Inspection on 16/01/09 for Longacre Neurological Support Unit

This inspection was carried out on 16th January 2009.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Longacre Neurological Support... 13/12/06

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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: Longacre Neurological Support Unit Howletts Loke off Station Road Salhouse Norwich Norfolk NR13 6EX     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: Alan Buttery     Date: 1 6 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 24 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 24 Information about the care home Name of care home: Address: Longacre Neurological Support Unit off Station Road Howletts Loke Salhouse Norwich Norfolk NR13 6EX 01603721365 01603721618 acornhomes@ukf.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Beeshaw Care Ltd Name of registered manager (if applicable) Mrs Jane Shaw Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: Date of last inspection Brief description of the care home Longacre is a care home offering personal care and accommodation to 3 service users. The service cares for adults who may have a number of needs, with particular specialisation in people who have had some brain damage. The service is privately owned and was established by the current proprietor a number of years ago. The home is situated in the village of Salhouse which is a few miles outside of Norwich and close to the town of Wroxham on the Norfolk Broads. The service operates from a domestic detached bungalow set in its own grounds. Service users have their own bedrooms and share other facilities. The current fee levels range between #565 and #950. 3 3 Over 65 0 0 care home 3 Care Homes for Adults (18-65 years) Page 4 of 24 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: As part of the inspection process we visited the home, and discussed the service provided with the proprietor of the service. We also spoke to one of the care staff who was working on the admission assessment for someone shortly moving to the home. During our visit we spoke to one of the residents, and had a look around the home. We also looked at paperwork that the home has including individual care plans for all three residents, the assessment documentation being completed for the new resident, and staff records. Care Homes for Adults (18-65 years) Page 5 of 24 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 24 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 24 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. Information is gathered in detail before anyone moves to the home to ensure that the home is able to meet the identified needs, and the person concerned knows what the service will provide. Evidence: Until very recently, the service has only provided accommodation for three individuals. However, they are now expanding, with the acquisition of another property, and will be able to offer a home to six people. The process of any admissions to the home was discussed with the manager of the service, and with one of the staff members working on the day of our visit, who is actively involved with planning for a new resident to move in. A detailed assessment of the person has been completed, and they have visited them in their current home, and discussed their needs with the home they currently live in, as well as with the individual themselves, and their family. They also have a copy of Care Homes for Adults (18-65 years) Page 9 of 24 Evidence: the care plan written by the current home as a guide. In the period leading up to their move, they are meeting with him on a regular basis, and arranging visits to his new home where appropriate. Care Homes for Adults (18-65 years) Page 10 of 24 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individual plans show how the support is provided, and how this id done is a way that suits the individual. Evidence: The service has detailed individual plans in place which have been rewritten since the last inspection. The plans clearly show that the individuals have been involved in writing the plan, We looked at all three individual plans during our visit, and the plans show the identified needs of the person, and how the needs will be met and also provide some background information on the person and detail of their likes and dislikes. The plans cover both the health and social care needs of the person and included detailed risk assessments with are cross referenced to the specific section in the plan they relate to. Care Homes for Adults (18-65 years) Page 11 of 24 Evidence: The plans are written with the individual in mind, and based on a who, what, when, where, why principle, showing the planned outcomes for the person they relate to. The person centred detail in the plans ensure that the support is provided in a way the individual prefers. The plans detail the family networks and contacts of the person they relate to, and this ensures that contact with families can be maintained. The three plans we looked at all included a daily record of significant events and activities, and evidence that the plans are kept under review and updated whenever necessary. Care Homes for Adults (18-65 years) Page 12 of 24 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. The service ensures that people living in the home can take part in activities and pursuits of their choosing, and maintain and develop independence. Evidence: The service provides a very domestic type of service for the three people currently living there, and they all assist in the running of the home. During the visit, one of the residents was happy to make tea for the inspector. This was particular noteworthy, as it demonstrated how far they had progressed since moving into the home, as when they first moved in, they were very withdrawn, and spent most of their time in their room. Following a closely monitored programme, they are now able to access a local day centre, travelling on their own by bus, showing just how much independence they have regained. Care Homes for Adults (18-65 years) Page 13 of 24 Evidence: The other people currently living in the home also have a range of activities that they enjoy, and one enjoys fishing, and is supported to do this on a regular basis. During the warmer weather, all three residents often go out with staff for the day, and the homes staffing patterns ensure that there is flexibility, to allow this to happen. In addition, they are all supported in taking holidays or short breaks. Food is cooked and eaten in a large kitchen diner, and a choice if foods always available. The three people currently living in the home assist staff with the cooking, and fresh fruit and vegetables are used regularly. Care Homes for Adults (18-65 years) Page 14 of 24 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. Personal health care support is provided in a way suited to the individuals living in the home Evidence: As indicated earlier, the individual plans details health and social care needs, and these ere seen during our visit. People living in the home have a range of health needs, and these are met by the service with support from local health professionals. Procedures are in place to ensure medication is administered safely, and staff that are involved with the administration all receive suitable training. If any new residents were able to manager their own medication, this would be supported, and risk assessed to ensure it was a safe action to take Care Homes for Adults (18-65 years) Page 15 of 24 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. Procedures are in place to ensure that people living in the home can be sure that any concerns, complaints or allegations are appropriately investigated and dealt with. Evidence: Everyone living in the home has a copy of the service complaints procedures, provided in a format suited to them, and is aware of who they should speak to in the event of a concern or issue. There have not been any complaints in the past year. A procedure is also in place to ensure the safeguarding of the people living in the home, and all staff receive training in safeguarding matters and ongoing updates. One member of staff that we spoke to was fully aware of the procedures, and told of the training she had received. There has been an ongoing safeguarding issue with the family of one of the people living in the home, and this continues to be dealt with by the service and local adult protection unit. Care Homes for Adults (18-65 years) Page 16 of 24 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 service is based in a well maintained and clean bungalow, providing a safe and homely environment for the people living there. Evidence: The home provides a comfortable and homely environment for the people living there. Communal space is good, with a large lounge and a dining area with conservatory. The service is run from a modern bungalow, and three bedrooms and bathroom facilities are appropriate to the people who live there. The planned changes will increase the number of people living within the service to six, split between two properties, situated very close to each other. Individual rooms are well equipped and during the tour round the home, it was clear that people are encouraged to help in choosing colour schemes and decoration. The home is set in pleasant grounds, within easy reach of local facilities. Care Homes for Adults (18-65 years) Page 17 of 24 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. Recruitment and staffing procedures ensure that all the required information is in place, and appropriate training provided to ensure he needs of the people living in the home are met. Evidence: A full staff team is in place to assist in supporting the people living in the home. The planned increase in numbers will of course need additional staffing, and recruitment is currently underway. In the past year a wide range of training has been undertaken by the team. A training plan is in place showing the training that has taken place and what is planned, and this has included the statutory training as well as more specific training. Training courses for care staff have included, t counselling, dementia and challenging behaviour. On the day of our visit, there were clearly sufficient staff to meet the needs of the people living in the home, There are normally at least two care staff available at all times, and with a flexible rota, staff are available at other times to boost the numbers to allow for activities and trips out. Care Homes for Adults (18-65 years) Page 18 of 24 Evidence: Regular staff meetings take place, ensuring that staff are able to raise concerns, and assist in future planning for the service, and these meetings are minuted to ensure that staff not able to attend are aware of the discussions that took place. The service has a detailed recruitment policy in place, and three staff records were examined which all contained information in accordance with the regulations, and details of the training that the individuals have received. Care Homes for Adults (18-65 years) Page 19 of 24 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 well managed, and the interests of people living there are at the forefront in all plans and decisions. Procedures and training are in place to ensure that people living and working in the home are not placed at risk. Evidence: One of the proprietors of the service manages the home, and is experienced and well qualified, and provides a consistent level of management to the home. A well qualified staff team is in place, with two of the care staff now adopting a senior role, and an assistant manager in place, which will ensure that the management style remains as the service expands. Procedures are in place to ensure that money is carefully managed on behalf of the people living in the home, at the same time encouraging them to take control of their own finances as far as they can, but under supervision. All the required policies and procedures are in place, but these are about to be Care Homes for Adults (18-65 years) Page 20 of 24 Evidence: rewritten, to ensure that they relate to the expanded service. Health and safety measures ensure that people living and working in the home are not at risk, and suitable training is provided to all staff. Care Homes for Adults (18-65 years) Page 21 of 24 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 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 23 of 24 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 24 of 24 - 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. 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