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Inspection on 22/10/08 for Helmsley Road Short Break Service

Also see our care home review for Helmsley Road Short Break Service for more information

This inspection was carried out on 22nd October 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Helmsley Road Short Break Service 27-33 Helmsley Road Rainworth Nottinghamshire NG21 0DQ 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 OLoughlin Date: 2 2 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to:  Put the people who use social care first  Improve services and stamp out bad practice  Be an expert voice on social care  Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 31 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Helmsley Road Short Break Service 27-33 Helmsley Road Rainworth Nottinghamshire NG21 0DQ 01623476939 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) : sarah.robinson@nottscc.gov.uk Nottinghamshire County Council care home 12 Number of places (if applicable): Under 65 Over 65 12 0 learning disability Additional conditions: That two named existing long-term service users may remain at the home Date of last inspection A bit about the care home There are 4 bungalows at Helmsley Road that provide single rooms for people who have a learning disability. The service is part of Nottinghamshire County Councils short-breaks provision. Located in the village of Rainworth, Helmsley Road is close to shops, pubs, post office and a garden centre - all within a mile distance. The last key inspection was done on 21/06/2007 and the report is made available for people within the Care Homes for Adults (18-65 years) Page 4 of 31 main offices at the service. Fees: The fee level is on an individual basis following assessment by a Social Worker. Care Homes for Adults (18-65 years) Page 5 of 31 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 Care Homes for Adults (18-65 years) Page 6 of 31 How we did our inspection: This is what the inspector did when they were at the care home We looked at information that the manager sent us. We looked at the care plans of 3 people having a short break. The manager sent us their Annual Quality Assurance document (AQAA) and information within the document was used to plan what areas we looked at. We spoke to relatives. Care Homes for Adults (18-65 years) Page 7 of 31 We spoke to staff. We looked at how you are supported if you are ill. What the care home does well Care Homes for Adults (18-65 years) Page 8 of 31 You decide how you want to spend your holiday and what activities you want to take part in. You can go out with staff every day. There is transport. Care Homes for Adults (18-65 years) Page 9 of 31 The food is good and there are choices. You have your own room. The staff team will understand how you want your support to be provided. Care Homes for Adults (18-65 years) Page 10 of 31 What has got better from the last inspection Staff always ask people about their experiences to make sure they can improve and give them a good short break. Care Homes for Adults (18-65 years) Page 11 of 31 What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Mary OLoughlin 01223 771397 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 12 of 31 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 13 of 31 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 . An efficient assessment and consultation process makes sure that people have their needs met. Evidence: Information received in the AQAA document shows that the manager has continued to improve the efficiency of the admission process by meeting with managers of the 3 other Council owned units that offer short breaks around the county of Nottingham, to discuss all referrals for short breaks, this allows more choice for people wanting a short break. We saw how staff have a record of the diverse needs of each person, which is used to determine which unit would offer the most suitable place for people to spend their short break. Staff team leaders spoken with had a clear knowledge of how the process of admission is undertaken and shows that they are fully involved before people come to stay at the home to make sure they can plan for the individual persons needs and expectations. Care Homes for Adults (18-65 years) Page 14 of 31 Evidence: We were told by staff that they go to great lengths to make sure people are happy and feel ready to come and stay, they offer tea visits and meet with the persons regular carer to get as much information as possible before the person comes to stay. Information about Helmsley Road is provided in suitable formats for people with communication difficulties. Care Homes for Adults (18-65 years) Page 15 of 31 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 . People using the service have an individual care plan that informs staff of how to maintain their safety and wellbeing and consider their individual aspirations. Evidence: We looked at 3 care files and saw that staff had used the information from professional assessments to develop a plan of care and activities for people during their stay. The plans described any risks to the persons safety and gave clear guidance to staff on how they were to support people during their stay. The full process of arranging a short break at Helmsley Road is based on seeking the views of each person and their carers to make sure the short break is tailored to the aspirations of each person. We saw how staff supported people to maintain their usual routines and independence. The key worker team completes reviews of each care plan regularly. Care Homes for Adults (18-65 years) Page 16 of 31 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People decide how they wish to spend their holidays and are offered a full and creative programme of events that suits their individual needs and aspirations. Evidence: We saw from the way people are consulted and the way their holidays were planned that the service is led by the people using it. Records of each persons daily activities are completed and these are kept by the person and their usual carer, at the end of their holiday to show what they took part in. There was plenty of evidence seen within daily records and photographs of places and people that shows the service continues to provide a wide and varied activity programme that suits the preferences of people who come for a holiday. Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: We saw how staff spent a lot of time considering the events each week and linking them to each persons personal preferences. Staff complete risk assessments and they were seen to follow safe practice when risks were identified during a trip out for one person. We know from the information within the AQAA that the service plans continued improvement and shows a can do attitude to providing as many varied and exciting opportunities for people as possible. The key team system allows people to always know the staff who are caring for them and who understand their style of communication. Staff consider the wishes of each person from talking to them and their carers at length, if they want a restful holiday where they lay in bed a little later, because they usually have to get up early, then that is what the service provides. People tell us that the food provided is good and varied. We saw how the service has recently been awarded 5 stars from the Environmental Health Department for the food hygiene practices within the service. Care Homes for Adults (18-65 years) Page 18 of 31 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People coming for a holiday are supported according to their wishes and have good access to a range of health care staff to manage any health issues that may arise, but the management of medicines is not sufficiently robust to fully protect them. Evidence: From the 3 care files we examined it was clear that staff take time to get to know the personal preferences of each person before they come to stay and as people can come for a holiday on a regular basis they always ring people to find out if there have been any changes since their last holiday. Care plans are written by the key worker team that supports the person who is coming to stay, they are written clearly to help staff to know how each person wants to receive their personal support. As there are National Health Service trained Nurses available on site 5 days each week, people have their health problems monitored by them and the nurses complete health care support plans to assist care staff in providing safe care and treatment where necessary. Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: Any general health matters are referred to the local medical practitioners as needed. We looked at how medicines were managed and found that they are held securely within each bungalow. Staff told us that they are trained to administer medicines safely. We saw that medication records are completed safely and there was good recording of medicines coming into the home, which allows staff to be able to audit medicines regularly to make sure people, are receiving the medicines as required. The manager told us in the AQAA that she has started to review staff competence annually to make sure they are up to date with safe administration of medicines. We have received 2 notifications of medicine errors since the last inspection and the information tells us that the service investigates all incidents and implements improved safety measures to prevent similar incidents happening. Some potent medicines were held in compliance with controlled medicine laws and we saw how staff complete a register of this type of medicine, which reduces the risk of errors and any misuse. However one medicine had not been accurately recorded into the register and staff had not signed the entries either which shows the system is not sufficiently robust or checked adequately. We also found that staff were not fully aware of the different schedules of controlled medicines and the required safe custody needs. Care Homes for Adults (18-65 years) Page 20 of 31 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 are listened to and taken seriously and staff are trained in how to protect them from abuse. Evidence: The complaints procedure is displayed throughout the bungalows, and is a sign and symbols format as well as the written word. The complaints procedure also forms part of the welcome pack, and relatives also have access to the procedure. Staff records tell us that they have received training in safeguarding adults, that they have either learned as part of the Learning Disability Award Framework (LDAF) training, or have taken part in specific safeguarding adults training. This training is aimed at raising staff awareness of abuse, and through raising the issues, offering people greater protection against abusive practice. Relatives told us that when they have concerns or complaints they are listened to and staff make sure issues are properly assessed and suitable action taken. The AQAA tells us that after people have had their holiday staff contact peoples regular carers to ask about their satisfaction with the service provided, this information is recorded and used to inform changes. The commission have not received any complaints or safeguarding alerts about the service since the last inspection. Care Homes for Adults (18-65 years) Page 21 of 31 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 environment is domestic in scale and provides suitable and safe facilities for people. Evidence: There are 4 bungalows, which are domestic in scale, and each provides a clean and homely environment for people who come for a holiday. There are suitable facilities for people with physical disabilities to move around safely and have access to assisted bathing. The Bungalows are set away from the main road and provide a quiet setting with views over open countryside. The bungalows were clean and well maintained. The AQAA tells us that there is a suitable infection control policy in place that staff have access to and some staff are trained in infection control procedures to protect people from any spread of infection. The call bell system was found to be faulty but staff told us that these were awaiting repair. Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: Some of the double glazed windows were in need of repair as they were drafty and the glass obscured though age. Care Homes for Adults (18-65 years) Page 23 of 31 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 . People are supported by a well trained staff team that are familiar to them and understand their needs. Evidence: Information we have about the service tells us that the current staff group, male and female are of various ages and are suitably trained to undertake their role. There has been a low turnover of staff over the last 12 months and more staff recruited to reduce the numbers of agency or temporary staff used, providing a more consistent and knowledgeable team. Staff spoken to were all happy in their role and motivated to provide a quality holiday break for people. We saw from staff files that the service continues to place a high level of importance on employing people safely and robustly, making sure they had suitable police checks and references before they started work which protects people from those that may be unsuitable to work with them. The service continues to provide new staff with a suitable induction and enrols them on to National Vocational training in the specific needs of people with a learning disability. Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: Records show that staff are always supervised and take part in regular meetings. We have not received any concerns about the numbers of staff at the service and from observation during the inspection there were plenty of staff available to support people with activities and personal support. Care Homes for Adults (18-65 years) Page 25 of 31 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 service is managed well and there is continuous assessment and improvement taking place to make sure people receive a positive experience when having their holiday. Evidence: The manager is registered with the commission and has completed her registered managers award. Information we received within the AQAA told us that she works continuously to improve the service and that she places a high value on making sure staff are suitably recruited and trained in their role. Our inspection found that there is a clear focus on making sure that people receive a holiday that they want and enjoy whilst keeping them safe through robust risk assessments before they come to stay. There have been no reported accidents since the last inspection showing that risks are managed well. Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: The service has a consistent record of meeting health and safety requirements and we found that the staff team continue to receive training in First Aid, Moving and Handling and Fire prevention. Care Homes for Adults (18-65 years) Page 27 of 31 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 28 of 31 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action 1 20 13 Accurate records of 30/11/2008 medicines coming into the home must be held in accordance with safe custody requirements. To provide a suitable audit trail of these potent medicines. 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 20 Provide clear guidance to staff on the storage and recording requirements for the different schedules of controlled medicines. Look at more robust practices of auditing how staff actually manage medicines in the service using the up to date guidance on how medicines should be managed in care homes. Consider the maintenance of the double glazed windows to 2 20 3 24 Care Homes for Adults (18-65 years) Page 29 of 31 ensure they are draft proof. 4 30 Increase the number of staff that are trained in infection control and audit the home using the Department of Health’s Essential Steps to Infection Control guidance. Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web:www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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