Care Home: 1 Charmandean Road

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What the care home does well 1 Charmandean Road provides a well maintained, clean environment for the people who live there. There are a wide variety of activities for residents to take part in and they are supported to maintain links with their families. There are aids and adaptations throughout the home to ensure that residents can live as independently as possible with the support they need. Staff feel supported by the the new manager. What has improved since the last inspection? Since the last inspection staff have received more training to enable them to provide for the needs of the residents. Water temperatures are now checked and recorded to protect the residents. Care plans are in the process of being improved by being more person centred. Relationships and communication between the home and the families of residents have improved. The dining room has been redecorated and new sofas have been purchased for the lounge. What the care home could do better: The new manager needs to register with the Commission. Key inspection report Care homes for adults (18-65 years) Name: Address: 1 Charmandean Road 1 Charmandean Road Worthing West Sussex BN14 9LB     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Jo Hartley     Date: 0 8 0 7 2 0 0 9 This is a review of 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. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Adults (18-65 years) Page 2 of 25 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 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 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. 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 Care Homes for Adults (18-65 years) Page 3 of 25 Information about the care home Name of care home: Address: 1 Charmandean Road 1 Charmandean Road Worthing West Sussex BN14 9LB 02085448900 01903231971 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: www.caremanagementgroup.com Care Management Group Ltd care home 8 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 8 The registered person may provide the following category 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 category: Learning disability Date of last inspection Brief description of the care home 1, Charmandean Road is a care home registered to provide accommodation for up to eight people who have a learning disability and are between the ages of 18 and 65. The home is situated in a suburban area in Worthing, with local shops and transport links. The accommodation is provided on ground and first floor levels, and there is a passenger lift. None of the bedrooms have en-suite toilet or bath/shower facilities. The responsible person for the home on behalf of the Care Management Group Ltd is Mr M. Buckingham. There was not a manager registered with CQC in respect of the home at the time of the inspection visit. The fee range is from 1800 pounds to 2600 pounds per week. 8 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The purpose of the inspection was to assess how well the home is doing in meeting the key National Minimum Standards and Regulations. The findings of this report are based on several different sources of evidence. These include: previous reports of visits to the home, the Annual Quality Assurance Assessment (AQAA) completed by the home, and an unannounced visit to the home, which was carried out on the 8th July 2009. We requested surveys to be sent to the home, however the home did not receive them prior to the visit. During the visit we looked at policies and procedures, and records kept at the home including staff recruitment and training, residents records and health and safety information. We observed interactions between staff and people living in the home, and visited areas of the home including bedrooms and the main communal areas. The manager of the home was present throughout the visit and gave any assistance Care Homes for Adults (18-65 years) Page 5 of 25 required. All regulatory activity since the last inspection was reviewed and taken into account including notifications sent to the Care Quality Commission and its predecessor, the Commission for Social Care Inspection. The last key inspection on this service was completed on the 28th August 2007. A random inspection took place on 18th September 2008. Care Homes for Adults (18-65 years) Page 6 of 25 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 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. Care Homes for Adults (18-65 years) Page 7 of 25 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 8 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have access to written information on the service which will help them make an informed choice about where to live. People are being admitted only on the basis of a full assessment undertaken by people competent to do so, and involving the prospective resident. Evidence: 1 Charmandean Road has an up to date Statement of Purpose and Service User Guide that provide prospective residents with information about the home. Before people move into the home, the home manager and a representative from the Assessment and Referral team meet with the prospective resident to assess whether the home can meet their needs. Following this a visit to the home is arranged, which may include a meal or overnight stay. A detailed pre-admission assessment is drawn up using the information from these meetings and information from professionals who are involved with the person. Care Homes for Adults (18-65 years) Page 9 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals are involved in decisions about their lives, and play an active role in planning the care and support they receive. Evidence: For each person living in the home, there is a detailed plan of care in place that covers all aspects of peoples lives. The manager is currently updating all the care plans to ensure they are person centred and easier for people to understand. We saw completed examples of these during the visit and found them to be an improvement on the current care plans. We tracked the plans for two people and found that areas such as personal history, care preferences, risk assessments, personal relationships, nutritional needs and activities were recorded. The plans are regularly reviewed and updated. Key workers complete a monthly report that summarises key events such as health visits, activities and any changes. These reports trigger a review of the care plan if changes are needed. There is a separate daily records book for each person that is completed by Care Homes for Adults (18-65 years) Page 10 of 25 Evidence: the staff on duty and gives a detailed picture of each persons day. Throughout the visit it was seen that staff on duty were kind and respectful in their dealings with people who live in the home and there was a friendly and supportive atmosphere. A member of staff told us how they support the people living in the home who have little or no verbal communication to make choices in their lives. For example, she described how one person turns their head away when they dont like something. The home also uses communication cards to assist people in making their feelings known. Care Homes for Adults (18-65 years) Page 11 of 25 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. The people living in the home are offered a wide variety of educational, community and social activities, and they supported to maintain family relationships. Evidence: We looked at the activity plans and daily reports for people living at the home and saw that they take part in a variety of activities and are part of the local community. One person attends college and others attend outreach activities. Activities people take part in include; music groups, swimming, discos, bowling, cinema, shopping trips, meals out, reflexology, music therapy and carriage driving. There are good relationships between the home and peoples families and service users visit their parents for week ends and also have an annual holiday. On the day of the visits three residents were away for a holiday in Kent. We were told by a relative visiting the home that the home keeps in touch with families and that relationships Care Homes for Adults (18-65 years) Page 12 of 25 Evidence: between relatives and the home have improved since the new manager has been in post. We saw that menus are varied and offer meals made with fresh ingredients. Residents are able to have a choice and alternatives are listed on the menu in the kitchen. The main meal on the day of the visit was shepherds pie with vegetables and gravy. Staff were seen giving assistance with eating to those people who needed it. Staff and residents eat together creating a family atmosphere at meal times. Peoples likes and dislikes are recorded in their care plans. Care Homes for Adults (18-65 years) Page 13 of 25 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents receive personal support in an appropriate manner. Their physical and emotional needs are met as far as possible. Suitable procedures are in place in respect of the administration of medication. Evidence: Staff were witnessed providing appropriate support to residents throughout the inspection. Each resident has detailed information in their care plans on how they prefer their personal care to be carried out. Every resident has their own keyworker to ensure consistency and continuity of support. Each resident has an individual Healthcare Action Plan. Evidence in residents health files show that they receive additional healthcare support, e.g. from occupational therapists, speech and language therapists, dietitians, opticians, dentists and general practitioners when it is required. A record is kept of all health appointments, the outcomes of the appointments and any action that needs to be taken. The company that owns 1 Charmandean Road has an in-house physiotherapist and Healthcare Care Homes for Adults (18-65 years) Page 14 of 25 Evidence: Facilitator to ensure that residents have thorough health plans and are referred to independent medical professionals when required. There is a section entitled Areas I want to Improve and an action plan on how this will be achieved. Another section called My Mobility details special equipment and aids that the individual needs and the support required to use them. Records of the receipt and administration of medication were seen. All records seen were complete and accurately recorded. Prescribed medicines are delivered monthly and are blister packed. We saw training records that show that all support staff undertake training in the administration of medication. Care Homes for Adults (18-65 years) Page 15 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has procedures in place for Safeguarding Vulnerable Adults and responding to complaints. These procedures are followed when needed. Evidence: The home has a complaints policy and procedure, which is available in pictorial format and is displayed throughout the home including residents bedrooms. The homes procedures on Abuse, Adult Protection and Whistle Blowing were seen. They were detailed and included descriptions on different types of abuse. Staff files contained certificates that show that all staff have attended Adult Protection training. Staff confirmed that they have received training and that Safeguarding procedures have been discussed in team meeting and individual supervisions. Care Homes for Adults (18-65 years) Page 16 of 25 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 residents live in a good standard of accommodation that is well maintained. Evidence: Arrangements are in place for the house and grounds to be maintained, and maintenance records are held which are signed to say what action has taken place. The gardens and premises are being maintained to a good standard. The home is accessible to wheelchairs throughout. Four of the bedrooms are on first floor level (accessed by a lift), and four are on ground floor level. None of the bedrooms have en-suite toilet, bath or shower facilities. The home is furnished and decorated in a comfortable and homely way, and bathrooms and bedrooms are equipped to facilitate safe moving and handling where the person has mobility needs. Peoples bedrooms have been personalised by them, and reflect their interests, needs and personality. There is a sitting room on the first floor that has recently benefited from the addition of new sofas. The dining room is on the ground floor and has been redecorated since the last visit. The garden is accessed from the dining room. Care Homes for Adults (18-65 years) Page 17 of 25 Evidence: All areas of the home visited were found to be clean and hygienic. Care Homes for Adults (18-65 years) Page 18 of 25 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. Residents receive support from well trained and supported staff Evidence: We were told that the home currently has staff vacancies. The shifts are being covered by the support workers in the Care Management Group and agency staff. We were told that prospective staff have been interviewed and the home is waiting for Criminal Record Bureau and Protection of Vulnerable Adults checks and references before new staff can start. We looked at the rota and found that there are a minimum of four staff on duty during the day and two waking night staff. Over fifty percent of care staff have a National Vocational Qualification (NVQ) level two or above. We looked at the files of the most recently recruited staff. They contained all the required information and documents including Criminal Records Bureau and Protection Of Vulnerable Adults checks, two written references and application forms. We were told that residents are involved with staff recruitment through informal meetings with prospective staff. We saw records that showed that staff receive regular supervision sessions and staff Care Homes for Adults (18-65 years) Page 19 of 25 Evidence: meetings are held every two months. During the visit we witnessed the staff chatting and working with the residents in a friendly manner. The staff that we spoke with during the visit were very clear about the needs, likes, dislikes and preferred routines of the residents. The home has a staff training programme in place that includes some training being completed through an E Learning programme. The training programme includes courses in Food Safety, Infection Control, Introduction to Learning Disability, Safeguarding, Dealing with Emergencies, Working Safely. Manual Handling, Fire Protection, Health and Safety, First Aid, Challenging Behaviour, Epilepsy, Mental Health, Diabetes, Communication and Autism. Staff told us that they receive relevant training that helps them meet the needs of residents. Care Homes for Adults (18-65 years) Page 20 of 25 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 being well managed, people are able to give feedback on the service being provided, records are current and health and safety issues are being addressed. The manager needs to complete her application to register with the Commission. Evidence: The manager at 1 Charmandean has been in post since January 2009. She told us that she is in the process of applying to the Commission for registration. The manager told us that she had started the process with the Commission for Social Care Inspection but when CSCIs duties were taken over by the Care Quality Commission her Criminal Records Bureau Check was no longer valid so she has applied for a new one. We saw that Regulation 26 Providers visits are undertaken and that reports are completed and used to monitor the home. The Care Management Group carries out an annual quality assurance process and outcomes are published. Service users and their families have opportunities to give feedback on the service being provided. Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: We saw records for the running of the business including the fire risk assessment, Health and Safety checks, incident and accident recording, and all were current and in good order. Regular environmental checks are undertaken and recorded and health and safety issues in the home are being addressed. Care Homes for Adults (18-65 years) Page 22 of 25 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, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 37 8 The registered person shall 31/12/2008 register a manager in respect of this service who is qualified, competent and experienced to run the home. To ensure that there is consistent management of the home. Care Homes for Adults (18-65 years) Page 23 of 25 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 Care Homes for Adults (18-65 years) Page 24 of 25 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). 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