8 of 29 Health action plans need to be further developed to incorporate health screening and to make sure that all of peoples health needs are identified and met. Records need to evidence outcomes for people so that peoples health needs are met and they are safe from the risk of harm. PRN protocols need to be developed for medication adminstered on an as and when basis so that staff understand what medication is to be given, when it is to be given, how much and how often so that people are kept safe from the risk of harm. Staff need to be assessed as competent to administer medication. 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 9 of 29 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 29 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. Peoples needs are fully assessed meaning that staff know what their needs are and are able to meet them. Evidence: This service has been recently registered with the CSCI to provide a two bedroomed home for two people that share the house. The people who live at this home have recently moved from another property within the city of Hull. That property was a rented property and the providers (foxglove care) were not satisfied with the landlords attention to maintenance issues. This house is owned and managed by Foxglove care. Assessments were seen on both care files that clearly outlined the peoples needs and the transition was sensitively handled by the managers and staff to ensure that the people were helped to settle in to their new home. Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: Both people appeared calm, relaxed and settled in their new home. Care Homes for Adults (18-65 years) Page 12 of 29 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. Peoples needs are met on a 1 to 1 basis by a stable and consistent staff team however more detailed plans need to be prepared to guide new staff in how to meet peoples complex needs. Evidence: Two care files were examined as part of this inspection. For each person there were several files containing a variety of information, they were very untidy and some of the information was duplicated. There were some support plans that were detailed i.e favoured routines and personal care, but there were gaps for areas such as medication, finance, culture and faith needs and family contact. Communication passports appeared to duplicate information found elsewhere in the Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: plans and did not adequately detail the peoples preferred communication methods. For example we were told that one person uses his own made up signs for things that are important to him. None of these signs were detailed in the communication plan so new staff working with him would have difficulty communicating with him. However the home does benefit from a stable and consistent staff team that know the people well and staff are provided on a 1;1 basis, meaning that peoples needs are well understood and met. Some attention was being given to enabling people to maintain their independence skills and develop new skills. The files contained a range of risk assessments to cover all areas that may pose a risk to the person and /or staff. For one person they had been reviewed by the placing Local authority in June 2007 and January 2008 and there were no concerns raised and the placement remained stable. The other person had been reviewed by the placing local authority in January 2008. The provider was advised that peoples care and support needs must be reviewed every 6 months. The manager was advised that care files must be tidied up and care plans must incorporate the full range of peoples needs and be developed in a more person centred way. A survey was returned by the placing local authority for both people, they did not raise any concerns and indicated that they were satisfied with the placement. Both people that live in the home can on occasions display some behaviours that may pose a risk to themselves or others. There were behaviour management plans in place however they were not very detailed and need further development so that staff understand what strategies are to be used on such occasions. Records indicated that the staff had been provided with training in how to manage difficult behaviours. Care Homes for Adults (18-65 years) Page 14 of 29 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. People are able to continue their personal development and access to the community for a wide range of leisure pursuits and holidays. People enjoy a healthy diet that respects their choices. Evidence: The people that live in the home enjoy an active social life which is detailed in their individual care files, such as bowling, shopping, attendance at the walking club run by the local Mencap group, pub meals and visits with family. One person goes to stay with his mum on some weekends and the other person has regular visits from his sister. The manager and staff promote a healthy eating menu but try to balance this with the persons likes/dislikes and special treats on occasions. Likes and Dislikes are clearly documented in the care file and agreed to by the people living in the home. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: One person was observed choosing what he would like to have for his lunch on the day of the visit and his choices were respected. The survey received from the placing local authority told us; the residents have the opportunity to engage in a full range of activities both individual and as a group (two residents only). The two residents have full use of a motability vehicle Staff told us that relationships with the next door neighbours was very good. Staff said they never receive any complaints from the neighbours. Care Homes for Adults (18-65 years) Page 16 of 29 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. Peoples basic health needs are met and medication is well managed however further development of health plans will ensure that all of peoples health needs are identified and met and people are kept safe from the risk of harm. Evidence: Two care files were examined as part of the inspection process which evidenced that in general peoples healthcare needs are met. Records evidenced that appointments had been attended with dentist, chiropody, psychology, psychiatry, GP and the community nurse, however the records did not identify the outcomes for people following these appointments. No health screening had been completed by the community nurse and this needs to be addressed to ensure that peoples full range of health needs are identified and met and that any new staff are helped to know what peoples health needs are. The health action plans and associated records although adequately identified the Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: persons health needs and how these would be met the records were untidy and difficult to track within the care file. Neither of the people that live at the home self-medicate. There are written policies and procedures in place for staff to adhere to regarding administration of medication and medication records were examined as part of the inspection and found to be in good order. Staff had received training but now need to be assessed as competent to administer medication. Protocols need to be developed for the administration of medication PRN (as and when required) so that staff are able to safely identify when people can be given this medication, in what circumstances and how often. Care Homes for Adults (18-65 years) Page 18 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff team are aware of the Protection of Vulnerable Adults policies and procedures and their responsibility within these, this means that people are fully protected from the risk of abuse, neglect and harm. Evidence: There had been no complaints either to the home or to CSCI since its registration. Foxglove care has good recruitment processes in place and all staff personnel files were examined and all documentation including satisfactory CRB checks were in place for the staff team. All staff have now completed training in the Protection Of Vulnerable Adults Policies and Procedures, this means that the people are better protected from abuse, neglect and harm. There has been one safeguarding referral made to the Local authority which was appropriate and is awaiting a strategy meeting to be arranged. Care Homes for Adults (18-65 years) Page 19 of 29 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 live in a safe, attractive and homely place that is individual to them and that meets all of their needs. Evidence: The service at 82 Willowdale is owned and managed by Foxglove care. It is registered to provide care and accommodation for two adults with a learning disability. The home is on Sutton Park. 82 Willowdale is a house with three bedrooms. There is a sitting room, dining room kitchen, upstairs there are two bedrooms, bathroom and the third small bedroom is used as an office. There is a small garden to the front and rear. There are shops, public houses, a medical centre and a post office all within walking distance. Public transport to various parts of the city is easily accessible. The home is well decorated and maintained, all maintenance certificates were seen and were up to date which means that the home is safe and provides a very individual home for the people who live there. Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: We were told that staff use a mattress which is stored upright in the dining room as a make shift sleeping in facility, we discussed this with the manager who agreed that it was an unsatisfactory arrangement and we advised that a single bed be put into the small bedroom (used as an office ) to give staff appropriate, comfortable and safe facilities for sleeping in. Care Homes for Adults (18-65 years) Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are met by a competent staff team that are aware of their complex needs and are able to meet them. Evidence: The people that live in the home are provided with 1 to 1 staff at all times. Throughout the inspection it was evident that the staff respected the people and were seen to be approachable and caring. The staff team is made up of 4 full time support workers and a team leader. Staff support people on a 1 to 1 basis during the day and there is a sleep in member of staff through the night. Foxglove care has good recruitment processes in place and all staff personnel files were examined and all documentation including satisfactory CRB checks were in place for the staff team. From examination of records and discussion with the manager and staff there was evidence of training and this was linked to the needs of the people e.g. epilepsy, use of Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: stesolid, basic food hygiene and first aid and all staff are now up to date with their mandatory training and have completed the medication and POVA training. All staff have received an annual appraisal and supervision is being provided on a regular basis, in addition to this regular staff meetings are held. Care Homes for Adults (18-65 years) Page 23 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager provides effective leadership; guidance and direction to staff to ensure that people receive consistent quality care promoting and safeguarding their health, safety and welfare. Evidence: The Registered Manager for 82 Willowdale is Johanna Thompson and the team leader responsible on a daily basis is Gary O Neal. The home is safe and comfortable for the people living there and provides a clean and homely environment. As part of the inspection all of the maintenance records were examined and those seen were in order. A member of staff spoken to told us that they loved their job and the company was good to work for and fair. They said the managers and directors were approachable Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: and responsive and were very supportive. A fire officer had visited the home and required that a smoke alarm be fitted to the upstairs and a fire extinguisher and fire blanket be purchased and fitted in the kitchen. Both of these had been actioned. Care Homes for Adults (18-65 years) Page 25 of 29 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 29 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 Behaviour support plans 31/03/2009 must be more detailed and describe the strategies to be used by staff at times of distress and/or anxiety, these must be agreed with the placing local authority so that all staff know and understand peoples needs and can meet them to keep people safe from the risk of harm 2 6 15 Service user plans must be developed that identify the full range of needs so that all staff know and understand peoples needs and are able to meet them 31/03/2009 3 19 13 Plans need to be developed that accurately describe all of peoples health needs and records kept to show outcomes for people 31/03/2009 Care Homes for Adults (18-65 years) Page 27 of 29 So that all of peoples health needs are met and people are kept safe from the risk of harm. 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 6 20 Peoples needs should be reviewed every six months to ensure that their changing needs continue to be met. Protocols should be developed for the administration of medication PRN (as and when required) so that staff are able to safely identify when people can be given this medication, in what circumstances and how often. Staff should be assessed as competent to administer medication. 3 20 Care Homes for Adults (18-65 years) Page 28 of 29 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 29 of 29 - 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. 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