Inspection on 10/09/09 for The Poplars

This inspection was carried out on 10th September 2009.

CQC found this care home to be providing an Adequate 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

The Poplars 14/08/08

The Poplars 10/03/08

The Poplars 17/09/07

The Poplars 15/12/05

The Poplars 08/09/05

The Poplars 08/02/05

The Poplars 21/10/04

The Poplars 19/02/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Key inspection report CARE HOME ADULTS 18-65 The Poplars Drayton Road Abingdon Oxfordshire OX14 5HY Lead Inspector Delia Styles Key Unannounced Inspection 10 September 2009 10:41 th The Poplars DS0000013126.V376625.R01.S.doc Version 5.2 Page 1 This report is a review of the 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. 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 home adults 18-65 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. The Poplars DS0000013126.V376625.R01.S.doc Version 5.2 Page 2 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 The Poplars DS0000013126.V376625.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Poplars Address Drayton Road Abingdon Oxfordshire OX14 5HY 01235 523630 01235 523630 haroon@caretech-uk.com 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) CareTech Community Services Ltd Mrs Kellie-Jane Copley Care Home 6 Category(ies) of Learning disability (0) registration, with number of places The Poplars DS0000013126.V376625.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Learning disability (LD). The maximum number of service users to be accommodated is 6. Date of last inspection 14th August 2008 Brief Description of the Service: The Poplars is a large detached house situated within easy reach of Abingdon town centre. The home is registered for up to six people who have a learning disability. The home has a spacious lounge, kitchen and dining room and a large garden with patio area. Each resident has his or her own bedroom. Each resident is supported to use local health care facilities. The home is run and managed by CareTech Community Services Ltd, a national organisation with experience in providing services for people with a learning disability. The fees for this home range from £997.72 to £1,015.19. The Poplars DS0000013126.V376625.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 1 star. This means the people who use this service experience adequate quality outcomes. This is what the inspector did when she was at the home. The visit lasted for just over 4 hours on a Thursday afternoon and early evening in September. The inspector met 4 of the 5 people who live at the home (one person was away on holiday) and was shown around so that she could see some of their rooms (if they said it was alright to do this). The inspector looked at some of the policies and procedures in the office. Policies are rules about how to do things. Procedures tell people how to follow the rules. The inspector talked to the person in charge and some of the support workers and the people who live here. We learned about how the staff help people to go to college, shopping, clubs, and trips out so that they have interesting things to do. We would like to say thank you for helping us to find out what you think about living at The Poplars. What the service does well: The house is clean and there is plenty of space in peoples’ rooms and shared rooms in the house so that people can have quiet times or share in what’s going on in the house. The Poplars DS0000013126.V376625.R01.S.doc Version 5.2 Page 6 People can go on outings most days with support workers, to visit interesting places and have meals out if they want to. The home helps people keep in touch with their families and friends. It makes sure that people are helped to stay healthy and visit the doctor or nurse if they are ill. What has improved since the last inspection? The home has a new manager. She and the staff have helped the people living here to have more choices about things that they like to do and the food they eat. People have more ‘talk time’ with their key staff worker. This helps staff to know about what each of the people living here wants to do and makes sure that they get to try out new activities. Everyone helps with doing some chores in the house if they can and this keeps the house looking nice and clean. People know what’s on and what they are going to do each day, because there is an activities calendar with pictures or symbols that are easier to see. The same with the meals – people can see pictures of the food that they can choose to eat because it’s shown on a board in the kitchen. All the people have a file with things written about them that tell staff what they like or don’t like and how to help them if they need to go to the doctor or dentist to keep them well. When things get broken in the house or new things need to be bought, the manager makes sure that they get fixed more quickly. The front drive looks much better because it has been mended. The garden is better too – the grass is kept cut and there are nice flowers in tubs at the front of the house. This gives everyone a nicer place to sit outside or do things in the fresh air. The Poplars DS0000013126.V376625.R01.S.doc Version 5.2 Page 7 We saw that some of the people who did not like to come out of their rooms the last time we visited, now like to come and join in with their friends to do activities and go out more. 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. The Poplars DS0000013126.V376625.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Poplars DS0000013126.V376625.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. An assessment of the needs of a person who wants to move to the home can be completed following guidelines and a procedure available at the home. The assessment process ensures that new residents can be confident that the home will meet their needs and aspirations. EVIDENCE: There have been no new people come to live here since the last time we visited. The homes Annual Quality Assurance Assessment (AQAA) tells us that CareTech has an established assessment and placement process that ensure each placement is appropriate to the individual and that there will be compatibility with other residents. Assessment of prospective service users is undertaken by managers who have received training about the process. People do not move in until a need assessment has been completed, they have visited and have stayed overnight (if possible). Following the assessment and visit(s) the service is then able to confirm whether they can meet the needs of the person and are sure that the person is happy to move into The Poplars. The Poplars DS0000013126.V376625.R01.S.doc Version 5.2 Page 10 We looked at information about the people who live in the home, which was written before they moved in to see whether it describes how they like and need to be supported. The information held about the most recent person who moved in showed us that their needs and how they want to be supported was clearly recorded. The Poplars DS0000013126.V376625.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Since our last inspection the people living here are much more actively involved in the ways in which they choose and plan their daily activities and their choices and preferences are recorded in more accessible formats in their care and support records. EVIDENCE: A sample of the support plans and risk assessments for 3 of the 6 people living here were looked at. Two of the people whose files were seen were able to talk about or indicate their understanding about what was in their individual file. The standard of the individual plans was much improved since our last inspection visit. It was clear that the manager and staff have worked hard to present information in a much more accessible format, so that residents are actively involved in discussions about their preferred care, support and day to day activities and longer term goals that they would like to achieve. ‘Talk time’ with residents is used by staff to get to know individual’s preferences and to plan with them what they would like to do and achieve in the coming month. The Poplars DS0000013126.V376625.R01.S.doc Version 5.2 Page 12 The plans are then reviewed by the staff and each individual to check to what extent the person’s goals have been met – ‘what have I planned and done this month’. The AQAA shows that the manager and staff are working to improve ‘talk time’ by making sure that there are a wider range of communication aids – objects and pictures and talking mats, for example, that help individuals to clearly express their likes and dislikes. When visiting 2 resident’s rooms (with their permission) there was an improvement in how those with little verbal communication have been encouraged to express their individuality and favourite activities through displays of art work and favourite singers on their room walls. Another resident’s favourite foods and things they like to cook was listed and displayed on the pictorial activity board and in their file. House meetings now take place every month at which the people living here choose what changes they would like to make to their home environment. There is a written record of these meetings, so that staff and residents can see what is planned and achieved as a result of sharing their ideas. From the evidence seen and comments received, we consider that this service would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. The Poplars DS0000013126.V376625.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): This is what people staying in this care home experience: People using the 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 are supported to make lifestyle choices that generally recognise their individuality. Since our last inspection staff have improved ways in which they engage people in activities both inside and outside the home. Important relationships and contact with family members is supported and encouraged. Food in the home is of a satisfactory quality and work has been done to improve the menu planning with the involvement of residents. EVIDENCE: The last time we visited the home several people living here were constantly congregating in the hall by the front door in anticipation of a visit from an Activity Support Worker to take them out. This time, it was clear that individuals knew when their planned activity or outing was happening and there were more staff available to help people with their chosen activities. This showed us that the home has improved the range of opportunities for people to join in community events and access activities suited to their abilities. The Poplars DS0000013126.V376625.R01.S.doc Version 5.2 Page 14 One person attends a local day service in the town centre and another, a day service in an outlying village. Five if the 6 people living here are supported by staff from the ‘Vision’ team to undertake activities away from home. A support worker arrived in the early evening to take two residents to an evening club at a nearby centre. This staff member confirmed that there are now more activities and outings for people to take part in if they want to and this includes evenings. The staff on duty follow an allocation of activities to be offered to the resident(s) for whom they are key worker, and house work tasks that need to be done during their shift. It was clear that considerable work has taken place with individual service users to help them cope with situations, such as car travel, that they found stressful and difficult before. As stated earlier in the report, there was a marked difference in the way that some of the residents now interact in social situations and with each other. The manager has sent us regular updates about the progress made in the home and the achievements of individual service users. The manager states in the AQAA that because the staff team has been more consistent, this has produced a calmer and more settled environment for service users, and improved the way in which staff can plan activities and liaise with the activity support workers to ensure activities are not duplicated. Two comments from health and social care professionals seen in the homes Compliments and Complaints book referred to the positive effects on individual service users because of the good intervention skills of the manager. Contact with people’s family and friends, is encouraged and maintained. There was evidence in talking to residents and staff that their family members are welcomed in the home. One person was looking forward to planning his birthday celebration and seeing his relatives for his party. The arrangement of furniture in the dining room has improved since our last visit. One large dining table gives more opportunities to use the room for activities and as a social gathering point, and allows residents and staff to sit down together at meal times to eat together. Each resident is encouraged to take turns in setting the table for mealtimes and clearing away afterwards. A new large pictorial menu board has been placed in the kitchen so that everyone can see what is planned for the day’s meals. If someone wants to have something different, they are given the opportunity to choose something else. On the day of inspection, the lunch time menu board showed steak pie, but oven-baked fish was being served instead. A staff member explained that the person who had shopped had forgotten to buy the pies, so residents had chosen the fish. There was also a change to the listed dessert – residents had ice-cream. The Poplars DS0000013126.V376625.R01.S.doc Version 5.2 Page 15 The manager had written a comment in the staff meeting (July 2009) minutes requesting that staff cut down on some of the portion sizes served as these were too large - residents were not able to eat everything, so there was unnecessary food wastage. The manager also pointed out that staff should cut back on carbohydrates, for example the amount of biscuits served at teatime, as there is always plenty of fresh fruit on offer for residents. The notes also indicated that staff had ‘agreed to stop purchasing salt’ for the house in an effort to cut down people’s salt intake– ‘No one is to purchase salt under any circumstances’. It is not clear whether residents have been involved in the apparent efforts of the manager to introduce a healthier diet and menu choices for residents. However, the AQAA states that ‘service users are all actively encouraged to plan the menus with staff assistance using the pictures and the items they know and like from the freezer and cupboards’ and ‘each person has a list of likes and dislikes which is referred to when planning menus’. The Poplars DS0000013126.V376625.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 people who live at The Poplars are supported to meet their personal care needs. Access to additional support from health care professionals is consistent and meets individuals changing health needs. Medication is stored securely and administration records are accurately maintained, ensuring the safety of the people who live at the home. EVIDENCE: Support and care plans include guidance of how people wish their personal and healthcare needs to be supported. Personal care is provided in private in either people’s bedrooms or the bathrooms. People are prompted with their personal care as needed and they choose their own clothes and hairstyle. Times for getting up, going to bed, and mealtimes remain flexible. Support plans refer to their preferred routines, likes and dislikes. All residents have a Yale lock and key for their room to protect their privacy. The Poplars DS0000013126.V376625.R01.S.doc Version 5.2 Page 17 People are supported to see their local GP and other community healthcare services when needed. Staff also support people to access specialist healthcare support. One person has had particular input from an occupational therapist to make adaptations to their room and bathroom facilities that meet their individual needs. Two comments from health and social care professionals seen in the home ‘Compliments and Complaints’ book referred to the positive effects on individual service users because of the good intervention skills of the manager. One wrote that the home manager ‘follows through with agreed objectives’ in relation to residents, so there is continuity of care and a recordable pattern of improvements. Staff continue to support people to take their medication as there is no-one assessed as able to safely manage their own medication. A sample of medication administration records (MARs) was viewed. Two lockable cabinets, which are securely attached to the wall, ensure the safe storage of medication in the locked staff office. MARs were well maintained with staff signatures alongside prescribed dose times showing that medicines had been given appropriately and at the correct times. There were laminated sheets of information and guidance available for staff with details about what to do in situations where tablets were dropped, spat out or refused for example. The common side effects of medicines and in what circumstances ‘as required’ medicines should be given. This information was very good and an indication of consistent and good medicines procedures that will protect residents from harm. There was one MAR with a handwritten entry made by staff for Paracetamol tablets for one resident that was not countersigned by a GP or second staff member. It is good practice to have any handwritten amendment to prescribed medicines orders signed by the GP who has ordered the change as soon as possible. Alternatively the staff member who received the instruction should have a second suitably trained staff member to check and countersign the amendment, to reduce the risk of misunderstanding and possible errors that may harm a service user. The home has a staff programme in place for training in safe administration and handling of medicines. One of the three staff members on duty had the required training to be authorised to give out medicines on the day of the inspection. As he was working a ‘sleep-over’ shift he would be able to administer medications required by residents. The AQAA outlines the ways in which the new manager has ‘worked and improved relationships with external healthcare professionals to ensure best practice’. The home aims to improve the use of pictures and other means of communication to make their person-centred plans more accessible and up to date with resident’s input. The Poplars DS0000013126.V376625.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has an effective system in place for responding to, investigating and recording complaints. Systems and procedures are in place to ensure the protection of the people who live in the home. However, staff training around safeguarding adults is not consistent so that not all staff are familiar with the guidance and this could put people living here at risk. EVIDENCE: No formal complaints have been received at the home. Concerns about staff shortages at a weekend in July 2009 were received by CQC and were followed up with the organisation at the time. Local authority social services managers said they had been kept informed about the situation. The CareTech operations manager explained this had been a temporary and emergency situation that occurred because of staff sickness and had quickly been resolved. A copy of CareTech compliments and complaints procedure is on display in the home as are the local learning disability teams and local authority policy on how to make a complaint to them directly. These are in pictorial format. People spoken to during the inspection visit appeared confident and relaxed in the company of staff, indicating that they would know who to talk to they’re not happy with something. The people who live in the home continue to attend house meetings and are given opportunities to share their views on issues that are important to them. They are also encouraged to discuss anything that worries them during their weekly talk time with their key support worker. The Poplars DS0000013126.V376625.R01.S.doc Version 5.2 Page 19 Staff were asked about their training and understanding of safeguarding of people living here. The senior carer on duty said he had had training about a year ago. Three other support staff did not understand what the term ‘safeguarding’ meant – one person asked if it was something to do with the Mental Capacity Act. When given scenarios by the inspector, staff said they would report any suspicions of abuse to the manager, but did not know other sources of advice and support, or seem aware of role of the local authority in safeguarding or the Oxfordshire safeguarding web-site and contact numbers. If staff lack confidence or knowledge about identifying possible abuse and reporting it appropriately, this may leave service users vulnerable to harm. The homes staff training matrix did not list safeguarding (adult protection) as a mandatory topic for induction and regular updates, and was not listed as outstanding mandatory training in an audit undertaken by the home in July 2009. The senior manager for the service undertakes monthly ‘provider’ visits and reports on the standards in the home (under Regulation 26 of the Care Homes Act 2000 and Regulations 2001). Her report for a visit made in August 2009 did identify the lack of adult protection training and that all staff team must have training by the end of September 2009. Telephone feedback with the senior manager and the home manager was given by the inspector two days after the inspection, regarding the concern about safeguarding training issues. The managers said they were ‘disappointed’ that staff had not appeared confident when asked questions by the inspector, especially as safeguarding had recently been discussed with staff at team meetings. Also, one of the staff present on the day of the inspection had dealt with an allegation made by a service user and reported it appropriately through the safeguarding procedure. The manager explained that there had been problems with accessing external training for staff. We consider that in-house training must be given to all staff and recommend that written information, including scenarios, web-site addresses and contact numbers for the local authority safeguarding team are made readily available to staff. The Poplars DS0000013126.V376625.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Further improvements have been made to the environment since the last inspection and generally the home presents a comfortable and domestic environment that meets the individual needs of the people living here. EVIDENCE: A tour of the building, including looking at 3 people’s rooms (with their permission) showed that there continue to be improvements made to the internal environment of the home since our last inspection. Throughout, the living areas of the house are clean, bright, fresh and homely. Most rooms have been redecorated. One person is making progress in accepting some changes to his personal space that make it more homely and personalised for him. All service users have been involved in choosing items for the communal area of the home including the garden area to the front of the home. The front approach driveway and parking area are much improved by wider access and resurfacing. The Poplars DS0000013126.V376625.R01.S.doc Version 5.2 Page 21 The staff sleep-in room has been improved as required at previous inspections but at the time of this inspection there were still open metal shelving units used for storing resident’s archived care records. We understood that this paperwork was to be transferred to a secure storage shed in the rear garden. Since our last inspection a new wooden shed has been erected but that does not appear to be used for the archived records. We strongly recommend that data-sensitive records should be kept in a lockable storage cupboard, to reduce the risk of unauthorised people accessing it, and ideally, not kept in the staff sleep-in room. The system for reporting breakages and maintenance problems in the home has improved since our last inspection. The homes AQAA states that ‘maintenance issues have been resolved by the landlords and a system has been developed to ensure works are given a timescale for completion’. It was noted at the inspection that one kitchen cupboard door next to the sink was missing and a tap was difficult to turn off. Staff said that some of the kitchen units are to be replaced in the near future. The laundry machines are in a small conservatory room at the rear of the kitchen. Staff said that all the machines were working effectively. The area was clean and tidy and there were protective gloves for staff to use when handling laundry. The Poplars DS0000013126.V376625.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Safe recruitment practices are in place, which safeguard the people who live at the home. Staff are offered mandatory training, which should ensure that the needs of people who live at The Poplars can be met by appropriately trained staff. Since the last inspection some progress has been made in improving the continuity in care and support for residents through the supply of reliable temporary staff, continued recruitment for more permanent staff and an improved training programme. EVIDENCE: There were three support workers on duty during the afternoon of the day of this inspection visit. One of the 6 residents was away on holiday. Another resident was out shopping with a staff member, leaving 2 staff with the remaining residents in the house. This meets the usual staffing numbers for the house – one senior support worker or the manager and 2 other staff during the day and a sleep-in member of staff over night. One staff member on duty was new to CareTech and had arrived in the country 3 weeks ago (though had completed the recruitment and police checks in June The Poplars DS0000013126.V376625.R01.S.doc Version 5.2 Page 23 2009). This person works for CareTech Flexi-bank that provides staff to homes where there are staff absences or shortages. This person confirmed that they had had induction training in fire safety, food hygiene, first aid and health and safety topics. On-going guidance about completing resident’s care records and the day-to-day routines and support needs of people living here were being provided in-house. Another support worker was also a new member of staff, having worked at the home for a week, and had some previous care work experience. This person was still to complete training in caring for people with learning disabilities, medication training and safeguarding. A planned 2 week duty rota for the flexi-bank staff member to cover at The Poplars included several nights and a ‘sleep-in’ duty. Managers said that they considered that this inexperienced staff member will have had sufficient supervision and information to competently fulfil their work with residents. Staff recruitment and personal files were not seen on the day of inspection as the home manager was not on duty so that access to confidential files kept in the home was not possible. The homes AQAA, completed in June 2009, indicated that the home had almost reached its recruitment target for new staff - there are 10 permanent staff members. Five staff had left the home in the 12 months (a 50 turnover). A check of the duty rota during the inspection showed that 3 further staff members had left the home in the past 3 weeks. The relatively high staff turnover appears to have had a negative effect on the percentage of staff who have achieved the recommended nationally-recognised training qualification in care. The AQAA reports just 2 of the total of 10 staff have NVQ Level 2 (in Care or Health and Social Care) – our expectation is that at least 50 of care and support staff have this qualification. The company does have an extensive training programme for staff. The manager acknowledges in the AQAA that there has been some difficulty in achieving the level of training for staff – in part due to the organisation holding training sessions at long distances from the home, making it difficult for staff to attend. However, all staff are now required to complete their training in relation to supporting people with learning disabilities within 12 weeks of commencement of employment. The Poplars DS0000013126.V376625.R01.S.doc Version 5.2 Page 24 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 provider company (CareTech) has policies and procedures in place to ensure that the home routinely reviews and improves aspects of the service and quality of life for the people living here. Since our last inspection, a manager has been appointed to the home who has improved the local organisation, training and supervision of staff, which in turn means that service users, their families and representatives can be confident that the focus of care and support is on the individuals living here. EVIDENCE: The manager of the home, Ms Kellie-Jane Copley, was appointed shortly after our inspection in August last year. She has recently successfully completed the process with the Commission to become the registered manager for the home. Last year, CareTech told us that they had improved their system for ensuring that managers submit applications to register with the Commission The Poplars DS0000013126.V376625.R01.S.doc Version 5.2 Page 25 with an expectation that this should be done within 3 months of their appointment. This does not appear to have been the case with Ms Copley’s application. Ms Copley has relevant experience to manage the home in the best interests of service users. She has an NVQ Level 3 in ‘Promoting Independence’ and has previously managed an NHS service. Ms Copley was on a day off when the inspection visit took place, but information and records requested were readily available in labelled files in the office. The fire safety log was seen and the fire safety records showed that the fire awareness training for new staff was up to date. One staff member questioned seemed unsure about the practical procedure that should be followed if they discovered a fire in the home. This may have been because of a language communication problem with the staff member. Managers should check the staffs understanding, through setting up regular unannounced ‘walk through’ exercises and discussion, to ensure that everyone knows what to do in the event of a fire or other emergency in the house. The emergency fire procedures and switch off points for electricity and water were displayed in the front hallway. All service users’ files had information in the risk assessments about how individuals would be likely to react in the event of a fire and on hearing the fire alarms, and how staff could best assist and reassure them to keep them safe. The AQAA tells us that in the last 12 months the home has compiled a service development plan. The manager and staff have clear objectives and targets to work to, to continue to develop the service and facilities to meet the varied needs of people living here. They are aiming to improve the ways in which staff demonstrate that they have read and understood the company’s policies and procedures and consistently follow these in practice. Staff have monthly formal supervision meetings with the manager and notes are kept of their meetings so that staff have feedback on their work and any areas that they may need to develop or have training in. There are also monthly staff meetings and service users’ house meetings, to discuss how the home is running and for residents to choose how they want to make changes to their home environment. An area manager for CareTech continues to visit the home and report on her findings as required under Regulation 26 (‘provider visits’) of the Care Homes Act. These visit reports include comments form service users and random checks on aspects of the home such as medicine storage and administration, record keeping (care plans) and resident’s personal spending money accounts. The AQAA tells us that the landlords of the property have ‘developed a system that will help ensure that maintenance issues are dealt with in a suitable period of time’. The Poplars DS0000013126.V376625.R01.S.doc Version 5.2 Page 26 There is a good system in place for monitoring and recording regular checks and tests in relation to health and safety in the home – for example the hot water temperatures, fire alarm tests and fire fighting equipment checks. Permanent and CareTech Flexibank staff undertake training in control of substances hazardous to health (COSHH) and health and safety, as well as manual handling, safe food handling and first aid. Data sheets were in place for cleaning products used at the home, in case of accidental spillage or ingestion. The AQAA contains clear and relevant information and lets us know about the changes they have made and where they still need to make improvements. The Poplars DS0000013126.V376625.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 X 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Version 5.2 Page 28 The Poplars DS0000013126.V376625.R01.S.doc NO Are there any outstanding requirements from the last inspection? 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. 1. Standard AD23 Regulation 13 (6) Requirement The registered person must make suitable arrangements, by training staff or by other measures to prevent service users being harmed or suffering abuse of being placed at risk of harm or abuse. Timescale for action 30/10/09 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Poplars DS0000013126.V376625.R01.S.doc Version 5.2 Page 29 Care Quality Commission Care Quality Commission Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: 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. 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. 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