Inspection on 23/02/09 for Watcombe Circus Care Home

This inspection was carried out on 23rd February 2009.

CSCI found this care home to be providing an Good 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

Watcombe Circus Care Home 06/11/07

Watcombe Circus Care Home 14/02/07

Watcombe Circus Care Home 13/07/06

Watcombe Circus Care Home 10/01/06

Watcombe Circus Care Home 14/07/05

Watcombe Circus Care Home 11/01/05

Watcombe Circus Care Home 07/09/04

Watcombe Circus Care Home 23/03/04

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Jubilee Villa Care Home

Thornham Grove

Beech Lodge

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Hunter`s Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Watcombe Circus Care Home 2-4 Watcombe Circus Carrington Nottingham NG5 2DT     The quality rating for this care home is:   two star good 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: Meryl Bailey     Date: 2 3 0 2 2 0 0 9 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. 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. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Watcombe Circus Care Home 2-4 Watcombe Circus Carrington Nottingham NG5 2DT 01158443745 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): marion.jennison@ncha.org.uk Nottingham Community Housing Association Name of registered manager (if applicable) Mrs Marion Jennison Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Service users shall be within category LD Date of last inspection Brief description of the care home The last inspection was 6 November 2007. Watcombe Circus is a large property that has been adapted from two semi-detached buildings. The home is sited in a residential area and has access to bus routes to Nottingham city centre. There are local shops, a post office, churches and other community facilities within walking distance. The home offers accommodation for up to fourteen adults with a learning difficulty. Accommodation is on two floors. There is no lift so bedrooms on the first floor would not be suitable for individuals with mobility problems. Information about the home is provided in the statement of purpose and service user guide. Care Homes for Adults (18-65 years) Page 4 of 26 care home 14 Over 65 0 14 Brief description of the care home The weekly fees range from £730 to £974. Additional charges are for chiropody home visits, transport (social) and hairdressing. 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 focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for people who live at the home and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice. In planning our visit we reviewed all of the information we have received about the home since we last visited and we considered this in planning the visit and deciding what areas to look at. We did this inspection with one inspector and an expert by experience who observed and spoke with people who are using this service. An expert by experience is a person Care Homes for Adults (18-65 years) Page 6 of 26 who either has a shared experience of using services, has specialist knowledge or understands how people in this service communicate. The expert visited the home with us to help us get a picture of what it is like to live in the home. This is important because the views and experiences of people who use services are central to helping us make a judgement about the quality of care. Another method of inspection we use is called case tracking which involves us choosing people who live at the service and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. We observed staff working with people, spoke to two members of staff and six individual people who live at the service so that we could form an opinion about the quality of the service being provided. We also read documents and records as part of this visit to help us understand how well the home is managed. 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. Care Homes for Adults (18-65 years) Page 8 of 26 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 9 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 health care 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 10 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. Suitable information is available about the home and the admission procedure ensures any new people will know that staff have information about how to meet their needs. Evidence: No new people had moved to the home since the last inspection. There were detailed pre-admission assessments and reassessments for each person. Some of these were in paper files and others in electronic files on computer. The company had recently updated the Service Users Guide and the manager had been working on an easy read version, which was ready for printing. The guide gives full information about the service and the easy read format covers basic information including how to make a complaint. 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 support people need is planned in detail, but people are not fully aware of the content of their plans. People are encouraged to make choices. Evidence: We looked at the records of three people living at the home. Support plans had been developed for each person. There were paper files with some information, but the most recently updated support plans were recorded only electronically on the computer. These were available by viewing on the computer screen. The content of assessments, plans and other records was very detailed. Staff told us they were used to using the computer and each of the staff added daily notes. Each part of the plan indicated when the next review was due and all plans were reviewed at least every 90 days. The manager said that, when they review the plans, the person sits at the computer with staff and is fully involved. Some people told us that they knew there were records and plans, but they could not read what was on computer and did not remember the content. The electronic support planning system included risk Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: assessments. Support staff were able to tell us about individual needs. They said that an email was sent or a note was written in the staff communication book when a plan was changed so that staff would know to read the new plan on computer. Some risk assessments were concerned with health and safety around the home and others were about activities and risks involved when going out and forming relationships. People were aware of agreed support for going out (see lifestyle section of this report). There had previously been some house meetings to establish rules and when people did not want to attend a meeting, staff consulted them individually. People told us they were consulted about holidays and about decorating their rooms. A member of staff told us two people recently went out with staff to choose pictures for the walls. 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. Suitable activities are provided, which meet individual needs and interests. Peoples rights are respected and people enjoy their meals. Evidence: Support plans gave information about how people spend their time and people told us: I do reading and writing in the home, I go to the Monday club, and the salvation army one I usually go to college, but I have not gone today because of what has happened this morning. I have been shopping today I went to Tescos to buy some clothes. I dont go to the shops alone as have to have support, On Wednesday nights I go to the disco where I play games, I go there in a taxi by myself. We saw percussion instruments in one lounge and a television in each lounge. There Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: were also facilities for Art and Craft within the home. One person told us that five people went to Spain last year and staff told us there were other holidays to Norfolk. Everyone had been to the Pantomime in Nottingham. Staff told us they had received training about assessing mental capacity and one staff member told us, If an advocacy service was needed, for example if someone moved in who didnt have any family or friends we would provide advocacy support to them by contacting an outside organisation. People were involved in planning the menu on a weekly basis and and pictures were used to help people chose. Records showed a nutritiously balanced menu was offered, but changes to the planned menu were made when people wanted something different. There was a plan to have Shepherds Pie on the day of inspection, but we overheard various discussions and individuals choosing different meals. People told us that the food was very nice and we can choose what we like. Care Homes for Adults (18-65 years) Page 15 of 26 Personal and health care 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. All health and personal care needs are well managed and independence is maximised. Evidence: Care and support plans identified individual preferences and how to provide personal support. People told us the staff gave support when they asked. Records showed that people received regular health care input. One person had been receiving palliative care at the home with further support from district nurses. Visits to the doctors and hospital appointments were supported by staff and were recorded. One person said, I go to the doctors by myself. There were also records of Well person checks. We found that medication was well organised and there were no gaps in records. There were checking systems in place to ensure staff kept records up to date. Care Homes for Adults (18-65 years) Page 16 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Any complaints are taken seriously and people feel safe in the home. Evidence: The complaints procedure was in a clear format including symbols to help people understand. It was on a notice board in the dining room, but this noticeboard was very cluttered with various posters and information, making it difficult to find the complaints procedure easily. People who completed our survey said they would tell staff if they had any complaint. There were records of one complaint received May 2008. Information about this was not all in the same place, but it was found and showed that the person was satisfied with the outcome. Staff told us they had attended training in Safeguarding Adults in December 2008. They were aware of the local procedures and said they would report any concerns to the manager or duty manager from the organisation and would also call police in an emergency. People living in the home made the following comments I feel safe in the home,I feel protected in the home no one bullies me. Peoples finances were well documented and we saw a secure method of looking after peoples cash and valuables. Care Homes for Adults (18-65 years) Page 17 of 26 Care Homes for Adults (18-65 years) Page 18 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a well maintained, clean and comfortable home. Evidence: We saw most of the premises, but not every bedroom. One half of the building has recently been redecorated and new carpets have been fitted. There were plans to complete the whole home within the next few months. People had chosen how they wanted the rooms decorated and furnished. The bedrooms we saw were very individual and mostly brightly painted. The home was on three floors with two sets of stairs, but no lift. There were two bedrooms on the ground floor. All areas were clean. There were two lounges and dining room on the ground floor and a further lounge on the first floor. This was used for art and craft activities. People told us they liked everything in the house and didnt mind the stairs as they keep fit using them. One person said, Its warm here and I like the new carpets. 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. People are supported by competent, trained staff. Evidence: We observed staff with people living at the home and they showed very caring attitudes as they supported people who were clearly distressed at the death of one person. One person told us that she could always speak to staff when upset about anything. Staff told us they felt there were sufficient staff on duty with three on every day shift and extra at weekends. There was always a member of staff awake at night and another sleeping in. We saw evidence that two references had been received and checks done through the Criminal Records Bureau before new staff started work at the home. Staff told us they had attended various training courses, which were relevant to their roles and more refresher courses were planned. There were records of induction training for new staff, which included Code of Conduct, boundaries, Safeguarding Adults, Record Keeping, Mental Capacity Act, Fire training via a DVD, Dealing with Accidents and Incidents, Risk assessments, Person Support Plans. Food Hygiene. Three new staff had commenced specific training about working with people with learning disabilities. Care Homes for Adults (18-65 years) Page 20 of 26 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. People benefit from a well managed home and their health and safety is promoted. Evidence: The manager has been assessed by the Commission and registered since the last inspection. Staff told us the manager was supportive and communicated well with the staff group. There were regular staff meetings and staff told us they were kept informed of policies and procedures. There had been some residents meetings and individual discussions when people did not want a house meeting. A manager of another service provided by Nottingham Community Housing Association (NCHA) had completed an inspection in December 2008 to ensure the quality of the service is maintained. The manager completed the last Annual Quality Assurance Assessment for the Commission in August 2008 and this gave us all the information we requested. This included dates of maintenance on equipment within the previous twelve months. Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: Staff training records showed that staff had been given training in health and safety as part of induction and refresher training was also given. The manager had consulted with fire service since last inspection. We saw a Fire Plan near main entrance and this indicated clearly where people were in bedrooms and used coloured zones separated by fire doors. There were clear records of health and safety tests and regular checks. 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 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 6 Print off updated plans for people to keep and use more pictures and symbols so that people living at the home are given more opportunity to fully understand and be involved in their own support plan. Tidy the noticeboard so that the complaints procedure can be clearly seen. 2 22 Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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