Inspection on 27/11/08 for Queensway

This inspection was carried out on 27th November 2008.

CSCI 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

Queensway 04/07/07

Queensway 17/10/06

Queensway 28/02/06

Queensway 05/10/05

Queensway 08/03/05

Queensway 29/06/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

Grayling

The Cornerstone

John Street Nursing Home

Pennine Camphill

Snydale Care Home

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: Queensway 46 Queensway Kirkburton Huddersfield West Yorkshire HD8 0SR     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Rob Padwick     Date: 2 7 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 © (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 26 Information about the care home Name of care home: Address: Queensway 46 Queensway Kirkburton Huddersfield West Yorkshire HD8 0SR 01484602523 01484428967 NOEMAIL23/5/07 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: St Anne`s Community Services care home 6 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 Queensway is situated in a residential area of Kirkburton and offers nursing care for up to six service users with learning disabilities. The accommodation is on two floors, four bedrooms on the first floor and two bedrooms on the ground floor. Rooms are single occupancy and do not have en-suite facilities. There is a bathroom and toilet on both the ground floor and first floor. Communal areas are of a domestic nature and furnished to a good standard. The home has its own transport, that people using the service contribute towards the cost of. The Registered Manager for the service told us on the day that we visited that the current Fee payable is 465.02 pounds. Items not covered in the fee include holidays and toiletries. There is a Service user Guide available, which gives information about the home and inspection reports by the Commission for Social Care Inspection are also available from the home on request. 6 6 Over 65 0 0 Care Homes for Adults (18-65 years) Page 4 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. This inspection report is based on information received by the Commission for Social Care Inspection (CSCI) since its last key inspection, which took place on 4th July 2007 Care Homes for Adults (18-65 years) Page 5 of 26 and includes information gathered during a site visit to the home. As part of the inspection process, we send out an Annual Quality Assurance Assessment (AQAA) which is a self-assessment document that the registered person must complete and return to the Commission. This should show how well the home is meeting regulations and national minimum standards and what has been done to improve it since our last site visit and what still needs to be done. This self assessment was completed by the manager for the home and information from this was used as part of the inspection process. Other information used included direct feedback from people living in the home, together with responses gained from relatives and professional staff, as well as official notifications received about the home. This information helps us make judgments about the service provided. The site visit took place on 27th November 2008, and lasted for 5 hours and the provider was not told in advance when it would take place. The manager was available throughout the period of our site visit, and as well as speaking to him, we talked staff who were on duty, as well as people living in the home. We looked round the building, including the bedrooms and shared areas of the home and we inspected the records of peoples care, some staff files, the health and safety documents and other records kept by 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The needs of people living in the home are assessed to ensure the service can meet their needs, however information about the home should be further developed, to help those thinking about using the service make a more informed decision about it. Evidence: The group of people living at Queensway are a longstanding group that have lived in the home for many years. The case files belonging to them contained evidence of a person centered approach that was based on a thorough assessment and review of their needs. Information about the home was contained in copies of the service users guide that were kept in the case files that we inspected. We suggested this could be improved, the last time we visited, to make it into a format that is easier to read. A recommendation is now made about this, to help people living in the home know more about the service and help those thinking about using it to make a more informed decision. Care Homes for Adults (18-65 years) Page 10 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are a supported by staff to ensure their needs and choices are met and they can take sensible risks as part of their lives. Evidence: Comments received from people living in the home confirmed they were involved in decisions about their lives and case files inspected, contained support plans that detailed a range of their needs and information on how staff should help them with these. There was evidence in the case files that people had been consulted about their needs, via the use of words and symbols, in order to help them understand things and ensure support provided was right for them. We saw evidence support plans were regularly reviewed, to ensure they were kept up to date and reflect current needs. Support plans contained information about the strengths as well as the needs of people living in the home, in order to ensure life opportunities could be maximised. The group of people living at Queensway have a wide range of abilities and many have difficulties in verbally communicating these. Whilst there was good evidence people Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: living in the home are consulted about decisions, a recommendation is made that specialist communication training is provided, to help staff engage with them better about individual needs and choices. Information provided by the manager indicated people living in the home are supported to take sensible risks and case files inspected contained assessments about a range of known factors and details for the management of these. As noted in our last report, some restrictions are in place concerning the safety of people living at Queensway, such as child locks on cupboards and a lack of soap and towels in the bathrooms. A recommendation is made that the reasons for these are regularly reviewed and alternatives sought that do not restrict others for the sake of one or two people. Care Homes for Adults (18-65 years) Page 12 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 in the home are appropriately supported to ensure they experience a lifestyle that can meet their needs and wishes. Evidence: People living in the home told us they took part in a variety of activities and we saw evidence of this in their case files, together with monitoring of these to ensure individual wishes and choices are appropriately met. Information provided by the manager indicated people living in the home are encouraged to be involved in the local community and we saw evidence of swimming sessions, meals out and visits to places of interest. The service has two vehicles, that enable small groups to go out separately and we were told one group had been on a holiday to Blackpool the previous week. Relatives confirmed they were welcomed to visit and take part the life of the home and we saw evidence that people living at Queensway are supported to maintain Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: friendships with others. We observed people living in the home involved in making drinks for themselves and their was evidence staff supported them to be as independent as possible. People living in the home told us they liked the food that was served and we saw evidence their nutritional needs were being appropriately monitored. Some comments from people living in the home indicated they would sometimes like more things to do at weekends and a recommendation is made about this. Information provided by the manager indicated staff shortages had prevented this aspect of the service to be further developed, although we saw evidence of plans to address this with more staff in the process of being recruited. Care Homes for Adults (18-65 years) Page 14 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Whilst the health and personal care needs of people living in the home were appropriately supported, some recording errors of medicines meant their safety was potentially being placed at risk. Evidence: Information about the health and personal care needs of people living in the home were contained in their support plans to ensure their wishes and feelings about these could be respected by staff. People living in the home indicated their needs about these were appropriately met and we observed staff involving both them and others to ensure their well being was safeguarded. Case files contained individual health action plans for people living in the home, together with evidence that these were appropriately monitored. On the day of our visit, a local doctor was visiting one person who had developed a cold, whilst another told us they had visited the doctors surgery earlier that day. Relatives confirmed staff kept in them in touch about changes to the health conditions of people living in the home and one told us that xxxx has always had the best of care, when he had trouble with his teeth, he was very well looked after. Care Homes for Adults (18-65 years) Page 15 of 26 Evidence: The last time we visited, we made a requirement about the management of medicines that are used in the home and we saw evidence of satisfactory action taken to implement this. The medicines book now contained details about the effects of each drug, together with details of when these should be given. Since our last visit the service had notified us of an error about the administration of medicine to one person living in the home. A random check of the records for these, revealed some errors in the totals of the stock levels that that were kept. This means it was not clear if medication had been appropriately given. A requirement is therefore made to ensure people living in the home are safeguarded from potential harm. Care Homes for Adults (18-65 years) Page 16 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The concerns of people living in the home are taken seriously and staff had been trained to ensure they could safeguard them from potential harm. Evidence: People living in the home and their relatives indicated they were happy with the service and comments received were generally very positive. The home has a corporate complaints procedure, which is written by people that run the service, however, this could be improved by making it easier to read to help people know more about their rights. The Commission for Social Care Inspection had received no complaints about the service since we last visited the home and the complaints log indicated none had been made to the service. There was evidence of work carried out to develop the home since the last time we visited and we were told about action carried out to involve an advocate for those who have no one to speak up for them. The staff files contained evidence of training given to ensure staff know how to safeguard vulnerable adults, together with further evidence of training to ensure they know how to safely physically intervene to protect people, as previously recommended. Care Homes for Adults (18-65 years) Page 17 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. People living in the home are provided with an environment that is clean, comfortable and well maintained. Evidence: People living at Queensway are provided with a homely environment, that was clean and being well maintained. Since our last visit, work had been carried out to upgrade the building and there was evidence of a programme of on going repairs, including redecoration of the kitchen, the hallway and stairway areas. Bedrooms inspected were individually decorated to reflect the personalities of the people living in the home and there was evidence the previous requirement, about a mortice lock fitted to a bedroom door had been implemented, to enable it to now function safely as a fire door. Some bedrooms however, still had no way to lock them to protect the personal possessions of people living in the home and the previous recommendation about this is therefore repeated. One relative commented positively on the home stating They create a warm and homely atmosphere. Care Homes for Adults (18-65 years) Page 18 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Whilst people living in to home are supported by staff who are trained to meet their needs, increased staffing levels would enable their individual choices to be more effectively met. Evidence: Queensway is registered to provide nursing care and qualified staff are always on duty to support care staff and ensure the needs of people living in the home are met. Information provided by the manager indicated there had been some difficulties in recruiting new staff since our last visit, but we saw evidence of appropriate action to resolve this situation. Staff indicated they were committed to meeting the needs of people living in the home and we observed them interacting sensitively with them in an appropriate manner. Staff told us there were occasions however, when it was difficult to meet individual needs due to the numbers of them who were on duty. People living in the home confirmed this and said that this sometimes restricted what they did at weekends. We made a recommendation about this the last time we visited and repeat this again, to ensure the combined wishes and needs of people living in the home can be met at all times. The people running the home, have a training department to ensure staff have the right skills and staff told us St Annes has a good training department that helps keep (us) up to date with training, qualified staff are Care Homes for Adults (18-65 years) Page 19 of 26 Evidence: encouraged to study professional accredited courses. There was evidence in the staff files of appropriate induction and foundation training, together with mandatory courses provided in addition to this. A staff training matrix was in the process of being developed and staff files contained evidence of regular supervisions and appraisals to help them to develop their careers. Recruitment policies and procedures were in place to ensure staff are safe to work with people living in the home and we made a requirement about this last time we inspected. Whilst the files of new staff contained details about them and a checklist to show the required checks had been completed, the details on this checklist however had not been completed. This meant we could not confirm if the right checks had been carried out. Care Homes for Adults (18-65 years) Page 20 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Whilst the home was being generally well managed, some improvements to the management and administrative systems would help staff to further support people living in the home and ensure it is run in their best interests. Evidence: People told us the home was generally well managed and we saw evidence of this in the records that were being kept. The manager is a qualified nurse and has managed the service for many of years and since our last visit some changes had been made to help support the management with a new deputy appointed. There was evidence of meetings taking place to ensure that a sense of direction and leadership is communicated to staff, however some office systems were rather disorganised and it is was therefore difficult at times to find some of the things that we needed. It is recommended action is taken to develop these systems, in order to develop this aspect of the service. We saw evidence of quality assurance systems to ensure people living in the home and their supporters can influence the running of the service, together with regular checks carried out to enable the service to monitor how well it was Care Homes for Adults (18-65 years) Page 21 of 26 Evidence: meeting its aims and objectives. The self assessment for the service gave a reasonable picture of the current situation within the home, however there were some areas where more supporting evidence would have been useful, to help illustrate what had been done or what improvements were planned. We saw evidence of work carried out to implement the requirements and recommendations made the last time we visited, together with evidence in the maintenance records of checks to ensure the health and safety of people living and working in the service is promoted. Care Homes for Adults (18-65 years) Page 22 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 23 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 20 13 The registered person must 25/01/2009 ensure that accurate records of medication administered to people living in the home are maintained This is to ensure people living in the home are safeguarded from potential harm 2 34 19 The registered person must ensure confirmation that required recruitment checks for staff working in the home are available for inspection This is to ensure people living in the home can be safeguarded from potential harm and that staff are safe to work with them 22/02/2009 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 24 of 26 1 1 Information about the home should be further developed, to help those thinking about using the service to make a more informed decision about it. Specialist communication training should be provided, to help staff engage with people living in the home about decisions concerning their individual needs and choices. Restrictions on individuals or on the whole group should be regularly reviewed with the aim of removing restrictions wherever possible. The registered person should continue to develop activities for people living in the home to ensure their lifestyle wishes and choices can be appropriately met. The complaints policy should be made easier to read to help people living in the home to understand their rights better. The registered person should ensure locks are fitted to all bedroom doors in order to protect peoples personal possessions. Staffing levels should be a minimum of three at weekends when all the people living there are at home, so that their choices of activities can be better met. The registered person should ensure the management and administrative systems are developed to further support people living in the home and ensure it is run in their best interests. 2 7 3 9 4 13 5 22 6 24 7 33 8 39 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. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!