Care Home: 1 Curlew Close

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What the care home does well The service has well a trained and motivated staff team who are provided with good levels of leadership and support. Then service provides person centred care and support that is appropriate to the needs of the service users. Health action plans help ensure that future needs are identified and planned for. The service uses risk assessing in a positive manner to further increase independence and opportunities for service users. What has improved since the last inspection? An increased number of staff have completed NVQ training. The care planning has been further developed to encourage and support service user involvement and choice. The home have actioned the recommendations made by the CSCI pharmacy Inspector. The staffing rotas have been made more flexible to ensure there is sufficient staff on duty to support activities at the weekends and in the evenings. What the care home could do better: No specific areas requiring improvement were identified during this inspection visit. CARE HOME ADULTS 18-65 1 Curlew Close 1 Curlew Close Northway Tewkesbury Gloucestershire GL20 8TJ Lead Inspector Mr Simon Massey Unannounced Inspection 20th January 2009 10:00 1 Curlew Close DS0000016309.V373888.R01.S.doc Version 5.2 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 1 Curlew Close DS0000016309.V373888.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 1 Curlew Close DS0000016309.V373888.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 1 Curlew Close Address 1 Curlew Close Northway Tewkesbury Gloucestershire GL20 8TJ 01864 297699 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) www.mencap.org.uk Royal Mencap Society Mrs Catherine Feasey Care Home 4 Category(ies) of Learning disability (4), Physical disability (1) registration, with number of places 1 Curlew Close DS0000016309.V373888.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th April 2007 Brief Description of the Service: Curlew Close is a detached property on a housing estate on the outskirts of Tewksbury. The accommodation is arranged over two floors, with one bedroom being on the ground floor. This bedroom has an en-suite bathroom. The home provides care and support for four adults with Learning Disabilities and is owned and staffed by the national Mencap Society. 1 Curlew Close DS0000016309.V373888.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. This inspection took place on 20/01/09. The Inspector met with the Manager, various care staff and all of the service users. Staff were observed supporting and working with the service users. Records relating to care planning, medication, staff recruitment, health and safety and staff training were examined. An inspection of the environment was also carried out. A number of questionnaires were circulated and returned as part of the inspection process. This was a positive inspection of a service that has provided a consistently good service over the previous few years. Progress has continued and various improvements were identified during this inspection. What the service does well: What has improved since the last inspection? What they could do better: No specific areas requiring improvement were identified during this inspection visit. 1 Curlew Close DS0000016309.V373888.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 1 Curlew Close DS0000016309.V373888.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 1 Curlew Close DS0000016309.V373888.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The assessment process ensures that needs are correctly identified before service users are admitted to the home. EVIDENCE: There have been no new admissions to the home for over two years and there are currently no vacancies. There is an admissions process in place that is part of the national policy of the Mencap organisation. Previous inspections have shown that this is followed thoroughly and detailed assessments have been completed and trial visits offered before placements are offered. All prospective admissions are given the opportunity to have visits and trial stays in the home prior to admission. 1 Curlew Close DS0000016309.V373888.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users needs are met by the use of person centred plans that they are fully involved in developing and reviewing. Risk assessing is used positively to encourage independence and develop skills. EVIDENCE: All service users have detailed person centred plans in place, which are reviewed regularly by the staff and management with the full involvement of the service users, depending on their interest and ability. The home are currently making some video records, or versions, of some parts of the care plans which also fully involve the service users. These plans will help further ensure that the service users are aware as far as possible as to the content of their plans, as well as provide clear guidance and information from the service users themselves as to how they would like their needs to be met. The care plans cover all aspects of personal care and daily living and also contain information on longer tem plans and goals. Service users spoken with showed a good understanding of their plans appropriate to their abilities and 1 Curlew Close DS0000016309.V373888.R01.S.doc Version 5.2 Page 10 appeared positive about this aspect the service provided by the staff and the home. A selection of care plans were examined. The home has continued to improve the system it uses with increased documentation being kept on all aspects of the care and support being provided. Care plans are regularly reviewed and updated and the information is person centred, providing clear guidance for staff on how the service is to be delivered. Risk assessments are in place, which gave examples of how greater independence is being encouraged and supported. One person spoken with explained how they now went to the shops and into the local town without staff supervision and how they had been supported to learn the skills to do this. Staff interviewed demonstrated a good awareness of the role of risk assessing as means of supporting independence and increasing choice. There was evidence of good recording, which showed the staff’s ability to observe and record in a non-judgemental style, increasing the knowledge of a service user’s needs. Staff spoken to were also able to show that they had a good understanding of the care plans and the various guidelines that were in place for the different service users. 1 Curlew Close DS0000016309.V373888.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service have opportunities to take part in a variety of activities in the community and in the day centre. Service users have the opportunities to develop independence skills within a structured framework and are supported to pursue a lifestyle of their own choosing. EVIDENCE: All service users have individual daily and weekly routines or programmes that they follow. People spoken with expressed their satisfaction with their current range of activities, both within the home and out in the community. One person has slightly less daily activities than the other service users but it was explained that they were trying to find some additional college courses that could be undertaken. Activities included a mixture of attending a local day centre and spending time with staff undertaking domestic and personal chores. Records showed that a number of group outings and activities are supported and that there are also occasional one to one activities undertaken. The 1 Curlew Close DS0000016309.V373888.R01.S.doc Version 5.2 Page 12 majority of evening trips recorded showed that people went out as a group and it was commented by the Inspector that maybe more options for spontaneous one to one trips in the evenings could be supported. It was evident from talking to service users that they enjoy going out as group, and people spoke enthusiastically about their holidays and weekends away, which were organised. Service users confirmed they are supported to maintain contact with their families and friends and records showed that regular visits are arranged and that families and friends are made welcome in the home. The home was well stocked with fresh and packaged food and all food was correctly stored and labelled. Staff have undertaken training in food safety. Staff explained how service users are involved in planning menus and cooking and how choice is respected, but healthy eating encouraged. One service user explained how they had been supported to lose weight and they were very pleased with this. Advice has been sought over specialist diets and guidance is provided to staff. There was evidence of good recording in relation to monitoring of diet and health issues. Service users were very positive about the quality and quantity of food provided. Service user are encouraged and supported to undertake domestic tasks and chores as much as their abilities allow. 1 Curlew Close DS0000016309.V373888.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People’s personal and healthcare needs are met, promoting their dignity and wellbeing. Health Action Plans help anticipate future needs and provide the staff with information and guidance to ensure that future needs can be met. EVIDENCE: Individual plans contain the details over what personal care is required and how this should be delivered. There are records of all health appointments that are kept and there was evidence that information was correctly recorded and advice actioned by the staff team. All service users have health action plans in place and these are regularly reviewed and updated when necessary. All medication was correctly stored and administration records were accurate and up to date. One person is being supported to learn how to self medicate and the correct documentation and risk assessments were in place to support this. The service user was very positive about this aspect of their personal care. The home have accessed specialist services when required and information was correctly recorded and staff demonstrated in interview their awareness of the issues relating to this guidance. 1 Curlew Close DS0000016309.V373888.R01.S.doc Version 5.2 Page 14 The home had an inspection completed by the CSCI pharmacy inspector in April 2007 and this made a number of positive comments about the service and rated this aspect of provision as being “good”. All staff must complete training in medication administration before they are allowed to perform this task. 1 Curlew Close DS0000016309.V373888.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has satisfactory arrangements and procedures in place for the protection of service users and provides a safe environment for service users in which they are respected and treated with dignity. EVIDENCE: All staff undertake training on Ault Protection both during their induction, when they complete a course run by Mencap and also at a later date when they attend the training run by the local authority Adult Protection team. Staff demonstrated a good understanding of the issues and the action they would they would take to raise a concern or make a complaint. Service users had some understanding of the Mencap complaint system, which was appropriate to their abilities, and recording showed that the system is regularly explained and reminders given about this during house meetings. Service users appeared confident and relaxed in the home and appeared to relate well to the staff on duty. Improved training around communication and the use of various visual aids have increased the ability of the staff to seek the views of the service users and also encourage people to make decisions about their daily lives. There appeared in general to be a relaxed atmosphere within the home during this inspection, with service users appearing comfortable and relaxed in their environment, and also in their interactions with the staff team. Two service users said that if they were not happy about something they would speak to a member of staff. The home has received no formal complaints since the last inspection. 1 Curlew Close DS0000016309.V373888.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are provided with a homely and comfortable environment though this may be compromised for one person whose personal area has a strong odour EVIDENCE: Some parts of the house have been recently decorated and the home provides comfortable and reasonably spacious accommodation. People are fully involved in choosing their décor and fittings, and all rooms are personalised according to person choice and preferences. One service user has been encouraged successfully to have more items and pictures in their room, which better meets their needs. One person has had their room adapted to meet their personal care needs, and three service users spoken to expressed satisfaction with their rooms. One ensuite bathroom has been converted to a “wet room” making the meeting of personal care needs easier. There was however a strong odour in this area that needs to be investigated and remedied, as it appears to be coming from the 1 Curlew Close DS0000016309.V373888.R01.S.doc Version 5.2 Page 17 drain. The manager stated that this had previously been looked at by the maintenance team but this had not resolved the issue. This needs to be addressed and a requirement has been made in respect of this. Service users confirmed that their privacy was respected by other service users and by the staff team and that people always knocked before entering their bedrooms. The outside of the property was well maintained and provides a comfortable and safe area for service users to enjoy. With the exception of the one bedroom with the en-suite bathroom mentioned previously, the home was very clean and hygienic throughout. 1 Curlew Close DS0000016309.V373888.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users needs are met by a trained and motivated staff team who are consistently supervised. EVIDENCE: The home is currently fully staffed and the rotas showed that staffing levels are maintained and that sufficient staff are provided to meet the needs of the service users. All staff must complete an induction period that covers a wide range of training and observed practice. During this time they receive regular supervision from the manager and are also mentored by an established staff member. On completion of the induction staff are expected to undertake NVQ training and the majority of the staff team are now qualified to at least NVQ level 2. Staff were positive about their induction and preparation for their roles and felt they were well supervised and supported during this period. Records showed that all staff received regular supervision and also annual appraisals. All staff were up to date with the required statutory training and also all staff had undertaken additional training in various areas appropriate to the needs of the service users. This has included training on dementia and epilepsy. 1 Curlew Close DS0000016309.V373888.R01.S.doc Version 5.2 Page 19 The home has regular staff meetings and the minutes from these show discussions on needs and practice, and also advice and guidance being provided by the management. Improved communication training has helped staff to understand some needs better. Staff interviewed appeared motivated to providing a high standard of care and were able to demonstrate their understanding of the needs and abilities of the service users. Service users were positive about the staff team and their key-workers and were observed interacting in a positive and relaxed manner with the staff on duty. 1 Curlew Close DS0000016309.V373888.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The Manager provides leadership and support to the staff team in developing and implementing a person centred approach to meeting needs and providing support. EVIDENCE: The Manager is qualified and experienced and has also worked at other Mencap services. Feedback from staff and service users was positive about the support and leadership from the Manager. There was evidence in care planning, meeting of health needs and developing of activities that a person centred approach to care is actively promoted and encouraged by the Manager. The home has made good progress in encouraging and supporting service users to make choices and exercise increased control over their lives as far as their abilities allow. 1 Curlew Close DS0000016309.V373888.R01.S.doc Version 5.2 Page 21 All staff said they thought the Manager was approachable and responsive to issue that are raised and all said they felt confident that if they need to make a complaint they would be listened to, and the correct action would be taken. There was evidence that the Manager monitors various aspects of the care and the different processes and recording within the home. The Manager receives regular supervision meetings with the area manager for the service and a continuous improvement plan is in place which monitors all the ongoing changes and developments that are in place. The recording for these meetings was seen and this showed that different aspects of the home are looked at different visits and that constructive criticism and advice is provided. Staff and service users also have the opportunity to speak and meet the area manager when they visit, which is on a monthly basis. All health and safety checks had been completed and recording was up to date in respect of fire safety and testing, water and fridge temperatures, and portable electrical appliance testing. All risk assessments seen were up to date and had been correctly reviewed and updated where necessary. All potentially hazardous material were correctly stored and the appropriate COSH assessments in place. The home is subject to the quality assurance system employed by Mencap, which ensure that approximately every three years the service is subject to full review from the Provider. 1 Curlew Close DS0000016309.V373888.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 x 1 Curlew Close DS0000016309.V373888.R01.S.doc Version 5.2 Page 23 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA30 Regulation 23 Requirement The home must investigate and remove the odour in one bedroom as identified in the report. Timescale for action 30/03/09 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 1 Curlew Close DS0000016309.V373888.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 1 Curlew Close DS0000016309.V373888.R01.S.doc Version 5.2 Page 25 - 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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