Inspection on 30/10/08 for Robert Heath Street

This inspection was carried out on 30th October 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

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

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Robert Heath Street Robert Heath Street Smallthorne Stoke-on-Trent Staffordshire ST6 1LH     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Mandy Beck     Date: 3 0 1 0 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 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Robert Heath Street Robert Heath Street Smallthorne Stoke-on-Trent Staffordshire ST6 1LH 01782934064 01782836460 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Karen Elizabeth Clare Evans Type of registration: Number of places registered: Creative Support Ltd care home 10 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users to be accommodated is 10. The registered person may provide the following category of service only: Care Home not providing medicines or medical treatment (Code NM) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Mental Disorder (MD) 10 Date of last inspection Brief description of the care home Robert Heath Street has been purposefully designed to support people during their rehabilitation programme. The service provides accommodation for 10 people who have mental disorder. There are five flats and five bungalows for people to live in. Each flat has a bedroom and en suite facility and people have access to communal living and dining space. Each bungalow has been designed to offer private living and dining space, a fully equipped kitchen and bathing facitlites. There is a courtyard garden for Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 10 Brief description of the care home people to enjoy and access to a greenhouse for those people who wish to grow their own vegetables. The service is located within five minutes walk of the local town. There are good public transport links for people to access larger towns should they choose to. The current service user guide does not include the range of fees people would be expected to pay for living at Robert Heath Street. Readers of this report as asked to contact the service directly for this information. A copy of the most recent inspection report is available for people to read in the reception area of the home. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced inspection of the home, they were given no prior notice that we were going. We looked at all the information that we have received, or asked for, since the home was registered in April 2008. This included the annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical about the service. Care Homes for Adults (18-65 years) Page 6 of 28 Information we have about how the service has managed any complaints What the service has told us about things that have happened in the home, these are called notifications and are legal requirement. We also spent time talking to people who use the service and to the staff who support them. We looked at the care of two people who use this service in depth. This is part of our case tracking process and helps us make judgements about the homes ability to meet peoples needs. 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 8 of 28 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 28 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. People who may choose to use this service will have the information they need to make an informed choice about living there. Peoples needs will be assessed in full before they move in this will make sure the service is aware of and able to meet peoples needs. Evidence: People who use this service have access to a wide range of information about Robert Heath Street and the service it provides. This information can be found in the service user guide that each person is given when they move in. People who use this service told us, I had all the information I needed to tell me about it. I knew that I would go from living in the flat to a bungalow and that was the plan. We looked at the care documentation of two people during this visit. We saw that each persons needs had been thoroughly assessed prior to moving into the home and they had been involved in the process. The home has told us in the AQAA that admission is only agreed once the prospective resident and staff have agreed the individual support Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: plan, risk assessments and management plans. This means that people choosing to use this service can be very sure the home understands and is confident they can meet peoples individual needs. Those people who answered our surveys told us they had been involved in their assessment and were supported when making decisions about their care. One person said I have a daily plan, I make my own choices. Everyone who chooses to use this service will have the opportunity to spend time there before moving in. This can be done gradually over a period of time and include a range of methods such as support visits, half day visits, full day visits and eventually building to overnight stays. This will help people to settle in and to meet with others using the service. People will also have the opportunity to meet with staff and to decide if this is the place for them. Once admission is agreed people will be expected to sign a licence agreement with the service. This agreement sets out the terms and conditions of peoples stay. The service will make arrangements through advocacy support services for people who may the support of an advocate. Care Homes for Adults (18-65 years) Page 11 of 28 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 using this service will be supported in making choices about their lives. Peoples individual needs are recognised and reflected in their individual support plans. Evidence: We looked at the service user plans of two people who use this service. We found that each persons plan had been developed and agreed with them. All care plans had been generated from peoples assessments and focused upon individual strengths. People are supported by key workers and we were told I can talk to my worker at anytime, I talk to them about things that bother me and they always listen. Those people who answered our surveys indicated they were supported in making choices and decisions about their care. The service told us in their AQAA that people are able to review the project at anytime. People are encouraged to voice their opinions at any time and residents meetings are encouraged. One person also has taken the opportunity to attend the organisations Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: meetings where policies and procedures are discussed. This means that people are being given the chance to influence organisational policy and procedures. The service also told us in their AQAA all residents have a comprehensive risk assessment completed prior to moving into the project, this also incorporates a comprehensive risk management plan that residents sign and agree to. This was confirmed when we looked at peoples individual risk assessments and by talking to staff. We saw risk assessments that included the support people needed when dealing with finances, taking medication and signs of relapse. Care Homes for Adults (18-65 years) Page 13 of 28 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 who use this service will have the opportunity to lead an active life and be supported in doing so. Evidence: When we looked at the individual support plans for people we could see that the home is helping people to be as independent as possible. People are encouraged to make choices about what they want to do and how they want to spend their time. The home has told us in their AQAA as the project is focused towards rehabilitation, promotion of communication and development of independence skills is paramount to the well being of all the residents in the project . One person told us I am free to come and go as I please, I go shopping on my own and have also been on holiday. We saw in one persons notes they had recently been away on a day trip. This was a big step as staff had explained how much support had been needed in getting the person used to Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: travelling in a car and leaving the security offered by the home. Each person has an allocated amount of money from the home each month to use for any activity they choose to do. If the activity is more than the allocated amount people will need to add the extra money. People told us we go to the cinema. Other choices have included ten pin bowling, eating out and shopping. Staff working here do not enter peoples private accommodation unless invited to do so. This means that people living here will have their privacy respected at all times. It also means that people are responsible for keeping their flat or bungalow clean. Each person has a daily plan that helps them to do this. People are also expected to do their own laundry as part of the rehabilitation programme. Each person has their own post box and no post is opened by the staff unless people request this support themselves. Almost all of the people living in the home plan, prepare and cook their own meals. As with activities people are allocated an amount of money to buy food for themselves each week. The home encourages people to look at healthy eating options when planning their menus. During the summer months people have also benefited from the fresh vegetables they have grown in the greenhouse. Where people have special dietary needs the home has consulted with dieticians and peoples own doctor in order to make sure they supporting people as best they can. There is a small kitchen that people can use to prepare breakfasts, suppers and drinks. All other meals are prepared in the main kitchen with staff support. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service will be supported in meeting their health and personal care needs. There are good systems in place for the safe handling of medication and people are protected from poor practice. Evidence: People using this service are supported by staff in the way they choose. People are consulted about the care they receive and how they want it. These wishes are clearly written down in an holistic assessment. These assessments focus on peoples strengths and aspirations and the support they need to keep them well. Staff make sure that the care people get is person led and support is flexible so that it can meet the needs of the people living there. For example, recently some people have needed to go into hospital for treatment. The home has responded by putting more staff on duty to offer extra support to people when they were discharged. Very few of the people using this service need help with personal care. For those that do staff respond sensitively and know how to support people. We saw in one persons bedroom a plan that shows how this is to be done and the prompts that people need to maintain their own personal hygiene. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: People have contact with their own doctors and other healthcare professionals who are there to support them. The mental health team are in regular contact with the home and keep peoples mental health under review. Staff we spoke to during this inspection were very clear about the care and attention that people needed. They were also aware of the signs of relapse that may become apparent for some people and the actions they needed to take to keep people safe. There are good systems in place for managing medication in this home. This means that people will have their medication as it is prescribed and they will not be placed at risk. All staff that help people with medication have been trained and are competent to do so. The home has a staged assessment for self administration of medicines. This means that each person is individually assessed and a care plan for administration of medication is drawn up based upon peoples capability. People are supported to be as independent as possible with their medication. We have made one recommendation to further improve upon this good practice. We have said that when staff handwrite entries on to the Medication Administration Record (MAR) sheet, two staff should sign the entry. This will reduce the risk of errors in transcribing occurring and offer a further safeguard to people. Care Homes for Adults (18-65 years) Page 17 of 28 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. People who use this service can feel confident their views will be listened to and acted upon. Staff have been appropriately trained to recognise abuse and they understand their roles and responsibilities in protecting vulnerable people from harm. Evidence: The complaints policy and procedure is clearly displayed throughout the home. People who answered our surveys told us they knew who to talk to if they were unhappy. They told us I would talk to my key worker, she will listen to me. The home has not received any complaints since its registration in April 2008. We, the commission, have not been made aware of any concerns about this home or the service it provides for people. All staff have received training in safeguarding vulnerable adults. When we spoke to them they were aware of their roles and responsibilities in supporting and protecting people from harm. The home has policies in and procedures in place to further protect vulnerable people. There are no forms of restraint being used in this home at this time. People who need assistance with their finances are supported appropriately and the Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: home has systems in place for checking and auditing peoples money to make sure they are keeping it safe and secure on their behalf. All of the current staff group have been checked against the Protection of Vulnerable Adults (PoVA) list and have a Criminal Records Bureau Disclosure (CRB). These checks form part of the homes recruitment process and are a way of making sure that unsuitable people do not work with vulnerable adults. Care Homes for Adults (18-65 years) Page 19 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a well maintained service. Each person has their own accommodation that has been decorated to reflect their own individual tastes. Evidence: The building is purpose built for the service it provides. We were able to look around most of the home and some people gave us permission to look at their individual accommodation. The home is well maintained and people are encouraged to make it their own. We looked at peoples own flats and bungalows. Both had been decorated to reflect peoples individual tastes. There is a communal dining room for people to use and the kitchen is available for use for those who wish to do their own cooking and meal preparation. The smoking room is no longer in use as people prefer to smoke outside of the home. We were told that there are plans to convert this room into an activity room in the near future for people to use. The home is located within five minutes walk of the local community and had easy access to shops and public transport if people want to use it. Care Homes for Adults (18-65 years) Page 20 of 28 Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff receive the training and have the skills they need to support people living in this home. Evidence: We spent time talking to all the staff on duty during this inspection. It was very clear that they all understood the work they did, the focus of the service and how people liked to be supported. Staff also answered our surveys, they told us I believe we offer the kind of care people want and should get, we work well with residents to achieve their full potential and integrate with the local community. we support ten people here to maintain or improve their mental health needs having a consistent staff team has helped us to achieve excellent standards. All of the staff who work here have achieved a National Vocational Qualification (NVQ) level 3 in social care. Both the deputy manager and the manager have achieved an NVQ level 4. In addition to this training staff also have the opportunity to attend courses in mental health issues, risk assessment and the required mandatory training. This means that staff working in this home are well equipped to meet the needs of the people they support. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: Staff also told us they felt supported and that they did receive regular supervision. Supervision gives staff the opportunity to discuss further training needs and support should they need it. Since the home was registered in April 2008 no new staff have been recruited. We could not assess this standard in full as a result. We did however talk to the manager about recruitment and took time to look at the organisations recruitment policy. We are satisfied that when new workers need to be recruited the home will do this safely and protect the people using the service from unsuitable workers. Care Homes for Adults (18-65 years) Page 23 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is managed by an experienced and competent person. People using this service can feel very confident the home is run in their best interests and their health and safety is promoted at all times. Evidence: The home is managed by Clare Evans. She has a very clear vision for the home and the direction of the service they offer to the people living there. The manager is working hard to improve the overall status of the home and we have been told by people who completed our surveys that she is approachable and very supportive. They told us if there is a problem I know who I can talk to to sort it out, the manager is very good she gives us all the support we need, she is very flexible and always thinks about what is best for the residents living here. The home has a quality assurance system in place. The manager has told us in the AQAA outcomes monitoring for the residents have been greatly improved for residents at the project based on the new individual support plans (ISPs). Staff also Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: told us this was the case they said the new ISPs are better they give us clearer information about what people want and need from us in terms of support, this has to be a benefit for residents. The home also has systems in place for people to raise their suggestions, concerns and praise for the service. People said we have meetings to attend to discuss things and also if i felt like it there are cards to fill in to. If I have ideas they are always listened to. The AQAA the home sent to us was comprehensively completed and gave us a very clear view and understanding of the service. It was clear about what the service does well and also showed us that improvements are planned as a result of listening to the people who use this service. We looked at the promotion of health and safety for people. We found that all required safety records are up to date. We spot checked the fire safety records and found them to be in order, everybody living and working in this home is expected to take part in fire drills and fire safety training. Staff also have the required training in order to keep their knowledge up to date, this includes first aid, food hygiene and infection control. Care Homes for Adults (18-65 years) Page 25 of 28 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 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 20 Two staff should sign handwritten MAR sheet entries. This will reduce the risk of error occurring during transcribing and offer further safeguards to people. Care Homes for Adults (18-65 years) Page 27 of 28 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 © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - 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. 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