Inspection on 27/02/09 for Welcome Home

This inspection was carried out on 27th 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

Welcome Home 20/03/08

Similar services:

Thorndene

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Southfields

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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: Welcome Home Marrow Cliff View Gardens Warden Bay Leysdown Kent ME12 4NH     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: Joseph Harris     Date: 2 7 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 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 03000 616161 (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.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Welcome Home Marrow Cliff View Gardens Warden Bay Leysdown Kent ME12 4NH 01795510884 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Neil Tucker Name of registered manager (if applicable) Mrs Susan Holton Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 4. 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: Learning disability (LD). Date of last inspection Brief description of the care home Welcome Home is a four-bedroomed bungalow, recently converted to provide a residential service for up to four adults, either male or female, with learning disabilities. The bungalow with its large garden is situated in a quiet residential part of the small town of Leysdown-on-Sea and is a short walk only from the beach. The service is offered within a regime and environment that respects individuality and aims to offer a home for life in a safe and stimulating environment. Service users are supported by a committed and well-informed staff group. Care Homes for Adults (18-65 years) Page 4 of 29 care home 4 Over 65 0 4 Brief description of the care home Reported fees are in the range 791 to 941 pounds per week. Care Homes for Adults (18-65 years) Page 5 of 29 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: This key unannounced inspection process culminated in a site visit to the service on the 27th February 2009. The visit commenced at 09:30 hours and lasted for approximately 5 hours. Prior to the inspection the home returned their Annual Quality Assurance Assessment (AQAA) when we asked for it and it contained all the information requested. This document formed part of the pre-inspection planning process. Durting the course of the visit discussions were held with service users and all of the staff on duty including the manager. A tour of the premises was undertaken and a range of documentation examined including service user and staff files and records relating to health and safety, medication and the running of the home amongst other things. Care Homes for Adults (18-65 years) Page 6 of 29 Care Homes for Adults (18-65 years) Page 7 of 29 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 Care Homes for Adults (18-65 years) Page 8 of 29 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –03000 616161. Care Homes for Adults (18-65 years) Page 9 of 29 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 10 of 29 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. Prospective service users and their families are enabled to make an informed choice about moving into the home and their needs are assessed. Evidence: The home has developed both a statement of purpose and service user guide that contain all the required information to enable people to make an informed choice about moving into the home. These documents are set out in an accessible format and the manager stated that she plans to develop a service user guide that uses pictures and symbols to aid understanding. A copy of the guide is provided to all prospective service users and their families. The manager has developed an in-house assessment format that address all key areas of need, support and preferences of the individual. Two completed examples of the assessment form were examined. In both cases these had been completed in good detail providing evidence that the manager had considered the needs of each individual. Alongside this the home requests assessment information from referring care managers, which form the basis of the initial care plans. Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: Prospective service users are able to visit and spend time in the home prior to deciding whether or not to move in. In one case the manager and staff have spent a number of months visiting an individual in their own home to aid a smooth transition into the service. Care Homes for Adults (18-65 years) Page 12 of 29 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 individual needs and choices of service users are supported and promoted. Evidence: The home has worked hard to develop a new system of care planning for all residents. The support plan for one individual was examined, which addresses the support and care needs for the service user in very good detail. The plan is written in an easy to understand and accessible manner providing clear guidance to enable staff to meet individual needs in a consistent manner. The plans cover all aspects of care and support and promote the independence of each service user. Residents are involved as far as possible in the development of the plans and they include symbols and pictures to aid understanding. There is evidence of monthly review and changes to plans where needs have changed. Similarly risk assessments have been developed in a consistent manner linked to the areas of need and support identified through the care planning process. They promote positive risk taking and provide clear guidance to minimise perceived risks. The risk Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: assessments are reviewed on a monthly basis. Service users are supported to make decisions affecting their day to day lives. Financial appointees are independent of the service and the home provides a safekeeping facility with records retained of all incoming and outgoing transactions. The home has enlisted the services of an Independent Mental Capacity Advocate (IMCA) for one service user which resulted in a positive outcome for the individual. Care Homes for Adults (18-65 years) Page 14 of 29 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. Service users have a lifestyle that suits their needs and wishes. Evidence: The home provides a positive and wide range of activities for all of the service users based on individual choices, hobbies and interests. As well as informal activities in the home residents are supported to access a number of community resources both specifically for people with learning disabilities and for the general public. One resident currently attends college courses in computing and numeracy. A number of local groups are accessed providing recreational and social activities. Two people attend the library every week and another person has joined a walking group at a healthy living centre. The home enjoys good staffing levels that enable residents to go out on a 1:1 basis regularly going for walks on the nearby beaches, shopping, pub trips and other activities such a swimming, ten-pin bowling and theatre trips amongst other things. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: One person is being supported by the home to develop independent living skills in a number of areas and has been identified as somebody with the potential to move on to more independent accommodation should they wish to do so in the future. Service users are supported to maintain positive relationships with family and friends and visitors are welcomed into the home at all reasonable time. One person visits their family every weekend. Staff were observed to interact with all residents in a friendly, respectful and enabling manner. It was evident through discussion that the staff team have a very good awareness of the individual needs of each service user. The home provides a healthy and balanced diet based on the preferences and choices of the residents. A menu has been developed demonstrating that healthy choices are made and alternatives are available at every meal time. Service users are able to have snacks and drinks throughout the day. Care Homes for Adults (18-65 years) Page 16 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The personal and healthcare needs of the service users are met. Evidence: The individual needs and wishes of personal care for each service user are clearly identified within the support plans. These provide detailed guidance for all aspects of support in this area and are reviewed and updated regularly. Discussions were held with all staff on duty who demonstrated both a very good understanding of individual needs and a clear commitment to empowering and supporting service users positively. One service user said, I like all of the staff, we get on well. They help me when i need it. All of the service users are registered with a local GP and receive support from the Community Learning Disability Teams and Care Managers. Other health care specialists are involved with some service users including an Epilepsy Nurse specialist. The home maintains clear records of all healthcare appointments and the outcomes and actions arising from these. Complimentary health needs are met via Chiropodists, Dentists and Opticians, etc. Policies and procedures are in place relating to medication issues and there is evidence Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: that the home adheres to these. Medication records are well maintained and up to date. Medication storage facilities are adequate for the needs of the home. The manager stated that there are plans to build an extension including a new office and the storage facilities will be further upgraded at this time. One service user is currently being supported to become self-medicating and is in the early stages of this process. Care Homes for Adults (18-65 years) Page 18 of 29 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. Service users are able to air their views and are listened to. They are protected from forms of abuse. Evidence: The home has a clear complaints process in place that is displayed in the home and included within the service user guide. The manager stated that service users are supported and encouraged to air any issues that they have with staff and these tend to be able to be dealt with on an informal basis. However, there is a complaints book in place should anyone wish to make a formal complaint. Residents are able to air their views through resident meetings and 1:1 time with their keyworkers. No complaints have been received in connection with the home since the last inspection. Policies and procedures are in place relating to issues of abuse and adult protection. It was noted and discussed with the manager that some minor amendments and inclusions could be added to these. All staff have received training in Adult Protection issues and this is also covered through the induction process. The manager has also attended courses covering the Mental Capacity Act 2005 and is due to attend training on the Deprivation of Liberty Safeguards. In discussion with the manager and staff it was evident that there is a very good awareness of issues of abuse and what to do should suspicions of abuse arise. The home has also requested the involvement of an Independent Mental Capacity Advocate for one service user in the past with positive outcomes for the individual. Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: There have been no Safeguarding Vulnerable Adult alerts raised in connection with the service since the last inspection. Care Homes for Adults (18-65 years) Page 20 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The premises are suitable for the individual and collective needs of the service users. Evidence: Welcome Home is situated on a quiet residential road in Leysdown on the Isle of Sheppey. It is very close to the beach and there are local amenities nearby. The larger town of Sheerness is also within reasonable distance and there are public transport links. The home is a single storey building with disabled access into and out of the home. There is parking and garden space surrounding the home and a large garden to the rear. There are some space limitations within the home, but sufficient communal space to meet the needs of the service users. All of the bedrooms are single occupancy with en suite facilities and have been personalised according to taste. There are suitable toilet and bathing facilities throughout. The manager stated that an application for an extension has been approved, which should benefit the overall needs of the service. There is evidence that any maintenance issues are addressed promptly and the home is clean and hygienic. Laundry and kitchen facilities are suitable for the needs of the home and it was reported that they meet the requirements of the environmental health and fire safety departments. the home has been awarded the clean food award. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: Suitable infection control measures are in place and the staff adhere to universal precautions in relation infection control. Care Homes for Adults (18-65 years) Page 22 of 29 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. Service users are supported by a competent and enthusiastic staff team who are well trained. Recruitment process protect the interests of the service users. Evidence: Discussions were held with all of the care staff on duty. They demonstrated a very good awareness of the needs and requirements of the service users. It was also noted that there was a refreshing level of commitment to the home, the service users and in providing a person-centred approach to care. All of the staff were very positive about the home, the management and how they work. The majority of staff have either achieved or are working towards their NVQ level 2 in care. The staff training matrix provided evidence that staff have attended courses in all mandatory training topics and additional courses including medication, Mental Capacity Act, Autism and sight awareness amongst other things. The manager stated that there is a positive attitude towards training and that the home is committed to ensuring staff have a good development programme. All new staff work through an induction process based on the Common Induction Standards. The home is flexibly staffed with between 3 and 5 staff on duty throughout the day depending on the needs and activities of the service users. There is one waking staff on duty at night. The manager is on call at all times and all staff live locally. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: Two staff personnel files were examined that largely contained all of the required information and pre-employment checks. It was noted that the current application form would benefit from some review and updating. The manager should ensure that a full employment history is gained for all new staff and any gaps in employment explored. Additionally in one case the document providing proof of identity did not include a photograph, which is recommended. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run in the best interest of the service users. The health, safety and welfare of residents is protected. Evidence: The manager of the service is also the joint owner and has developed the home from its inception. She has a positive management style and this was evidenced by the testimonies of staff who all stated that they enjoy working in the home and benefit from strong leadership. The manager has a good level of experience in care and has achieved all required qualifications. The home, despite having only been in operation for approximately 18 months, has developed quality assurance processes that include satisfaction surveys for service users, staff and relatives. The manager is in day-to-day control of the home and is able to demonstrate the on going development of the service including audits of key areas of work and record keeping. A range of documentation was examined in relation to health and safety including fire safety records, accident logs and service certificates such as CORGI gas, NICEIC Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: electrical and other information. All of these records are up to date. Environmental risk assessments have been completed and are reviewed regularly. Care Homes for Adults (18-65 years) Page 26 of 29 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 27 of 29 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 34 The home should ensure that a full employment history is gained for all new staff. Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or 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) 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 29 of 29 - 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. You have been warned!