Care Home: 1 & 2 Hunts Lane

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What the care home does well People who live at the home are assessed and their needs met through a dedicated staff team. The home has good relationships with other Health care professionals and utilises their skill and expertise in a timely way for the safety and well being of residents. Residents are part of the community and access activities in the local area, providing stimulation and quality to their lives. What the care home could do better: Residents would benefit from staff receiving good communication at all times about the needs of residents in both houses, to ensure they can appropriately meet needs should they be asked to assist in the other house during their shift. Residents would also benefit from the implementation of clear communication systems identified for each of them. The provision of training for staff in specialist areas e.g. pressure sore management and the application of the Mental Capacity Act 2005 would ensure knowledgeable and competent staff were able to fully meet residents needs. An open approach to complaints ensuring staff understand how they can be of benefit to the service provision would enhance the well being of residents. The recording of the outcome of complaints would ensure it had been fully addressed for the complainant. Staffing levels and the dependency needs of the residents need to be matched to ensure residents needs can be met and quality care provided. The safety of the environment would be improved if there was attention the timely addressing of maintenance issues. Fire safety provision and review needs to be regular and more frequent to ensure the residents are protected. Random inspection report Care homes for adults (18-65 years) Name: Address: 1 & 2 Hunts Lane Wellington Hill Horfield Bristol BS7 8UW two star good service 13/10/2008 The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Patricia Hellier Date: 1 1 1 1 2 0 0 9 Information about the care home Name of care home: Address: 1 & 2 Hunts Lane Wellington Hill Horfield Bristol BS7 8UW 01179354310 01179699000 dee.smart@brandontrust.org www.brandontrust.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : The Brandon Trust care home 10 Number of places (if applicable): Under 65 Over 65 0 0 learning disability physical disability Conditions of registration: 10 10 The maximum number of service users who can be accommodated is 10 The registered person may provide the following category of service only: Care home with nursing - Code N to service users of either gender whose primary care needs on admission to the home are within the following categories: Learning disability (Code LD) Physical disability (Code PD) Date of last inspection Brief description of the care home 1 & 2 Hunts Lane is two purpose built bungalows that are are joined by a link corridor. This provides accommodation for ten adults with a learning and physical disability. The home has ten bedrooms five on each side. The communal area consisits of a large lounge and dining area, both houses have a kitchen, and large bathrooms which are suitable for the use of specialist equipment and adapations which assist nursing care. The home can be found in the residential area of Horfiled in Bristol; in close Care Homes for Adults (18-65 years) Page 2 of 10 1 3 1 0 2 0 0 8 Brief description of the care home proximity to Gloucester Road and its local facilities. The area has a number of pubs, a sports complex, shops, a variety of parks and resturants as well as a local supermarket close by. The building is leased to Brandon Trust who provides and manages the care. Western Challenge are responsible for all the repairs and decor within the home and own the building. The fee charged for each placement is based on needs assessment and ranges from 455 pounds - 1529 pounds. This information was provided in 2008. There are additional charges for extra activities such as hairdressing, music sessions and mini bus hire. Care Homes for Adults (18-65 years) Page 3 of 10 What we found: Two care files were inspected and found to contain clear and relevant information about care needs and how they are to be met in a person centred manner. Risk assessments and actions to be taken in case of need to go to hospital were completed in one file but not in the other. Following discussion with the manager an amended AQAA was returned in which we are told the staff team know the residents well and understand their needs. This was observed during the inspection however we did see an incident in which the care staff had not foreseen a potential hazard and we had to call them to prevent potential injury to the resident. Staff told us they do not always get a hand over for all the residents in the home. They told us they do receive hand over for the side of the home they are working in, but not for the other. This means that when they are asked to go to the other side to assist in the care of residents there, they do not always have current information about residents needs and how to meet them. Evidence was seen of residents preferences being respected, and choices were observed being offered, during the inspection. Records inspected in one care plan showed limited variety of activities for the individual. In the AQAA we are told that some residents have communication profiles providing more choice to individuals. It was acknowledged that not all residents do not have these profiles. We are told a planned improvement for the next 12 months is introduce communication profiles for all individuals, to ensure that all people supporting them fully understand the needs of the residents. Communication with residents is crucial to providing person centred and non institutional care. In discussion with the manager and staff were were made aware they have not received training in understanding and applying the Mental Capacity Act 2005 for the benefit of residents. Personal support is responsive and varied to meet individuals needs. In the two care plans inspected we saw well documented needs with clear actions as to how those needs are to be met for the comfort and well being of the resident. Evidence was seen of timely referrals and interactions with other health care professionals, together with the implementation of their advice in the management of care for the well being of the resident. In discussion with staff and the manager we were told that staff would benefit from training in the prevention and management of pressure sores to ensure best practice provision for the health of residents. In the AQAA we are told the service provides specific nursing care to meet identified needs. We are also told that not all residents have health action plans to assist in meeting their current and potential needs. It is recommended that the implementation of these for all residents is completed at the earliest opportunity. The home has a complaint procedure that is accessible in an easy read format, a copy of Care Homes for Adults (18-65 years) Page 4 of 10 which is in each residents folder. The complaint book was inspected and clear records of the complaint and the action taken were seen. The outcome of the complaint for the complainant was not recorded. This is recommended to ensure any complaint has been fully and appropriately investigated. In the AQAA we are told the home could improve by providing more training for staff to be able to deal with complaints. This is of concern to us as we would expect all staff to have a working knowledge of the complaints process and an openness to ensure all provision is resident focused. The manager told us she has been away managing another service and this is why some of the management issues have not been fully completed. We remain concerned about the lack of clear leadership and under pinning management of this service for the safety and well being of residents. We heard that staffing levels are not always adequate to meet the level of needs of the residents, and while the arrangement of splitting the house has provided continuity of staff to resident, we are told it has affected the communication of issues and needs in the home. The potential effect of this is residents care needs may not always be met. In discussion with the manager we were told that there are staffing issues due to the reorgnisation of the services within Brandon Trust, and the home cannot advertise for staff as they have to await the redeployment of staff from other homes in the group. Maintenance records inspected showed that recording is inconsistent and actions to address maintenance issues are not always recorded as completed. the issue of a bed not working appeared not to have been addressed. Another example seen was a request for emergency lighting to be repaired and still no action five days later. These examples potentially put residents at risk from inadequate care provision. Fire safety records reviewed showed the fire risk assessment as not having been reviewed since for at least two years. Staff when interviewed told they receive fire training annually. Evidence was seen of two fire drills earlier in the year. The report on both occasions demonstrated that the actions taken were unsatisfactory and needed improving. In the further AQAA submitted we are told the service provides care and support to individuals who have very specific needs and the staff team are committed to providing a good standard of care. This statement was support in the care provision observed. What the care home does well: What they could do better: Care Homes for Adults (18-65 years) Page 5 of 10 Residents would benefit from staff receiving good communication at all times about the needs of residents in both houses, to ensure they can appropriately meet needs should they be asked to assist in the other house during their shift. Residents would also benefit from the implementation of clear communication systems identified for each of them. The provision of training for staff in specialist areas e.g. pressure sore management and the application of the Mental Capacity Act 2005 would ensure knowledgeable and competent staff were able to fully meet residents needs. An open approach to complaints ensuring staff understand how they can be of benefit to the service provision would enhance the well being of residents. The recording of the outcome of complaints would ensure it had been fully addressed for the complainant. Staffing levels and the dependency needs of the residents need to be matched to ensure residents needs can be met and quality care provided. The safety of the environment would be improved if there was attention the timely addressing of maintenance issues. Fire safety provision and review needs to be regular and more frequent to ensure the residents are protected. 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 2. Care Homes for Adults (18-65 years) Page 6 of 10 Are there any outstanding requirements from the last inspection? Yes R No £ 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 6 15 The registered person shall keep a written plan which shows how the peoples needs in respect of their health and welfare are to be met and to maintain under review and revise with up to date information. Written care plans in respect to residents specialist health needs are to be followed which would improve their status of health and help to monitor residents progress. Any changes to care plans must be clearly documented to avoid room for error when proving care. 13/01/2009 Care Homes for Adults (18-65 years) Page 7 of 10 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, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 8 12 The registered person should 11/01/2010 enable, as far as is practicable, residents to be involved in care decisions. To ensure communication with residents is as good as possible for their involvement in their care and activities. 2 24 23 The registered person must take adequate precautions against the risk of fire by ensuring a current fire risk assessment that is regularly reviewed and staff receive regular training. To ensure residents are protected by good fire risk assessments and well trained staff. 31/01/2010 3 24 23 The registered person must ensure that all equipment in the home is maintained in good working order. To ensure residents are protected and staff able to 11/01/2010 Care Homes for Adults (18-65 years) Page 8 of 10 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 implement safe working practices. 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 22 The registered person to ensure staff receive training to enable them to understand the positive nature of complaints for the benefit of all in the home. To record outcomes of complaint investigations to ensure the complainant is satisfied their concerns have been addressed. The registered person to ensure there are adequate staff on duty at all time to meet the needs of residents throughout the home. The registered person to ensure that management practices in the home are tightened to ensure that all issues and risks are well managed for the safety and well being of residents. 2 33 3 37 Care Homes for Adults (18-65 years) Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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. 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