Inspection on 15/03/09 for Homestead

This inspection was carried out on 15th March 2009.

CSCI found this care home to be providing an Adequate 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

Homestead 11/03/07

Homestead 03/02/06

Homestead 25/10/05

Homestead 24/08/04

Homestead 16/04/04

Homestead 19/01/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2010.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Homestead 7 Bedford Road Yardley Hastings Northants NN7 1HJ     The quality rating for this care home is:   one star adequate 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: Ansuya Chudasama     Date: 1 5 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Homestead 7 Bedford Road Yardley Hastings Northants NN7 1HJ 01604696782 01933664333 postmaster@oakfieldjm.force9.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Oakfield (Easton Maudit) Limited care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Providing single bedroom accommodation for up to four residents aged between 18 and 65 years, Homestead is located in a small village near to Northampton and Wellingborough and offers personal care to four people with learning disabilities. Residents have the use of a people carrier vehicle making easy access to colleges, local community facilities and the day service provision at the sister home Oakfield in Easton Maudit. At the time of this inspection the weekly fee was #947. 4 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate 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 home has 1star rating and this means that the people using the service receive an adequate service. We inspected the home on the 15th of March 09 and spoke to the staff, and the deputy manager who came to assist with the inspection of the home. We were informed that the manager had resigned on the 23rd of February 09. We looked at information about some of the people in the home to find out how their needs are being met by the staff. This is called case tracking. We spoke to all of the people and watched how they got on with staff working in the home. Staff recruitment and training records are kept at the sister home. These were looked at when we recently undertook an inspection at the home. Care Homes for Adults (18-65 years) Page 5 of 26 This Inspection was undertaken at the weekend. This was so we could meet all the people and staff on duty. 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 26 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Needs assessments are carried out before people are admitted to the home to ensure their needs can be met by the home. Evidence: The Statement of Purpose and Service User Guide needed to be indivisualised to the home. The home has not had any new admissions since 2001. We were told that the home had carried out assessments for the people admitted to the home and they had also visited the home. These assessments were kept at the sister home. We were told that a new potential person was going to move into the home. The room the person was going to be admitted was being decorated. The deputy manager told us that the assessment procedures would be undertaken for this person. Care Homes for Adults (18-65 years) Page 9 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care planning documents are being updated to ensure that the needs of the people are met by the home Evidence: All the people have care plans and we looked at two plans. The plans had information on health care, medication, communication, mobility, food, behaviours and daily routines. We were told by one staff that they were due to do their training in person centred planning (PCP) soon. None of the care plans were in a PCP form. There was no information recorded to state how the peoples goals are to be met with time scales. The deputy manager told us that the staff had received training from the Local Authority about person centred planning (PCP). We were told that PCP was being completed with people in the sister home and all the other people in this home would have this done. The deputy manager told us that everyone involved in the process found it to be a valuable exercise. Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: The person centred care plans we had seen at the sister home had detailed information about the person and highlighted goals and expectations and recorded how they were to be met. The goals were quite modest, but were a starting point, and can become more adventurous as people become familiar with this form of planning for peoples future lives. During the inspection we saw staff talking to people in a friendly and supportive way. The staff on duty had not read the care plans for the people in this home. This was because they were on their own and had to complete the chores that needed doing and look after the people. The home had risk assessments but these needed expanding to include the five steps to assessing risk. The risk assessment needed to be indivisualise to each activity that is being assessed. The risk assessments should be written in a format the people can understand. The peoples files were kept in the lounge and these needed to be locked in a secure place. Care Homes for Adults (18-65 years) Page 11 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are aware of the need to plan the routines and activities of the home in a way, which meets the choice and wishes of the people. Evidence: Daily records showed that people attend the local gateway club, local shops and visit the local pub. The staff told us that the people go to the cinema, swimming, college, horse riding, country parks, on holidays, and to the sister home. There were photographs displayed of the people when they had been on activities and holidays. Evidence shows that activities for the people appear to be happening at the home. However there was still no planned activity programme nor any records of what activities actually took place apart from what is recorded in the daily notes. The manager needs to audit the activities that are planned and carried out, and the outcomes for people recorded. When the person centred plans are introduced; the Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: deputy manager said the people will be enabled to access a wider selection of activities. The people in the home maintain contact with their families and go on regular home visits. Friends and families are welcome at the home and the people are able to use the privacy of their room and dinning area to have private time with their visitors. The home has a computer in the corridor and some of the people use this. One person was observed playing on their own computer in their own room and enjoyed this. We were told that the menus are chosen each week on each Tuesdays. We observed staff cooking the Sunday lunch and the people were not encouraged to get involved in the process. This was discussed with staff on duty and it was said I do dinner on my own and get concerned if they get hurt. We observed one person wanted to get involved with cooking but was not able to do this. We spoke to two people and they told us that they wanted to get involved with cooking. We were told that due to having one staff on duty, and having to carry out other chores such as cleaning, washing, doing the paperwork and looking after all the people, it was difficult to do individual tasks such as cooking with the people. The people enjoyed the Sunday meal and there was very no food left on their plates. One person said it was nice and another person said enjoy food and I like living here. We were told the staff took their radio to the home so they can listen to music whilst cooking. However the staff need to be proactive in ensuring that the music played in the home is what the people enjoy listening to. The people should be encouraged to play their own music. We were told that the home held a house meeting in February 09 where people have an opportunity to talk about activities, and food. Care Homes for Adults (18-65 years) Page 13 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a medication policy, where medication systems are in need of action the home is working towards improvement, and there is evidence in the care plan of health care treatment and intervention. Evidence: The care plans we saw clearly set out peoples support needs and preferences in receiving personal care. We observed staff interaction and noticed that they talked to people in a respectful way and were careful to preserve their dignity. The records read stated that people are offered support for their physical and emotional health needs. There are records of doctors and hospital appointments, and people have access to opticians, dentists, and other health care professionals. The staff on duty did not have medication training. A staff member from the sister home came to the home at 10:AM to give out medication. The Mar sheets seen had gaps and we were not able to ascertain if the person had received their medication. Information on the date a medication was being discontinued was not recorded. Management needs to to monitor that the medication procedures are followed by all Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: staff. Care Homes for Adults (18-65 years) Page 15 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The peoples concerns are listened by staff to ensure their needs are met. Evidence: The staff spoken to informed us that they had completed the safe guarding of vulnerable adults procedures training. They had good understanding of this. The deputy manager told us that the complaints procedures had been updated in picture format. They had not received any complaints since the last inspection. The deputy manager told us that the people had their own bank accounts. The bank statements need to be kept in the peoples individual files so they know how much money they have in their accounts. This will also help the people to budget their money for planning holidays and buying things they like. We were told that the finance manager still withdraws the peoples money from their bank account. The people with support from staff must be encouraged to carry out this task to increase their independent living skills. The people need to be supported to sign their name when they are given money. At present two staff signatures were observed when signing out for the peoples money. The information on managing the peoples finances needed expanding because it says collects personal allowance from the finance office. The policy on managing peoples finances also needs to be reviewed in line with current practice. Care Homes for Adults (18-65 years) Page 16 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean and homely and provides a relaxing atmosphere for the people in the home. Evidence: A tour of the home showed that the home is clean and tidy. The peoples bedrooms seen are homely and comfortable and individual to the person. We were told that the people had chosen the colours for their rooms. One of the beds in a bedroom needed a head board. The peoples bedrooms do not have locks so they are unable to lock their doors. The communal rooms are homely and corridors are light and airy. A risk assessment is needed for the radiators that are not covered in the home. We observed one of the people going up and down the stairs by holding on to the wall and a banister on the other side of the wall. The home needs to provide another banister on the other side of the stairs. This is to help make it safer for the person to use the stairs. We were told the empty bedroom on the ground floor was being decorated for a new person moving into the home. The kitchen needed painting. The sink in the utility room needed attention as it was old and worn out. The deputy manager told us that the house was being decorated. Care Homes for Adults (18-65 years) Page 17 of 26 Evidence: The side of the kitchen door needed two handles for the people who needed this to help them get into the kitchen. This was discussed with the deputy manager and it was agreed that they will look into this. Consideration should be made towards putting a door between the pantry and the kitchen. This would reduce the risk of fire spreading and make the kitchen more homely. The garden area needed attention to make it user friendly for the people to sit in the summer months. The deputy manager discussed some of the options and they sounded very good in meeting the needs of the people. Care Homes for Adults (18-65 years) Page 18 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staffing in the home needs reviewing to ensure there are adequate number of staff on duty to meet the peoples needs. Evidence: The staff spoken to said that they had an induction at the sister home when they started work. We were told that new staff shadowed an experienced member of staff for a number of weeks. This was until they were confident to work on their own. All new staff did the skills in care induction course. The staff member had completed training in food hygiene, infection control, and safeguarding of vulnerable adults procedures. Training on how to manage peoples behaviours when cuddling staff inappropriately is needed. The staff working rota was inspected and showed that the home did not always have two staff on duty especially at the weekends. We were told that two staff were needed so the staff could work with people individually and work on their independent living skills. The last Annual Service Review also talked about staff not being happy working on their own. The staff we spoke to told us that they enjoyed working at the home and the training provided was said to be good. Care Homes for Adults (18-65 years) Page 19 of 26 Evidence: The staff recruitment files were looked at the sister home at a recent inspection and evidence showed that the home was obtaining all the relevant information required. However one file looked at showed that there was no information in the file about the persons CRB check. We were told that this would be sent to the CSCI but at the time of writing this report we have still not received this information. Evidence showed that not all the staff were receiving supervision on a regular basis. This needs to happen at least six times a year and needs to be recorded Care Homes for Adults (18-65 years) Page 20 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management is aware of the areas where they need to make improvements to meet the needs of the people living in the home. Evidence: We received a letter from the Chairman of the Board of Directors to inform us that the manager had handed in their notice of employment on the 23rd of February 09. We were told that the managers position has been advertised. At the time of this inspection the Registered Managers post was still vacant. We were told that management did not come to Homestead home often and the staff were left to get on with the work. We were also told that the other sister home was seen as being more important than this home. The paperwork in the home needs to be better managed. This was because information was difficult to find. The money box for the home was inspected. The tin had communication forms and Care Homes for Adults (18-65 years) Page 21 of 26 Evidence: this was completed each time money was spent. There was no way of knowing how much money was left in the tin. This was because when transactions were made, this was not recorded in a book in a chronological order. The home needs to review this practice of recording. Staff spoken to and evidence showed that they were not receiving regular supervision. This needs to happen at least six times a year Some of the policies and procedures of the home needed updating. The staff on duty were not able to tell us if Regulation 26 visits were being carried out on a monthly basis. There were no copies seen in the home. The home did not have a quality assurance system that met the standard. The radiators in the home were not covered and the deputy manager said that this was going to be done. The Environment Health Officer had visited the home in June 2007 and gave a score of 3 Stars, which was good.However they have not been back since this time. The fire drill was carried out on the 30/12/08. The time and how long this took needs to be recorded. Information on emergency lighting and weekly fire testing was not found. The home needs to have a qualified first aider on each shift. We were told that the staff had training on food hygiene, fire safety, manual handling and infection control. Care Homes for Adults (18-65 years) Page 22 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 23 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 33 18 There must be sufficient staff on duty at all times. This is so their individual needs can be met. 30/05/2009 2 34 7 Recruitment files must have all the information as stated in Schedule 2 of the Care Homes Regulations This is to protect people from receiving care by some one who may not be suitable to work at the home. 13/05/2009 3 39 24 There must be systems in place, including the seeking of the views of the people that live in the home. This is so that management then act upon and subsequently change the delivery of care so that they influence the running of the home. 16/07/2009 Care Homes for Adults (18-65 years) Page 24 of 26 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 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 26 of 26 - 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!