Care Home: 110 Primley Park

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What the care home does well The person lives with the owners as a member of their family, and shares normal domestic tasks. These help develop self care and life skills;The person being supported has opportunities to follow a full and active lifestyle, including regular meals out and holidays abroad;The home offers consistent care which means the person has learned strategies for managing behaviours that could be challenging. What has improved since the last inspection? Since the last inspection the home has continued to improve the environment, with new furnishings and floors and internal alterations to provide a larger lounge and dining space.A new car has been purchased and new opportunities for the person living there to develop new skills and have new experiences have been explored. What the care home could do better: The home owner must talk to the fire authority and make sure people are safe if there is a fire.Staff records must be kept for everyone who works at the home.All staff should have training in core areas such as first aid.Staff should be trained in people’s rights and the Mental Capacity Act.Medication training should be given to all staff and medication should be stored safely. Key inspection report Care homes for adults (18-65 years) Name: Address: 110 Primley Park 110 Primley Park Paignton Devon TQ3 3JX The quality rating for this care home is: two star good 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: Michelle Finniear Date: 2 3 0 4 2 0 1 0 This report is a review of the 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 stars – excellent  2 stars – good  1 star – adequate  0 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. They reflect the things that people have said are important to them: 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 32 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 32 Information about the care home Name of care home: Address: 110 Primley Park 110 Primley Park 110 Primley Park Paignton Devon TQ3 3JX 01803556319 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr William Henderson Name of registered manager (if applicable) Mr William Henderson Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 1 0 care home 1 learning disability Additional conditions: Registered for maximum 1 LD Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 32 A bit about the care home The service provides a home for one person with a Learning Disability. It is a family home, and the person who lives there enjoys aspects of their family life such as entertainment, family holidays, eating out, shopping and how to be an individual in a family situation. The present charge for the service is 1200 Pounds per week. Care Homes for Adults (18-65 years) Page 5 of 32 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 Care Homes for Adults (18-65 years) Page 6 of 32 How we did our inspection: This is what the inspector did when they were at the care home Before we went we sent the home some forms so they could tell us about the home; We visited the home and spoke to the person who lives there We looked at the records the home keeps such as care plans and policies. Care Homes for Adults (18-65 years) Page 7 of 32 What the care home does well The person lives with the owners as a member of their family, and shares normal domestic tasks. These help develop self care and life skills; The person being supported has opportunities to follow a full and active lifestyle, including regular meals out and holidays abroad; The home offers consistent care which means the person has learned strategies for managing behaviours that could be challenging. Care Homes for Adults (18-65 years) Page 8 of 32 What has got better from the last inspection Since the last inspection the home has continued to improve the environment, with new furnishings and floors and internal alterations to provide a larger lounge and dining space. A new car has been purchased and new opportunities for the person living there to develop new skills and have new experiences have been explored. Care Homes for Adults (18-65 years) Page 9 of 32 What the care home could do better The home owner must talk to the fire authority and make sure people are safe if there is a fire. Staff records must be kept for everyone who works at the home. All staff should have training in core areas such as first aid. Care Homes for Adults (18-65 years) Page 10 of 32 Staff should be trained in people’s rights and the Mental Capacity Act. Medication training should be given to all staff and medication should be stored safely. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Michelle Finniear Colston 33 33 Colston Avenue Care Homes for Adults (18-65 years) Page 11 of 32 Bristol Avon BS1 4UA 01179307110 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. 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 12 of 32 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 13 of 32 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is designed well to cater for the needs of an individual, who chose to live there. Evidence: 110 Primley Park is a service designed to cater for one person, who was known to the proprietor from their previous placement. They do not intend to take in any other people to live there, and the owner confirmed that if the placement were to cease the home would de-register. Discussion was held with the proprietor around the homes current registration status and he is to seek advice on possible alternatives. The home has a statement of purpose and service user guide available which outlines what the service aims to provide. The person who lives there has been in residence for ten years living with the owners as a member of their family. The owners told us We provide a homely environment and a good structure that enables the client to develop. A contract has been provided which details what they can expect to receive for the fees paid and some information about their rights. Care Homes for Adults (18-65 years) Page 14 of 32 Evidence: The home does not provide intermediate care. This is a specialist service which provides intensive rehabilitation with a review to returning the individual to their home. Care Homes for Adults (18-65 years) Page 15 of 32 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. The person using the service is enabled to make choices and decisions about their lives within a framework of management of risk. Evidence: The home has a care plan for the individual living there. This explains the care and support they need and has some information about how the home manages behaviours that are challenging. The person has some involvement in drawing up the plan which is being reviewed regularly. However as the person lives with the owners as a member of their family, apart from scheduled attendance at day centres the home can be full flexible in meeting the individuals needs, wishes and community activities available. Assessments and care plans also include behaviour charts indicating potential causes of challenging behaviours to assist in preventing them. There are some risk assessments available which help to indicate how the home manages to reduce and minimise risks. These may include risks to the individual or to others around them. These also help to maximise the persons opportunities for new experiences Care Homes for Adults (18-65 years) Page 16 of 32 Evidence: and personal development in a way that ensures this is done in a least restrictive but safe way. The person living at the home has a say in the ways in which they spend their time and they remain relatively independent in many areas, such as personal hygiene care. They told us they helped with some tasks around the house, and were able to make drinks and choose what to eat, although they did say that they ate out more times than they ate in as that was what they enjoyed to do. The home told us Care plans are reviewed on a regular basis and include our client. The person who lives at the home has their own bank account and card, which the proprietor holds on their behalf. We looked at the records for the management of this system on our visit. Information is available in the plans on emergency action in the case of the person going missing or needing a hospital admission or treatment. This includes photographs and information on support needs. Care Homes for Adults (18-65 years) Page 17 of 32 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. Opportunities are available to lead a full life within the local community and in a family orientated home environment. Evidence: The person using the service has opportunities to experience a family orientated lifestyle in which their independence can be maximised within the confines of a risk managed environment. It is not envisaged that they will be able to take up employment or training opportunities, but do attend a day centre two days a week, where they have opportunities to spend time with other people and undertaken activities such as swimming, crafts and walking. They also told us that they enjoyed animal care tasks at the day centre and did some weeding as well as taking care of plants at the home. The home has a vehicle available to enable community access. The person who lives at the home also takes part in usual household activities such as food shopping and is able to make their own drinks, help wash up and make choices Care Homes for Adults (18-65 years) Page 18 of 32 Evidence: about meals. They told us they also enjoy eating out, and following the inspection were going out for a meal in a local pub. Fruit is always freely available as snacks. Local opportunities are available for community involvement and neighbours are supportive of the person and involve them in local events such as parties. The owners take the person who lives at the home away with them on holiday, including long distance travel to Thailand, and on occasions when they do not, known friends move into the house to support them while the owners are away. Although family contacts are limited the person is encouraged to retain links with family and significant others who are welcome to visit at any time. The person who uses the service has their own accommodation of a private bedroom in the house, but shares other facilities with the owners, such as kitchen and bathroom. There is good outside space available and there are no restrictions on the use of these areas. Care Homes for Adults (18-65 years) Page 19 of 32 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. Health care needs are being addressed. Evidence: On the site visit we looked at the health care the person living at the home receives. The person who lives at the home told us that she was well and that the owners made sure she looked after her health. Arrangements made to ensure the persons health care is maintained include access to community facilities, including regular reviews by general practitioners, consultants and other community services such as speech therapy. Opportunities have been offered to attend pro-active health care, for example well woman clinics and dentists. The person would be able to indicate if they felt unwell and would communicate that to the manager. The local GP is said to be very supportive and to review the client every three months, along with a review of their medication. No health action plan is in place but evidence was seen of health care being accessed as identified and the close relationship with the practitioner means it is unlikely that medical needs would remain overlooked. The home deals with medication for the person who lives there however they are aware Care Homes for Adults (18-65 years) Page 20 of 32 Evidence: of what they are taking and consent to the administration. Medication is kept in a cupboard in the kitchen however this is not locked and is not ideal in terms of temperature and humidity fluctuations. No record sheets are signed for the administration of medication however very little medication is held and supplies given monthly so it would be easy to check the balance. Limited numbers of people also would deal with the administration. The GP reviews the prescriptions every three months and regular screening tests are undertaken as needed. Support is available form other community and hospital based professionals as needed. Care Homes for Adults (18-65 years) Page 21 of 32 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. Policies and procedures are in place to manage complaints. The owner should receive updated training in legislation to support peoples rights and protect them from abuse. Evidence: The home has a complaints procedure available and information on what to do in case abuse is suspected. No complaints have been received since the last Inspection. The owners told us that the person who lives at the home has access to professionals and support services outside of the home where they could raise any concerns if they wished to and that they would have the capacity to do so. This would be in addition to the homes own internal complaints procedure. The owner is recommended to undertake an update in safeguarding policies and procedures and in the Mental Capacity Act. Safeguarding training helps ensure staff are aware of signs of abuse and of what to do if any abuse is suspected. The Mental capacity act helps ensure peoples rights to decision making are respected. This is new legislation since the last inspection. Care Homes for Adults (18-65 years) Page 22 of 32 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a domestic environment where the person being cared for can live as a part of the family. Evidence: 110 Primley Park is a domestic, reverse level house set in an elevated residential area of Paignton. The home currently offers two bedrooms, a lounge, kitchen, office and bathroom. One bedroom is shared by the owners the other is occupied by the person living at the home. The third bedroom is currently being used as an office. The person living at the home has free access around the building, which is well maintained and comfortable. There are no separate service areas at the home - the laundry facilities are situated in the kitchen as in a domestic setting and the person living there uses the same bathroom facilities and the owner’s family. There are gardens to the front and rear of the home and several sunny patio areas with seating. There is off street parking to the front of the home and plentiful on street parking nearby. The registered owner/manager could tell us about the changes and updating that have been made to the premises since we last visited, which has included extensive refurbishment. They told us that in the last year they have changed the floors, extended Care Homes for Adults (18-65 years) Page 23 of 32 Evidence: the kitchen diner, bought new furniture for the lounge, provided new bedroom furniture, bought a new stair carpet and installed new smoke alarms. No specialist equipment is required by the person who lives there and their room is well, personalised and individual. This room is not lockable and reasons for this were detailed in the care plan. Care Homes for Adults (18-65 years) Page 24 of 32 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The owners provide almost continuous staffing cover. Records need to be provided for everyone employed by the home who has unsupervised access to the person being supported. Evidence: 110 Primley Park is mainly staffed by the owner and his wife, who live with the person needing support as a family group. The owner/manager has a file containing copies of a criminal records bureau check undertaken for himself and evidence of his qualifications, training and experience. No checks were available to detail this process for his wife. Criminal records bureau checks should be obtained for everyone who has substantial unsupervised access to the person being supported. When the owners go away for breaks they said that some friends of the family who know the person needing support will come and stay for the time they are away. This provides continuity of care for the individual. However although the owner/manager knew the carers had a criminal records bureau check, copies of this were not being held in the home so it was not possible to verify the information. A full recruitment procedure helps to ensure that the person receiving care can be supported by people who are suitable to be caring for potentially vulnerable adults. Evidence could be seen of the training and qualifications the owner/manager has Care Homes for Adults (18-65 years) Page 25 of 32 Evidence: undertaken, although some of these now would benefit from being updated. These included First Aid which was last completed around three years ago and Infection control last completed around 8 years ago. Other training included holistic approaches to care, managing challenging behaviour, counselling, total communication, epilepsy, observation and recording, speech and language therapy, control and restraint, breakaway and food hygiene. Mrs Henderson has experience of working in hospitals abroad. The person living at the home is supported at all times, but has freedom around the accommodation. The owners provide 24 hour care with the exception of when the person attends day care. Care Homes for Adults (18-65 years) Page 26 of 32 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. 110 Primley Park remains primarily a family home setting, and health and safety arrangements undertaken are in proportion to this. However the home does need to ensure legislation regarding fire precautions is complied with and advice taken. Evidence: On the site visit we looked at the way the home is managed and how the safety of people living and working there is maintained. The owner/manager of the home has worked in business for many years and has also had several years of experience working in care settings with people exhibiting challenging behaviours. This home was set up 10 years ago to provide a specific service for one person, and the owners live with them as a family. As such the home does not have a formal quality assurance system, as the manager feels that as they live with the person they would have a clear understanding of anything that she was not happy with or felt could be improved. However regular reports are produced concerning the running of the home which indicate the activities that have been followed and any changes that have been made. Care Homes for Adults (18-65 years) Page 27 of 32 Evidence: The home is a domestic sized building and fire exits are available to the outside from both floors as the home is reverse level. There are smoke detectors in the building but no fire fighting equipment such as extinguishers or a fire blanket. The owner is advised to compile a fire precautions (workplace) risk assessment and discuss this with the local fire authority. The person being supported would be able to leave the property without assistance, and regular checks are undertaken of the smoke alarms. Some other health and safety requirements are in place, such as the regular testing of electrical appliances for electrical safety and there are restricted openings on windows according to the owner. Other areas have been risk assessed. The accident book was seen but no accidents have occurred since the last inspection. Policies and procedures sampled were in proportion to the setting, which remains primarily a family home. Certificates for insurance were seen. Care Homes for Adults (18-65 years) Page 28 of 32 Are there any outstanding requirements from the last inspection? Yes  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 Care Homes for Adults (18-65 years) Page 29 of 32 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 Description 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 Description Timescale for action 1 34 19 The registered person must 30/06/2010 not allow anyone to work at the home unless he has obtained the required information on them. This includes references, criminal records bureau checks and evidence that they are fit to work at the home. This is to help ensure that the person is cared for by people who are suitable to be working with a potentially vulnerable person. 2 42 23 The registered person must consult with the fire authority and produce an appropriate fire precautions workplace risk assessment and implement any requirements. 30/06/2010 This is to ensure people are Care Homes for Adults (18-65 years) Page 30 of 32 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 Description Timescale for action kept safe from fire. 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 20 It is recommended that medication be stored in a locked cupboard and that records of administration of medication be kept. The registered owner/manager should attend training in the Mental capacity Act and deprivation of liberty safeguards. Staff should receive updated training in first aid, infection control and other core areas where appropriate. 2 3 23 35 Care Homes for Adults (18-65 years) Page 31 of 32 Helpline: Telephone: 03000 616161 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. 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