Inspection on 04/06/08 for Queensway House

This inspection was carried out on 4th June 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

Queensway House 26/09/06

Queensway House 28/02/06

Queensway House 10/08/05

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Queensway House Weston Road Stafford ST16 3UQ Lead Inspector Dawn Dillion Unannounced Inspection 4th June 2008 09:30 X10015.doc Version 1.40 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Queensway House DS0000063817.V365696.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Queensway House DS0000063817.V365696.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Queensway House Address Weston Road Stafford ST16 3UQ Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01332 296200 home.fxg@mha.org.uk Methodist Homes for the Aged Janet Marie Coulston Care Home 22 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (22) of places Queensway House DS0000063817.V365696.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th September 2006 Brief Description of the Service: Queensway House is a purpose built unit designed to support 22 individuals with enduring mental health needs. The home is owned by MHA, Methodist Homes for the Aged. The home is split on two floors, a ground floor and a lower ground floor. The premises are located on the outskirts of Stafford, close to amenities and on a frequent bus route. The people that live at the home have access to patio areas, a green house and gardens around the home. Each person has an individual flat with a lounge, bedroom, en-suite and kitchen area. Television and telephone sockets are available to those who wish to have their own. There are seventeen flats with the lounge area converted into another bedroom, for those who wish to share. There are adequate communal and activity areas within the home. This home is linked by a corridor to an adjacent home, and has shared catering and laundry facilities. The home operates within a rehabilitation-orientated environment. Individuals are actively encouraged to contribute and help formulate their own care plan to achieve realistic goals. Registered Mental Nurses, and teams of Resident Support Workers trained to NVQ Level 2 and above, work alongside people who live at the home to help them achieve their maximum potential. People who use the service have access to relevant healthcare services. The home is served by local General Practitioner, Community Nurses and a Pharmacist. Consultant Psychiatrists and Psychologists undertake domiciliary visits on a regular basis. Information relating to the fees charged for the service provided at Queensway House was not available; the reader may wish to contact the home directly for this information. Queensway House DS0000063817.V365696.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 Star. This means the people who use this service experience excellent quality outcomes. The unannounced key inspection of Queensway House was undertaken within eight hours. The inspection methodologies that were used, to establish the quality of care provided and the effectiveness of the management of the home, to promote equality, diversity and best practices entailed the examination of the records, relating to the homes policies and procedures. During the process of the inspection, discussions took place with three people that used the service, three staff members, a Chaplain and a person who provided a reflexology service. Information contained within the homes Annual Quality Assurance Assessment, (AQAA) is incorporated within the contents of this report. The AQAA is a selfassessment that focuses on how well outcomes are being met for people using the service. It also gives us some numerical information about the service. Questionnaires received from people who use the service are also included within the contents of this report. A tour of the property was undertaken, to ensure that the environment and systems in operation were safe and conducive in meeting the needs of the people who use the service. The registered manager was present on the day of the inspection. What the service does well: Care plans provided detailed information to promote the health and welfare of people who used the service. It was pleasing to see that where possible people were encouraged to be involved in the review of their plan of care. There was a positive emphasis focused on social contact and activities, on the day of the inspection people were observed to engage in a range of activities such as gardening, a religious service and some people went horse riding. Some of the comments received from people that use the service are as follows: “The staff do respect my privacy.” Queensway House DS0000063817.V365696.R01.S.doc Version 5.2 Page 6 “I like it here, you have got your freedom.” “The food is lovely.” “Staff are nice.” What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Queensway House DS0000063817.V365696.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Queensway House DS0000063817.V365696.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who may wish to use the service have the information needed to enable them to establish if the home would be suitable to meet their needs to ensure their health and welfare. EVIDENCE: The Statement of Purpose and Service User Guide provided detailed information relating to the service and provisions available at the home. For example the aims of the service, staff team and the qualifications they held, care plans, complaint procedure and information relating to the key worker system, amongst other things. Queensway House DS0000063817.V365696.R01.S.doc Version 5.2 Page 9 The AQAA stated that, “As a direct result of surveys discussions, comments and complaints, we have recently improved our Statement of purpose and residents guides.” The Service User Guide did not provide information relating to the fees charged for the service and provisions accessible at the home. Discussions with the registered manager confirmed that people were subject to a needs assessment prior to a placement being offered. This information was seen on people’s files. Queensway House does not provide intermediate care. Queensway House DS0000063817.V365696.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs to promote their physical and mental health. The principles of respect, dignity and privacy are put into practice to ensure the quality of peoples life. EVIDENCE: Information obtained during the process of the needs assessment provided the foundation for the development of the care plan. We looked at three care plans during the process of the inspection, all provided detailed information relating to the individuals assessed needs and the level of support they required to promote their wellbeing and independence. Queensway House DS0000063817.V365696.R01.S.doc Version 5.2 Page 11 Care plans were reviewed on a regular basis to reflect the changing needs of the individual; it was also pleasing to see that where possible people were actively involved in the review of their plan of care. The AQAA identified that; “We hold regular individual reviews of the care plans for all residents.” Care plans incorporated information about the persons clinical diagnoses, special dietary needs, communication and assistance required with regards to maintaining their personal hygiene. Care plans also evidenced that people had access to relevant healthcare professionals, to promote their mental and physical health. Records also evidenced the intervention of a Psychologist, General Practitioner and Tissue Viability Nurse. With reference to the home’s medication systems and practices, the Boots Blister Pack method was used. We looked at how medicines were stored and recorded which, were found to be satisfactory. Homely remedies were in use and the home had obtained signed authorisation from the prescribing General Practitioner for the use of these medicines. The Care Manager informed us that there was no one in residence who was able to self-administer their medicines. The Care Manager also confirmed that all Nurses were responsible for the administration of medicines and that they received an annual competency assessment. This assessment was also incorporated in the induction programme of all new Nurses. With reference to privacy and dignity, we observed staff to interact with people who used the service in a professional and respectful manner. Staff were seen to knock on doors prior to entering bedrooms. All flats and bedroom doors were fitted with a lock to promote the privacy of the individual. One person who lived at the home told us that, “The staff do respect my privacy.” Systems in the laundry ensured that people wore their own clothes to promote the individuals dignity. Queensway House DS0000063817.V365696.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who use the service are able to engage in social activities and have a positive presence within their local community to promote their lifestyle, culture and religious beliefs. EVIDENCE: The daily routine was observed to be relaxed with people having freedom of movement throughout their home. Staff involved people in activities at a pace suitable for the individual. One person who lived at the home said, “I like it here, you have got your freedom.” During the course of the inspection some people that used the service were seen in the garden planting bedding plants with the assistance of a Carer. Some people also went horse riding on the day of the inspection. A person who provided reflexology and Indian head massages visited the home on the day of the inspection. She informed us that the home had contracted her service and that she attended the home once a week. Queensway House DS0000063817.V365696.R01.S.doc Version 5.2 Page 13 Information contained within peoples care plans identified that they were able to continue to practice their religious faith. The home had contracted the service of a Chaplain and on the day of the inspection, we heard a religious service taking place, with people participating in praying and singing. The Chaplain informed us that, “I build a relationship with people and their families, I provide end of life support and respond to their spiritual needs, hope, meaning and purpose.” The AQAA confirmed that, “Whilst a Christian based home, we promote our services for all people according entirely to need.” One person who lived in the home confirmed that they were able to practice their religion and attended church every Sunday. Discussions with people that use the service, the Care Manager and information contained within care plans evidenced that they were able to maintain contact with their family and friends. General observations during the process of the inspection confirmed that the conduct of the home exercised personal autonomy and choice. For example peoples accommodations reflected the individuality of the person, being able to bring in their personal possessions to reflect their interest. One person who used the service told us that, “I love it here, it’s a nice place.” With reference to meals and mealtimes, discussions with the Cook in charge confirmed that the home had a six-week menu. We looked at a number of menus, which confirmed that people were offered of variety of nutritional meals. The Cook demonstrated a sound knowledge of the nutritional needs of people who accessed the service. He informed us that there were a number of people who required a special diet due to health problems or choice. For example reduced sugar for people suffering with diabetes, gluten free, soft, liquid and vegetarian. Records in the kitchen evidenced that the Cook discussed people’s likes and dislikes, which was incorporated within the menu. People were asked the day before regarding their preference of meals. We spoke to one person who used the service who told us that, “The food is lovely.” The home consisted of seventeen self contained flats, one person who lived at the home informed us that, “I cook my own breakfast and make my own sandwiches.” Queensway House DS0000063817.V365696.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are able to express their concerns and have access to a thorough, effective complaints procedure to promote their rights and ensure their protection. EVIDENCE: There was a complaint procedure in place to ensure that people who use the service were able to share their concerns, promote their rights and protection. One person who lived in the home told us that, “If I had a problem I would go to the staff, they would see to it straight away.” Information from a service user survey identified that they would speak to the nurse if they were not happy. The homes AQAA stated that, “Our Compliments, Complaints and Comments system is advertised and leaflets are available to complete to give additional options for residents and relatives to give their views.” The Registered Manager told us that people living in the home had access to a self-advocacy service. Queensway House DS0000063817.V365696.R01.S.doc Version 5.2 Page 15 The home also had a safeguarding policy. The Registered Manager informed us that staff would be receiving Mental Capacity Act training on 15/07/08. The training records that we looked at evidenced that staff had received training with regards to the Protection of Vulnerable Adults. The AQAA identified that the home had not received any complaints in the last 12 months. We, the Commission for Social Care Inspection have not received any concerns, complaints or allegation relating to Queensway. We looked at three files pertaining to staff working in the home, which evidenced that the appropriate safety checks had been carried out to ensure the protection of people that used the service. Queensway House DS0000063817.V365696.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables people who use the service to live in a well maintained and comfortable environment to promote the safety and independence of the individual. EVIDENCE: Queensway House is located in Stafford, Staffordshire and is in close proximity to local amenities and accessible via public transport. The two storey purpose built property consisted of seventeen flats that provided twenty-two single occupancy bedrooms. The flats also provided a lounge/dining area and a kitchen, equipped with essential furnishings to ensure the comfort of people who used the service. Queensway House DS0000063817.V365696.R01.S.doc Version 5.2 Page 17 A large communal lounge/dining room was also provided; bathrooms with an assisted bath and toilet areas were situated within close proximity to communal areas. There was also an activity room where people were encouraged to partake with various social activities. A passage lift was in place to ensure that people had access to all facilities available within the home. Grabs rails were provided throughout the corridors to assist people with limited mobility. People had access to a well-maintained garden. Ample car parking was provided within the grounds. The cleanliness and hygiene standard within the home was very good. The AQAA stated that, “Particular attention is paid to creating a homely, odour free environment.” “Residents are encouraged to bring in their own furnishings and personalise their rooms.” Information obtained from a staff survey stated that the home provided a, “Nice living environment for the residents.” Queensway House DS0000063817.V365696.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service benefit from a team of staff who are trained, skilled and in sufficient numbers to ensure that the individuals assessed needs are catered for to promote their physical and mental health. EVIDENCE: The home was registered to provide a service for twenty-two people, on the day of the inspection twenty people were in residence. We looked at the staff working rotas that evidenced that sufficient staffing levels were provided to meet the needs of people who lived at the home. The Care Manager informed us that out of twelve Residential Support Workers, eight had obtained the National Vocational Qualification Level 2 and one person had achieved Level 3 in Care. The AQAA identified that 78 of staff had obtained the National Vocational Qualification. We looked at staff training records that evidenced that staff had received the following training: Health and Safety, recognising and responding to adult Queensway House DS0000063817.V365696.R01.S.doc Version 5.2 Page 19 abuse, fire awareness. The Care Manager informed us that staff had also received up to date training in moving and handling. Information obtained from a staff survey identified that, “Good training for staff in order to meet the needs of residents.” One survey identified the need for improved training for working with people who express challenging behaviours. We sat in the garden with one person who lived at the home who informed us that the, “Staff are nice.” As previously identified within the contents of this report, we looked at three files pertaining to staff that worked in the home. All provided relevant evidence that the appropriate safety checks had been carried out before the individual commenced employment, to ensure the protection of people who used the service. Information contained in the AQAA identified that people who use the service were involved in the recruitment of staff. “We ask residents to help with staff recruitment by meeting applicants and discussing their skills following that interaction.” Queensway House DS0000063817.V365696.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect to promote the rights of people. An effective quality assurance system ensures that people receive a service that guarantees their welfare. EVIDENCE: Discussions with the Registered Manager confirmed that she had several years’ experiences in social and healthcare and had obtained the necessary qualification pertaining to her roles and responsibilities. She demonstrated a Queensway House DS0000063817.V365696.R01.S.doc Version 5.2 Page 21 sound knowledge of the needs of people in her care and was very enthusiastic in providing a high standard of service delivery to promote the welfare of people who used the service. Information derived from a staff survey identified that the, “Registered Manager and Care Manager were lovely and did their jobs well.” One staff member said, “The management support is very good and the Care Manager is brilliant and supportive.” With reference to quality assurance, the homes AQAA provided detailed information relating to the quality of the service and future developments. The homes quality assurance system also included a Standard and Values Assessment that was carried out on an annual basis, this was being conducted out on the day of the inspection. We looked at a previous inspection report relating to the Standards and Values Assessment dated 05/09/07 – 06/09/07, that stated that, “The aim of the assessment is to reinforce Methodist Homes for the Aged (MHA’s) commitment to quality of care and how our standards and values work in practice.” Various inspection methodologies were used during the process of the assessment. For example direct observation, discussions with people who used the service and staff, previous audits. The assessment covered values, spiritual needs, respect, dignity, personal growth and development, environment amongst other areas. Information collated from this assessment was developed into an action plan to improve/maintain the quality of the service. The Care Manager told us that people living in the home required some element of support with their financial affairs. Some people were under Court of Protection and Social Services were also appointee for a number of people. We looked at two records and funds held in the home for people. One was found to be correct, the other one had a large discrepancy. However, due to the fact that the homes financial procedure was quite thorough an audit trail carried out on the day of the inspection identified the reason for the deficient and the records were amended accordingly. With reference to practices that promote the health, safety and welfare of people living in the home, records evidenced that routine checks were being carried out on appliances and fire fighting equipments. We observed that two bottles of lighting fluid were stored in a cupboard where medicines were contained; it is recommended that these bottles should be removed to eliminate the risk of medicines being contaminated. Queensway House DS0000063817.V365696.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 3 Queensway House DS0000063817.V365696.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP1 OP38 Good Practice Recommendations To ensure that the Service User Guide is reviewed to include information relating to the fees charged for the service and provisions provided at the home. To ensure that bottles of lighting fluid stored with medicines are removed to eliminate the possibility of contamination. Queensway House DS0000063817.V365696.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection West Midlands Office West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Queensway House DS0000063817.V365696.R01.S.doc Version 5.2 Page 25 - 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. 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