Inspection on 18/08/09 for Norton Street

This inspection was carried out on 18th August 2009.

CQC found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

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Extracts from inspection reports are licensed from CQC, this page was updated on 18/02/2010.

Key inspection report Care homes for adults (18-65 years) Name: Address: Norton Street 28 Norton Street Old Trafford Manchester Lancs M16 7GQ     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Adele Berriman     Date: 1 8 0 8 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Adults (18-65 years) Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC 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 27 Information about the care home Name of care home: Address: Norton Street 28 Norton Street Old Trafford Manchester Lancs M16 7GQ 01612262979 01612270427 nortonstreet@deepdenecare.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Deepdene Care Limited Name of registered manager (if applicable) Type of registration: Number of places registered: care home 30 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC. To service users of the following gender: Either. In the following premises: 11 Khartoum Street 4 service users, 13 Khartoum Street 5 service users, 15 Khartoum Street 4 service users, 39 Milner Street 5 service users, 41 Milner Street 4 service users, 24 Norton Street 4 service users, 26 Norton Street 4 service users. Whose primary care needs on admission to the service are within the following category: MD (Mental Disorder, excluding disability or dementia). The maximum number of people who can be acommodated is: 30. Date of last inspection Brief description of the care home 30 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 27 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: We carried out an unannounced visit to the home on 18th August 2009. The visit formed part of a key inspection of the home in which all the key standards were assessed. This was the first key inspection of the home since it was registered under the company name of Deepdene Care Ltd. During our visit we spent time talking to six people who live at the home, the manager and a member of staff. We visited several of the houses to look at the environment and four people invited us to see their bedrooms. We looked at a selection of records, policies and procedures during our visit, these included care plans, staff files, medication records and daily records. At the time of our visit two staff completed a survey form to tell us their thoughts on the service. Care Homes for Adults (18-65 years) Page 5 of 27 Prior to our visit, the manager of the service had completed an Annual Quality Assurance Assessment (AQAA). This document gave them the opportunity to tell us what they did well, what they thought they could improve on and their plans for improvement over the next 12 months. The AQAA told us the information we asked for and also contained some numerical information that we had asked for. Care Homes for Adults (18-65 years) Page 6 of 27 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 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 27 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 27 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 assessed before they move into the home to ensure that their needs can be met. Evidence: Prior to a person moving into the home, the manager of the service carries out an assessment of their needs. The purpose of this assessment is to ensure that the home has the facilities and knowledge to meet the persons needs. A set format was available to record the outcome of the needs assessment. We saw that this gave the person carrying out the assessment the opportunity to record peoples needs and wishes in their day to day life. They told us that information from the persons social worker and any other healthcare professional involved in their care and treatment was included in the assessment process. We looked at the needs assessments of a person who had moved into the home since we last visited. We saw that the information was detailed. During our visit we spoke to the person and asked what their experience was when they were planning to move Care Homes for Adults (18-65 years) Page 9 of 27 Evidence: into the service. They told us that they were given information about the service and they were given opportunities to visit prior to moving in. Care Homes for Adults (18-65 years) Page 10 of 27 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. The way in which peoples needs are met means they can maintain their independence. Evidence: We saw that each person had their own individual file that contained personal information and their care plan. We looked at three peoples files during our visit. We saw that the files included information specific to peoples mental and physical health, maintaining relationships and peoples goals and aspirations. A key worker system was in place to assist people with their care planning. Some of the information recorded in peoples care plans was not completed, for example, each care plan had a section for recording activities of daily living, one care plan did not contain the persons admission date and two care plans did not demonstrate the individuals current medical status under the Mental Health Act. Care plans should consider all of the information known about the person to help ensure Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: that they always receive the care and support they require. We saw that they were considering the Mental Capacity Act when devising care plans with people. For example, We saw one persons care plan that recorded that the persons capacity to make a decision may alter in particular circumstances. We saw that individual risk assessments formed part of peoples care plans. We saw that risks were initially recorded and assessed on a set format that considered past and present risk factors. In the event of task or situation being assessed as a high risk they then develop a comprehensive assessment of the situation and a management plan. Both staff who completed a survey form told us that they are always given up to date information about the needs of the people they care for. Daily records were maintained by the staff team for each resident. We looked at a selection of these records and saw that the content of the records varied in detail. For example, several of the records that we saw contained little information and staff had recorded no issues. Daily records should contain detailed information about the support people have received and been offered throughout the day. Detailed daily records help ensure that people receive the care and support they require. We spoke to six people when we visited the home. They all told us that they were encouraged to make their own decisions in their day to day life and that staff were available to assist them with advice in relation to making decisions. Care Homes for Adults (18-65 years) Page 12 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The daily routines are flexible although the lack of social and recreational activities means that people are not always provided with a stimulating environment. Evidence: At the time of our visit no formal arrangements were in place for activities and social opportunities within the local community. To promote social inclusion and lifestyle opportunities the service should identify peoples needs and wishes relating to recreational and educational activities as part of their care planning process. Several people visited a local day service and drop in centre where they have the opportunity to carry out arts and crafts. People told us that they were able to access the local shops to purchase food. Other people told us that they visited local pubs, social clubs and the betting shop on a regular basis. At the time of our visit none of the people living at the home were in paid or voluntary employment. Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: One member of staff told us in their survey form that they thought the home could improve by having more staff for external facilities. We saw evidence that peoples cultural needs were being considered. For example, one person visited a local church of their faith on a regular basis and another person visited an area of Manchester on a frequent basis to socialise with people of their culture. When the English language is not a persons first language they told us that an interpreter would be employed to attend care plan reviews to ensure that the person was able to communicate and contribute. People told us that they had a key to their home and where able to come and go as they please. One person told us you can go out any time but the staff like to know when your going and when you get back. Its for safety. People who we spoke to during our visit told us that staff always respect their privacy and dignity. People have the opportunity to participate in planning the menu for their house, going to purchase the food from local shops and cooking meals of their choice. We saw that food was prepared and cooked in the kitchens of the houses and staff encouraged people to participate in the preparation and cooking of meals. Care Homes for Adults (18-65 years) Page 14 of 27 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. Individuals healthcare needs were met and people were happy with the healthcare support they received. Evidence: People living at the home told us that staff always respected their privacy and dignity. Care plan records demonstrated that people had regular access to local healthcare professionals including their GP, community psychiatric nurses and care managers. People told us that they always received the healthcare they needed. One person told us they will call my GP anytime I ask. We saw that medication was stored securely and that all medication administered was recorded on a Medication Administration Record (MAR). We looked at several of the MARs and all had been completed appropriately. A policy and procedure was available for the safe management and administration of medication. We saw that the procedure did not include information relating to medication prescribed on an as and when basis (PRN). No information was available Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: regarding what signs and indicators may be apparent prior to the medication being offered. To help ensure that people receive their PRN medication when needed, it is essential that detailed information is available to inform the staff team when it is appropriate for the medication to be offered. Care Homes for Adults (18-65 years) Page 16 of 27 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. Policies and procedures were in place to protect people. Evidence: We saw that a detailed complaints procedure was available. People told is that there was always somebody available to speak to if they were not happy and that they were aware of how to make a complaint about the service. We saw no register for complaints to be recorded. To help ensure that that detailed records are maintained details of any investigation, action taken and outcome of complaints should be recorded. Both staff who completed a survey form told us that they knew what to do if a person had concerns about the service. A policy was in place for the protection of vulnerable people. The document contained information of what constitutes abuse, the prevention of abuse and what action people needed to take in the event of abuse being suspected or disclosed. Care Homes for Adults (18-65 years) Page 17 of 27 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 were provided with domestic style accommodation. Evidence: A number of terraced houses provide accommodation for this service. We saw that the homes were within easy reach of shops, public transport, pubs, social clubs and places of worship. We visited four of the houses and saw that they each had a fully functioning kitchen where meals and snacks were prepared. A small domestic team were employed to support people with the cleaning of communal areas within the houses and to encourage people to participate in the cleaning of their own rooms. People told us that they were happy with their homes and four people invited us to see their bedrooms. We saw that the bedrooms contained peoples personal effects. They told us in their AQAA that they their plans for the next 12 months included instigating a rolling programme of refurbishment so that the accommodation remains at a standard that provides a pleasant environment for people to live. They have access to a maintenance team that undertakes all repairs throughout the Care Homes for Adults (18-65 years) Page 18 of 27 Evidence: houses. Some garden chairs were available and during our visit we sat with people in one of the gardens. The garden areas had not been maintained for sometime. The manager told us that he planned to arrange for a gardening project with people living in the houses to improve the environment. The outside areas of the houses should be maintained to provide a pleasant environment for people to sit and socialise. They told us that the local fire service had recently carried out an inspection of the premises and had judged the services fire prevention and detection systems as adequate. They had a no smoking policy in place for inside of the houses. A shelter and two other covered areas had been created for people to smoke with the gardens. During our visit we saw that the communal areas of the houses were clean and tidy. Care Homes for Adults (18-65 years) Page 19 of 27 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. In the absence of good recruitment practices people who use the service may not be fully protected. Evidence: At the time of our visit there were three carers, a senior member of staff and the manager on duty to meet the needs of people. The manager told us that for planned appointments staff rotas were altered to ensure that there was always sufficient support around. One staff member told us that there were always enough staff to meet the individual needs of the all the people who use the service and one person said that there usually were. People said good things about the staff who support them. Comments included they are patient, they know what I need and staff are very good. We saw that the service had comprehensive recruitment policies and procedures. They told us that all the administration of newly recruited staff was managed by the HR department at the companys head office in Croydon. Care Homes for Adults (18-65 years) Page 20 of 27 Evidence: We looked at the recruitment files of five staff who had been employed within the previous 12 months. We saw that not all of the information that was required was present on the files. For example, several files had no photograph of the staff member, references on another file had not been sought from their previous employer and two application forms did not contain a full employment history of the individual. Several files did not demonstrate the employment start dates and two files failed to demonstrate that completed Criminal Record Bureau disclosures had been completed. The lack of information in the staff files was discussed with the Human Resources Director who visited during our inspection. They demonstrated a commitment to ensuring that all issues raised regarding the recruitment files would be addressed. They told us that all staff have to undertake mandatory training as part of their role, this training includes health and safety, safeguarding adults and medication training. We saw no evidence of the dates that this training had taken place. All training undertaken by staff should be fully recorded. We saw a training matrix that demonstrated that several staff had undertaken training in equality and diversity, building relationships with difficult to engage clients, the principles of care and person centred care, the Mental Capacity Act and mental health awareness. Both staff who completed a survey form told us that they were being given training that helps them understand and meet the individual needs of people, that keeps them up to date with new ways of working and that gives them enough knowledge about healthcare and medication. Both staff told us that they always had enough support, experience and knowledge to meet the different needs of the people living at the home. Care Homes for Adults (18-65 years) Page 21 of 27 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. People are supported by the management of the home but poor recruitment practices could leave them at risk. Evidence: The registered manager has been in post for several years and had completed his Registered Managers Award. He told us that he had enrolled on an NVQ level 4 course in care management. During our visit the manager demonstrated a clear understanding of peoples needs and wishes and what actions were needed to improve the service. We saw that the manager communicated well with people and all of the people we spoke to during our visit were very positive about the support they received from the manager. They told us that they had recently given people a survey to gain their view on what the home does well and what can be improved. They told us that once they have collated all of the information from the surveys they intended to develop an action Care Homes for Adults (18-65 years) Page 22 of 27 Evidence: plan of how to improve the service. We saw that detailed policies and procedures were in place to protect peoples health, safety and wellbeing. We saw that weekly checks were carried out on the fire detection system around the building. A recent visit had taken place by the local fire service that had assessed the service as adequate. Care Homes for Adults (18-65 years) Page 23 of 27 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 24 of 27 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 20 12 Full details of when medication prescribed on an as and when required basis (PRN) should be administered must be recorded in detail. The medication procedures must also reflect how staff are to administer PRN medication. This is to help ensure that people are offered and receive PRN medication when they need it. 23/10/2009 2 34 19 Staff files must contain evidence of all the information required in Schedule 2 of the Care Homes Regulations 2001 to demonstrate that appropriate recruitment checks have been completed. 23/10/2009 Care Homes for Adults (18-65 years) Page 25 of 27 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 This is to help ensure that people using the service are supported by people suitable for the role 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 6 Daily records should contain detailed information about the persons activities of the day and what support and care have been delivered nd offered. Care plans should contain the individuals admission date and the individuals status under the Mental Health Act. To promote social inclusion and lifestyle opportunities the service should identify peoples needs and wishes relating to recreational and educational activities as part of their care planning process. To help monitor complaints and concerns raised within the home a register should be developed to record details of any investigations, actions taken and outcomes of complaints. Arrangements should be made for the garden areas to be attended to on a regular basis so that they provide a pleasant environment for people to sit. A record of all training undertaken by staff should be maintained. 2 3 6 12 4 22 5 24 6 32 Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. 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