Inspection on 25/11/08 for Pontesbury Project

This inspection was carried out on 25th November 2008.

CSCI found this care home to be providing an Excellent 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

Pontesbury Project 04/05/06

Pontesbury Project 04/11/05

Pontesbury Project 20/07/05

Pontesbury Project 01/11/04

Pontesbury Project 18/05/04

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Polesworth Group 70 Long Street

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10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Pontesbury Project Hill Farm Pontesford Shrewsbury Shropshire SY5 0UH     The quality rating for this care home is:   three star excellent 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: Amanda Hennessy     Date: 2 5 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect 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 © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Pontesbury Project Hill Farm Pontesford Shrewsbury Shropshire SY5 0UH 01743791975 01743791617 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: The Pontesbury Project care home 6 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 Hill Farm is provides care and accommodation for up to six adults with a learning disability. The home is a converted farmhouse which has been sensitively adapted to meet the needs of the people who live there without losing any of its homely character. All bedrooms are single, bathrooms and toilets are near to peoples rooms and the communal rooms. Hill Farm is located approximately nine miles from Shrewsbury on the edge of the village of Pontesford. Access is from Bogey Lane, along a long singletrack tarmacadam road leading to the original farmyard. Adequate car parking is available. As no information is included in this report about fees that the service charges the reader is advised to contact the service for this information. 5 Over 65 1 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: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 3 stars. This means that the findings of this inspection is that people who use this service experience excellent quality outcomes. The previous inspection of this service was undertaken on 4th May 2006. This unannounced inspection was carried out in one day by one Inspector. The home had five people living there at the time of the inspection. Time spent visiting the service was six hours. As it was unannounced neither the service or the manager knew we were going. The manager was present throughout the inspection. Care Homes for Adults (18-65 years) Page 5 of 26 Information for the report was gathered from a number of sources: a questionnaireAnnual Quality Assurance Assessment (AQAA ) was completed by the homes manager and sent to us before our visit; We looked at the premises, records and documents. We had discussions with the manager and care staff and observed the care experienced by people who live at the home. We looked at how the service would manage any concerns (no concerns were received), how it protects people from abuse and how staff are recruited and trained. We also looked at the number of staff available to care for people at the home. Two people who live in the home were case tracked this process involves establishing the experience that people have living in the care home by meeting them, discussing or observing their care and interaction with staff, looking at care files, and focusing on outcomes of the care that they receive. Tracking the care that people receive helps us understand the experience of people who use the service. 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 26 Care Homes for Adults (18-65 years) Page 8 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 9 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their needs assessed, are able to visit the home and have information about the home that enables them to decide that they would like to live there and that it is suitable for them. Evidence: The home has a service user guide which provides an accurate and full picture of the home and what it has to offer. The service user guide is in easy read / pictorial format and has photographs of the home making it easier for people to understand. We were told that each person living at Hill Farm has their own service user guide a general copy is also available for people who may wish to live there. People who want to come and live at Hill Farm have a comprehensive assessment of their needs. It is also good that the home want people to come and visit the home before they decide they want to live and a series of visits are arranged for them. We were able to see that only people who are suitable to live at Hill Farm live there. Care Homes for Adults (18-65 years) Page 10 of 26 Care Homes for Adults (18-65 years) Page 11 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are involved as much as possible in decisions about their lives including their care and support needs. Evidence: It was evident from looking at support plans and observing staff with people who live at Hill Farm that people are supported to lead purposeful and fulfilling lives. Each person has their own indiviual programme plan that details their likes, dislikes, needs, capabilities, interests as well as things that they do well and would like to improve upon. Staff try as much as possible to involve people in identifying their care needs, and as most people have limited communication this is done both verbally and non verbally. It was positive that when we spoke to staff they were able to tell us how people living in the home are able to show that they are happy or sad and their care and support needs. Support plans seen comprehensively included all information about the person including their needs, interests, things that they do well and things that they want to be able to do. Care needs are monitored appropriately by the home and Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: formal reviews take place with relevant agencies and relatives. The home has good working relationships with other health and social care professionals. Staff told us that as a result of these good relationships one persons medication had been changed and the number of seizures they had had decreased. A record of the persons day is comprehensively recorded in their diary. The diary includes information on what activities and outings they have taken part in, care they have received and their mood and, behaviour. The entries seen also showed that people are encouraged to make choices and decisions about their daily lives including the things they do, places they go, food they like, clothes that they wear and the time that they got up and went to bed. The home has good risk assessments to show staff how they can enable people to have a full and active life but minimising any risk as much as possible. Staff spoken to demonstrated a good awareness of situations where the person may be at risk and were able to identify the action to be taken to minimise this. Care Homes for Adults (18-65 years) Page 13 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. People living at Hill Farm are able to lead a fulfilling life that meets their individual needs and interests. Evidence: It was positive to see the range of things that people who live at Hill Farm are involved in. People are given the opportunity to take part in activities that interest them and also to try new activities. Some people go to college whilst others go to a day centre. We found people regularly go to the library, bowling, visit the cinema and theatre, go for long walks and drives out with staff enjoying the beautiful surroundings of the home, go to football matches at Shrewsbury Town football club or go swimming. Staff told us about one person and their enjoyment of swimming: You can see that she loves swimming and throughly enjoys being in the water. Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: We were also able to see that people are involved in different activities and not expected to do something as all the others were. One example of this was horse riding which has been a long term interest of the majority of people living at the home. They originally went out to riding stables, but due to the amount of enjoyment of horse riding they have been fortunate to have their own horse which is kept on the farm. We were told that three people living at the home regularly ride Flicker the horse, someone else is involved in carriage driving whilst the other person has no interest in horses at all and has other interests. The Manager told us that families can and do visit regularly and people living at Hill Farm also go out and visit their families and sometimes stay overnight. Staff and people living at the home eat together and it made lunch feel like a family occasion. All meals including puddings and cakes are homemade. Food was found to be tasty and enjoyed by all. Care Homes for Adults (18-65 years) Page 15 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The personal and healthcare needs of people living at Hill Farm are met. Evidence: People receive personal and healthcare support using a person centred approach, this means care and support is given to reflect individuals needs and capabilities. Support plans identify what support people need and require. Staff told us how they support and enable people to make choices and decisions including what they would like to wear. We saw from people diaries that they get up when they choose and like to have a lie in at the weekend when they do not have to go to college or their day centres. We were able to see that staff ensure that people visit different health professionals such as Doctors, Opticians and Dentists depending on their need. We saw records to show that staff ensured that one person had seen an Orthotician due to difficulties with their footwear that was causing blistering to their feet and making walking painful. The home has appropriate policies and procedures for the safe handling, storage and Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: receipt of medicines to reduce the risk of any error with the medicines. Staff have all received training in the safe handling or medicines before they have any responsibility for peoples medicines. We saw records to show that people have their medicines at required times and there are regular checks to ensure that this continues to take place. Care Homes for Adults (18-65 years) Page 17 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. Peoples concerns are responded to and they are protected from harm. Evidence: The Manager told us that there have been no complaints or safeguarding referrals made since the last inspection. The home has a complaints procedure which is included with the service user guide and is also in pictorial format. The level of peoples disabilities mean that most people would be unable to say if they are not happy about anything. Staff were able to tell us how people show that them that they are unhappy and what they do if this is the situation. It is positive that staff receive training in the Protection of Vulnerable Adults. Staff told us about the types of abuse and what they would do if there was any concern about abuse. A copy of the homes and the Local Authority Procedures for Safeguarding People is available within the home. Care Homes for Adults (18-65 years) Page 18 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 provides people with a homely, comfortable and safe place to live. Evidence: The home is warm, clean, decorated and furnished to a high standard with domestic type furniture and furnishings making it feel like home. The ground floor consists of a lounge, dining room, large conservatory, kitchen, laundry and staff office. There are doors from the conservatory leading to the large and pleasant garden. All bedrooms are single, with three bedrooms upstairs and three downstairs. All bedrooms are furnished to a high standard and reflect the persons own personality and interests. There is a bathroom with bath that is suitable for people with mobility difficulties downstairs, a shower downstairs and another jacuzzi bath upstairs. Toilets are close to bedrooms and the communal rooms. Care Homes for Adults (18-65 years) Page 19 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are skilled and in sufficient numbers to support the people who live there. Evidence: We found that the home is staffed with the appropriate number and skill mix of staff to meet the needs of people who live there. There are at least three staff on duty during the day and two staff available at night. Staff we met spoke postively about the support and training they receive and were knowleable about peoples needs. Staff told us that they are key workers for identified people which means that they ensure that they have everything they need such as clothes and toiletries. Staff told us that they are encouraged and supported to undertake a care qualification. The Manager told us that staff are supported to do their National Vocational Qualification (NVQ) level 3, this is above the minimum requirement. Nine of the current twelve staff have NVQ level 3. The home ensures that all required checks are undertaken before people start working there. This means that people living at the home will be protected from unsuitable Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: people working at the home. It is positive that people living at the home are involved in the interviewing of new staff by asking staff their own questions. All new staff have induction training that meets the skills for care standards and we saw records to show this. Care Homes for Adults (18-65 years) Page 21 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has effective leadership and appropriate health and safety practices to keep people safe. Evidence: The Manager Katy Dillow has worked for Pontesbury Project for fifteen years and became the registered manager of Hill Farm in May 2007. Ms Dillow has required qualifications and experience of working with people with learning disabilities and managing a care home. The Manager demonstrated to us that she and her staff have an awareness of peoples needs as individuals and respecting their rights of equality and diversity. The home does have a quality assurance programme. The manager undertakes regular audits of different aspects of the home such as medicines and care records and when actions are needed an action plan is identified. A person with no direct contact with the home comes to the home to determine the views and experience of people who live at there. Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: The homes Annual Quality Assurance assessment (AQAA) was sent to us when we asked and gave a reasonable account of the services provided and identified areas of development. There are appropriate arrangements in place to assist people living at the home look after their own money. We found records of all transactions and receipts were available to confirm these transactions. We did advise that two people should confirm each transaction which would give greater assurance that peoples money is being looked after more safely. The home has an up to date health and safety policy for safe working practices which includes required risk assessments. We were also able to determine that staff receive required mandatory training. The Manager told us that all maintenence contracts were up to date. Maintenance records and contracts including hot water safety checks and fire safety checks we checked during the visit confirmed this. Care Homes for Adults (18-65 years) Page 23 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 24 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 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: 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. 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