Inspection on 15/09/09 for Resolve

This inspection was carried out on 15th September 2009.

CQC found this care home to be providing an Good 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

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

Key inspection report Care homes for adults (18-65 years) Name: Address: Resolve Low House Binchester Bishop Auckland Co Durham DL148AW     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Eileen Hulse     Date: 2 3 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Resolve Low House Binchester Bishop Auckland Co Durham DL148AW 01388458128 01388458128 david.king@improving-futures.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Resolve Name of registered manager (if applicable) Mr David King Type of registration: Number of places registered: care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is 3 The Regsitered person may provide the following category of service only Care Home only - Code PC to service users of the following gender: Male whose primary care needs on admission to the home are within the following category Learning Disability Code LD, maximum number of places 3 Date of last inspection Brief description of the care home Resolve is a large stone built detached house situated on the edge of Bishop Auckland town and is set in a rural area with panoramic views from all windows in the house. It has large rambling gardens with grassed areas, shrubs and plants and a number of seating areas that can be used by service users and their families or visitors. The home opened in April 2009 and can accommodate three people between the ages of eighteen and sixty five with a learning disability. Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 3 Brief description of the care home The home is a short distance away from the town centre that has amenities such as a Library, variety of shops, leisure centre, public houses, GP surgeries and post office. The home is easy to get to with a bus route at the front door to Darlington, Metro Centre and other places and there is a large car parking facility at the rear of the building. It is a two storey building offering single bedrooms on the first floor. People using this service must be ambulant as there is no lift. There are three lounges for service users use, a dining / kitchen area, shower room, wcs and bathroom. The home cannot provide nursing care. The fees are £1300.00 to £1900.00 per week depending upon the care needs. Additional charges are made for personal items such as hairdressing and toiletries. Care Homes for Adults (18-65 years) Page 5 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: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The first inspection on this service since being registered with the Care Quality Commission was completed on 15th and 23rd September 2009. This is an overview of what the inspector found during this inspection The quality rating for this service is 2 STAR. This means that people who use this service experience GOOD quality outcomes. How the inspection was carried out. Before the visit we looked at information we have received since the service was registered. How the service has dealt with any complaints and concerns. Any changes Care Homes for Adults (18-65 years) Page 6 of 26 to how the home is run since registration. The providers view of how well they care for people. The views of people who use the service their relatives and staff. During the visit we observed staff practice and talked with the one service user currently living in the home. We looked at how well peoples needs are met. We looked at other records which must be kept. Checked that staff had the knowledge skills and training to meet the needs of the people they care for. We looked around the building to make sure it was safe clean and comfortable and checked if any improvements needed to be made. Care Homes for Adults (18-65 years) Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 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. Good assessments are included within the plans of care for all service users that help to form the basis of the individual care plan, this ensures that before admission takes place the home is able to know if the care needs can be met by them. Evidence: One service user is currently living in the house and this person has had a needs assessment carried out by a care manager and the manager of the service prior to their admission. The Manager was able to explain in detail the process that was used prior to the admission into the service. The care manager made a referral to the home and the prospective service user then made several visits there either having a meal and meeting staff to eventually having overnight stays. An assessment was carried out at this time to ensure the placement was suitable and to ensure the service could meet the care needs. This also gave the person the time to decide if they would like to move in and to ensure a care plan was made available prior to moving in. The organisation has comprehensive policies and procedures regarding the admission process, however, all areas of the assessment records must be fully completed. Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: Prior to admission, the service user was given a copy of the service user guide and a date was arranged for admission. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The care plans are easy to understand and reasonably well maintained, however, further information needs to be included to make sure staff provide the care people can expect to receive on a daily basis. Evidence: The service user currently living in the home has an individual care plan that has been completed by staff and gives the staff some guidance on how the care needs of the person will be met. The care plan includes personal details and pen picture, everyday care needs, healthcare needs and a daily activity timetable is in place. Although the care planis organised and provide some information to help care staff to ensure that the individual care needs are met on a daily basis, the content needs more information. What staff have to do to meet the care needs is vague and do not give clear guidelines for staff. Monitoring and evaluation of the care plan needs to be carried out to ensure the care plan is working and that the care needs are being met. Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: Staff were observed to understand the person well with a good knowledge of their likes and dislikes and support is given to help the person make their own decisions. The risk assessment records are completed and well maintained and include areas such as what the risk is, what risks are associated with it, the benefits of taking the risk and give step by step information so that they can be followed by staff in various situations. Risk assessments are completed and included within the care plans to make sure that any element of risk to the service user has been assessed and minimised where possible. The service is currently reviewing the care plan process so that staff have the information and a good knowledge they need about people and the support that is needed by staff to help meet the needs on a daily basis. 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. There is a good range of social activities made available to service users to fulfill lifestyles and this ensures people are able to choose how to spend their leisure time. The rights of people as individuals is recognised by support being given to maintain personal relationships and to maintain contact with their families and friends. Menus include nutritious and varied meals with good choices. Evidence: There is a good range of social activities made available to service users to fulfill lifestyles and this ensures people are able to choose how to spend their leisure time. The rights of people as individuals is recognised by support being given to maintain personal relationships and to maintain contact with their families and friends. Menus include nutritious and varied meals with good choices. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A number of specialist health professionals are used by the service and this ensures that the healthcare needs of people are identified and met. Evidence: Within the plans of care there was evidence to suggest that the healthcare needs of service users are addressed. Service users are escorted by staff to attend all healthcare appointments including hospital and GP visits and all appointments such as optictions or dentists appointments are attended in the local town centre. The home has a policy and procedure on the administration of medication but no medications are currently used in the home. The policy covers areas on the recording, administration, safekeeping and disposal of unwanted or unused medicines should this be required in the future. Care Homes for Adults (18-65 years) Page 15 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 home has a clear and easy to understand complaints policy and procedure that is accessible to service users and their representatives should they have a complaint or concern about the service and good safeguarding procedures help to protect people should and abuse situation arise or be suspected. Evidence: The complaints policy is detailed and suitable for the people currently living in the home. They are able to communicate well and voice any complaints or concerns they may have about the service they are receiving. The manager confirmed the two staff that are employed are aware of how to deal with a complaint should one be made whilst they are on duty and stated they had received training regarding complaints during their induction training and had also received Safeguarding of adults training. A complaints book is in place but no complaints have been received by the home and to date no complaints or concerns have been received by the Care Quality Commission. When looking at records to document complaints, the records show that they will be dealt with effectively. Safeguarding of vulnerable adults procedures are available in the home for staff guidance should they need to be referred to that also includes whistle blowing. When talking with the service user he stated he knew how to make a complaint should Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: it be necessary but that he was really pleased I am living here and have no complaints. 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. The home is clean, homely and well maintained and this provides people who live there with a pleasant and safe place to live. Evidence: The home is a large stone built detached house offering accommodation in a homely setting. This newly adapted house has been opened for eight months and all the communal areas and bedrooms looked at are well maintained and in good decorative order with many homely and personal touches. There are four service users bedrooms although current registration is to use three of them. They are comforable and personalised to suit individual tastes and have a homely feel to them and externally the home has large well maintained gardens with good access for service users. There is a large dining / kitchen area, two lounges with a computer and games console in one of the lounges and TV and DVD etc in the other lounge , another room is to be used for anyone wishing to pursue hobbies or crafts. The main office is opposite the kitchen area and there is a shower room and bathroom. The large gardens include well maintained lawns, shrubbery and plants, there are several seating areas and a patio and barbecue area for use by service users on warm Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: sunny nights. Plans are in place to change another seperate garden area into an allotment for people to use that are interested in gardening. There were no health and safety issues or areas needing attention but should any maintenance issues be identified the manager stated these would be addressed with reputable outside companies. Staff have completed training in Infection Control and the good standard of cleanliness ensures the home is free from any odours. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels within the home are good and sufficient in numbers to enable the needs of service users to be addressed and this helps to ensure that service users can lead fulfilling lives in a safe environment. Evidence: There are two care staff employed in the home with the inclusion of the manager and deputy manager covering rota duties also and both members of staff have achieved the Learning Disability Qualification. As new staff join the team they will be requested to complete NVQ levels in a care qualification. At the time of the visit the manager was on duty. The staff rota was up to date and well maintained and evidenced that staffing levels were adequate to ensure the needs of the service user could be met. The home has a recruitment policy and procedure in place when employing new staff and the manager was able to describe in detail the procedure that is used when the home have a staff vacancy. The personal files of both members of staff were looked at and showed references had been obtained, a Criminal Records Bureau check and an application form were completed and other records that are required to be kept were also in the individual files. The staff employed have completed all mandatory training and other courses they have attended included, Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: Essential Drug Administration Safeguarding of Adults Management of Violence and Aggression Forensic Awareness Training 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 is well managed by a competant person who shows leadership skills in managing the staff team and ensures risks to the health and safety of people are minimised. This ensures service users are kept safe at all times. Evidence: The manager has a lot of experience and has worked in various care settings in the last fifteen years. He is a Registered Nurse and has experience of working in hospitals, care homes,working with community placements, and as a community nurse. He also has experience at managerial level within the NHS and the private sector. To update his knowledge and skills he is currently completing the Leadership and Management in Care Services and the Registerd Managers Award and Level four in Care. Records evidenced all staff receive one to one supervisions and regular staff meetings take place and observation showed that staff throughout the day followed safe working practices at all times and records evidenced that staff receive regular training Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: in fire safety, moving and handling and infection control. 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 1 7 15 All care needs must be detailed fully within the care plan This will ensure that staff have the information to meet the care needs on a daily basis 15/01/2010 2 7 15 The care plans need to be monitored and evaluated on a regular basis Staff will be aware of any changes to the care plan and will help to know care needs are being met 15/01/2010 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: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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