Care Home: 201a Berrow Road

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What the care home does well 201a Berrow Road is a domestic dwelling set in a residential area. It provides a homely environment for the people who live there. Only two people live at the home and all care and support is provided by the owners meaning that people receive very individualised care. There are no strict routines in the home and people make choices in line with family type living. Food is prepared in line with known likes and dislikes and people are able to use the kitchen to make drinks and snacks. What has improved since the last inspection? There have been few changes in the home since the last inspection although the manager has begun some distance learning courses. What the care home could do better: Care plans and risk assessments need to give evidence that they have been regularly reviewed and continue to be appropriate to the individuals who live at the home.201a Berrow RoadDS0000016279.V378639.R01.S.docVersion 5.3Although the home informally seeks the views of the people who live there, there are no formal quality assurance systems in place, which seek the views of other interested parties. The manager has many years experience of working within the care sector but needs to attend periodic training courses to make sure that her knowledge and practice is kept up to date. The home need to ensure that people living at home have clear information about what is included in the basic fee and where additional charges will be incurred. Key inspection report CARE HOME ADULTS 18-65 201a Berrow Road 201a Berrow Road Burnham-on-sea Somerset TA8 2JF Lead Inspector Jane Poole Key Unannounced Inspection 4th December 2009 10:00 201a Berrow Road DS0000016279.V378639.R01.S.doc Version 5.3 Page 1 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. 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 home adults 18-65 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. 201a Berrow Road DS0000016279.V378639.R01.S.doc Version 5.3 Page 2 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 201a Berrow Road DS0000016279.V378639.R01.S.doc Version 5.3 Page 3 SERVICE INFORMATION Name of service 201a Berrow Road Address 201a Berrow Road Burnham-on-sea Somerset TA8 2JF 01278 786358 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) Mrs Veronica Margaret Hawkins Mrs Veronica Margaret Hawkins Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 201a Berrow Road DS0000016279.V378639.R01.S.doc Version 5.3 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th January 2009 Brief Description of the Service: 201a Berrow Road is registered to provide personal care for up to 3 people who have a learning disability. Mr and Mrs Hawkins own the home and the Registered Manager is Mrs Veronica Hawkins. Both owners live at the home and provide all care and support. The home is spacious and is set in attractive gardens. It is within easy reach of Burnham town centre and the sea front. All bedrooms are located on the first floor and are for single occupancy. People living at the home share a family type bathroom with a bath and overhead shower. People who live at the home are able to use a separate small lounge and dining room on the ground floor. There is a large rear garden that has a summerhouse and hot tub. Fees range between £503.00 - £872.00 each week. This sum does not include the purchase of toiletries, clothes or monies to engage in social activities or hobbies. 201a Berrow Road DS0000016279.V378639.R01.S.doc Version 5.3 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The focus of this inspection visit was to inspect relevant key standards under the Commissions Inspecting for Better Lives 2 framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are:- excellent, good, adequate and poor. This inspection was carried out by one inspector. We, the Commission, were able to talk with the owners, view records and the building. Both people living at the home completed questionnaires after the site visit and some of their responses have been included in this report. What the service does well: What has improved since the last inspection? What they could do better: Care plans and risk assessments need to give evidence that they have been regularly reviewed and continue to be appropriate to the individuals who live at the home. 201a Berrow Road DS0000016279.V378639.R01.S.doc Version 5.3 Page 6 Although the home informally seeks the views of the people who live there, there are no formal quality assurance systems in place, which seek the views of other interested parties. The manager has many years experience of working within the care sector but needs to attend periodic training courses to make sure that her knowledge and practice is kept up to date. The home need to ensure that people living at home have clear information about what is included in the basic fee and where additional charges will be incurred. 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. 201a Berrow Road DS0000016279.V378639.R01.S.doc Version 5.3 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 201a Berrow Road DS0000016279.V378639.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1&5 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. No new people have moved to the home and the owners do not intend to take further referrals. Therefore this section has not been fully assessed. The service user guide needs to clearly state what is included in the basic fee and where additional charges will be made. EVIDENCE: The home has a statement of purpose and service user guide which has been made available to the people who live at the home. Both these documents are basic in line with the size and nature of the home. People living at the home have a financial agreement with the local authority which sets out their fees and personal contribution. Currently people do not receive information about the charges that are made for transport and this should be clearly set out to ensure that people are aware of what is included in the basic fee and where additional charges will be incurred. 201a Berrow Road DS0000016279.V378639.R01.S.doc Version 5.3 Page 9 No new people have moved to the home for several years and the owners gave assurances that they are not intending to accept any new referrals. 201a Berrow Road DS0000016279.V378639.R01.S.doc Version 5.3 Page 10 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9. People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home have basic care plans which are appropriate to the size and nature of the home. EVIDENCE: Both people living at the home have a basic care plan which is appropriate to the size and nature of the home. Care plans give details of the level of support that people require with day to day activities including personal care. Care plans seen set out any restriction in place and these had been agreed with the person living at the home. There was no evidence that care plans had been fully reviewed since the last inspection however a handwritten entry on one indicated that they had been up dated in line with a change in circumstance. 201a Berrow Road DS0000016279.V378639.R01.S.doc Version 5.3 Page 11 There are some risk assessments in place which outline the risk and the control measures in place. The manager of the home assists people with personal finance and acts as a financial appointee for one person. We saw that records are maintained of all transactions and receipts are kept for all purchases. Both people living at the home completed questionnaires and both said that they were always able to make choices about what they did during the day, in the evening and at weekends. 201a Berrow Road DS0000016279.V378639.R01.S.doc Version 5.3 Page 12 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): This is what people staying in this care home experience: 12, 13, 15, 16 & 17. People using the 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 assists people to keep in touch with friends and family. People are assisted to take part in some leisure activities and are able to pursue their own hobbies. EVIDENCE: There are no set routines in the home and people are able to make choices about their day to day lives. One person answered ALWAYS and one answered USUALLY to the question ‘Do you make decisions about what you do each day?’ 201a Berrow Road DS0000016279.V378639.R01.S.doc Version 5.3 Page 13 Both people have opportunities to access the local community, with the support from the home and unsupported. One person continues to enjoy going out for walks and another rides a bike and visits friends in the locality. The home assists people to keep in touch with family members and at the time of this inspection both people were away from the home staying with family. People living at the home have not had a holiday away with the providers this year. Neither person attends further education or takes part in paid or unpaid work. One person receives additional support from the local authority to assist them to go out weekly and take part in activities away from the home. Daily records kept by the home show that people go out shopping and for meals out with the home owners. One person continues to pursue their hobby of bell ringing and goes to a local gym. Both people have TVs in their personal rooms and there is a TV and video in the communal lounge. The home owners stated that they felt one person living at the home now needed more opportunities for personal development than they were able to offer. There is no set menu in the home, food is cooked in line with known likes and dislikes. There is a communal kitchen which people have unrestricted access to and are able to make drinks and snacks. Meals are recorded in daily records. One person commented on their questionnaire that they enjoyed the food in the home and went out to restaurants to eat with the home owners. 201a Berrow Road DS0000016279.V378639.R01.S.doc Version 5.3 Page 14 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20. People using the 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 healthcare professionals according to their individual needs. EVIDENCE: Care plans seen gave details of the level of support people require with personal care. Both people living at the home share a family type bathroom where personal care can be undertaken in private. People are able to choose their own clothes and visit hairdressers in the local town. People living at the home are registered with local healthcare professionals such as GPs and dentists. Records are kept of all appointments. One care plan seen had records of personal weight and these showed that the persons’ weight remained stable. One person living at the home takes regular medication and this is administered by the homes manager. Records of doctors’ appointments show 201a Berrow Road DS0000016279.V378639.R01.S.doc Version 5.3 Page 15 that the medication is reviewed regularly. A monitored dosage system is in use and the manager has attended a short course on medication administration. At the time of the inspection there was no medication in the home as the person was away on holiday. 201a Berrow Road DS0000016279.V378639.R01.S.doc Version 5.3 Page 16 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Appropriate measures are in place to enable people to raise concerns and make a formal complaint. EVIDENCE: The home has a complaints procedure and a copy of the local authority ‘Safeguarding Vulnerable Adults’ policy. Both people who live at the home have access to personal and professional contacts outside the home who they would be able to share any worries or concerns with. People have unrestricted access to their personal rooms and to the communal areas of the home. Both people who completed questionnaires said that they knew who to speak to informally if they were not happy and how to make a formal complaint. No complaints have been received by the home or the Commission since the last inspection. 201a Berrow Road DS0000016279.V378639.R01.S.doc Version 5.3 Page 17 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 201a Berrow Road is a domestic property that provides a homely environment for the people who live there. EVIDENCE: 201a Berrow Road is a large detached house in a residential area. It is within walking distance of the Sea front and close to Burnham town centre. The owners, Mr and Mrs Hawkins, live at the property and have a private lounge, bedroom and conservatory. All areas are domestic in style. One the ground floor there is a kitchen/diner and a basic lounge that can be used by people living at the home. Bedrooms are on the first floor. There is no lift so people living at the home need to be physically mobile to access the bedrooms. 201a Berrow Road DS0000016279.V378639.R01.S.doc Version 5.3 Page 18 People are able to personalise their rooms if they wish to. People share a communal bathroom with bath and shower over. There is a small utility area with washing machine and drier in line with domestic style living. All areas of the home seen were clean and fresh. 201a Berrow Road DS0000016279.V378639.R01.S.doc Version 5.3 Page 19 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience excellent/good/adequate/poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home does not employ any staff. All care and support is provided by the home owners. EVIDENCE: 201a Berrow Road DS0000016279.V378639.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 37, 29 & 42. People using the 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 home is adequately managed but does not formally seek the views of the people who live there or other interested parties. EVIDENCE: The registered manager and joint provider is Mrs Veronica Hawkins. The home is run in partnership with her husband. Both live on the premises and are available 24 hours a day. The manager has worked in the care sector for many years and has a National Vocational Qualification (NVQ) in care at level 2. Since the last inspection 201a Berrow Road DS0000016279.V378639.R01.S.doc Version 5.3 Page 21 Veronica has made contact with local training co-ordinators and has begun to undertake some distance learning courses. No course has yet been completed. The manager has up to date certificates in first aid and food hygiene. She has also undertaken a short course on the administration of medication. There are smoke detectors within the home that are regularly tested. Records show that qualified trades people have tested the electrical installation and gas boiler within the home. The fire risk assessment states that all portable appliances will be tested on an annual basis, this has not been done for over 12 months. There are no formal quality assurance systems in place although the owners of the home have day to day contact with the people who live there and regular contact with family members. Up to date certificates of insurance and registration were seen at this inspection. 201a Berrow Road DS0000016279.V378639.R01.S.doc Version 5.3 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 2 2 x 3 x 4 x 5 3 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 3 STAFFING Standard No Score 31 N/A 32 N/A 33 N/A 34 N/A 35 N/A 36 N/A CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 3 x LIFESTYLES Standard No Score 11 x 12 2 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 x x 2 x 1 x x 2 x Version 5.3 Page 23 201a Berrow Road DS0000016279.V378639.R01.S.doc YES 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 YA6 Regulation 15(2)b Requirement The registered person must ensure that care plans and risk assessments are regularly reviewed and up dated when needs change. (Requirement made at Previous Inspection) Timescale for action 31/03/10 2. YA37 9 (2) bi The registered manager must 31/03/10 attend periodic training to ensure that their knowledge and practice is kept up to date. (Requirement made at Previous Inspection) The registered person must ensure that people have clear information about what is included in the basic fee and where additional charges will be made. 31/01/10 3 YA1 5 (1) [b] RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. 201a Berrow Road DS0000016279.V378639.R01.S.doc Version 5.3 Page 24 No. 1 Refer to Standard YA39 Good Practice Recommendations The registered persons should seek feedback from people living at the home, relatives and healthcare professionals as part of the quality assurance process. (Recommendation made at previous inspections) Mr Hawkins should attend training in food hygiene and first aid. (Recommendation made at previous inspections) The registered person should ensure that the portable electrical appliances in the home are tested annually in line with the homes fire risk assessment. 2 3 YA42 YA42 201a Berrow Road DS0000016279.V378639.R01.S.doc Version 5.3 Page 25 Care Quality Commission South West Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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