Care Home: 21 Potterill Lane

What the care home does well The people who live at the home have lived together for a long time. They all have assessments which had been done before they moved in together from long stay hospitals, these have been changed and updated as their needs have changed. This makes sure that staff always have up to date and current information about the persons needs. Lots of detailed information is kept by the home about the people who live there; this includes information about how staff are to care for people and how their health care needs are to be met. People are supported by families or some one who will look out for their welfare, these people are called independent advocates. This makes sure that the person receives the best care possible and that other people are involved in the care people receive making sure the staff`s practice is open and transparent. People are supported to undertake lots of activities both inside and outside the home. The staff make sure people can pursue hobbies and interests and people go on holiday both abroad and in this country. Staff make sure people continue to have links with families and friends and help them to maintain good social links with the surround community. This makes sure people can lead a fulfilling life and have the opportunity to experience new things. The company makes sure staff are well trained and have clear management support. The company have their own training department which makes sure all of the staff`s training is up to date and they have the opportunity to undertake specialist training about the needs of the people they care for. The company also makes sure staff are recruited properly and all checks are done before someone starts working at the home. This means that people are not exposed to staff who maybe unfit to care for vulnerable people and are cared for by staff who are well trained and can meet their needs. The home is small and has the feel of a family type environment. The home is pleasantly decorated and people have had a say in how their rooms are decorated. People can use their rooms as they please and are encouraged to personalise these with posters, photos and mementos; people can use the kitchen under supervision. The company makes sure all the equipment used is checked regularly and repairs are done quickly. This means that people can feel at home and live in safe well maintained environment. What has improved since the last inspection? This was the home`s first inspection. What the care home could do better: People have detailed records kept about their needs and how staff are best able to meet these, some are more user friendly and better presented than others. We would recommend that all the records are of the same quality. This would mean that there is a consistency in the records kept and all are of the same quality. Key inspection report Care homes for adults (18-65 years) Name: Address: 21 Potterill Lane 21 Potterill Lane Sutton-On-Hull Hull N Humberside HU7 4TF     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: George Skinn     Date: 1 7 1 1 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 25 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 25 Information about the care home Name of care home: Address: 21 Potterill Lane 21 Potterill Lane Sutton-On-Hull Hull N Humberside HU7 4TF 01482708431 01482329337 info@avocettrust.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Avocet Trust Name of registered manager (if applicable) Type of registration: Number of places registered: care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who may be accommodated is: 4 The registered person may provide the following category of service only: Care Home only-Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following category: Learning DisabilityCode LD Date of last inspection Brief description of the care home The home has recent completed the CQC registration process. It is registered to provide care and accommodation for four (4) adults with a learning disabilities. It is in the village of Sutton on the outskirts of Hull. The home consists of four (4) bedrooms, two (2) on the first floor and two (2) on the ground floor, a lounge, a separate dining room and domestic style kitchen. There are Care Homes for Adults (18-65 years) Page 4 of 25 Over 65 0 4 Brief description of the care home two (2) communal bathrooms and a wet room which is en-suite to one of the ground floor bedrooms. There is small paved garden to the rear of the home. The home is close to local amenities and the people who live there make full us of these and there is bus service into the city centre. Information about the home is provided in the Service User Guide and the Statement of Purpose both can be obtained from the manager. Care Homes for Adults (18-65 years) Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means that people who use this service experience good quality outcomes. This is a new registration. We brought our inspection forward because the home has been running unregistered for six months. We did not take any enforcement action because to move people would have been too disruptive for them. We sent comment cards to the home for people and staff to complete but none have been completed and sent back to us, none were handed back to us during the site visit. We visited the home and spent five (5) hours there looking at records, speaking to staff and generally observing staff practice and the running of the home. We visited the company head office to look at staff recruitment files. Care Homes for Adults (18-65 years) Page 6 of 25 We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future if a requirement is repeated it is likely that enforcement action will be taken. This was the homes first inspection and the acting manager was available to assist. Care Homes for Adults (18-65 years) Page 7 of 25 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Adults (18-65 years) Page 8 of 25 following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 25 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs were assessed prior to moving into the home. Anyone thinking of moving into the home would be provided with up to date information to enable them to make an informed choice. Evidence: The people who live at the home have recently moved from a different establishment and have lived at the current address for about six (6) months. The acting manager told us that people had visited the home during refurbishment and had been fully involved with the move. We looked at all of the files which belonged to the people who live at the home and we saw full assessments had been completed when they first moved into their previous home from long stay hospitals many years ago. These assessments had been updated following reviews and the changing needs of the people. All of the people had copies of an updated Service User Guide and the homes Statement of Purpose had been updated to reflect the change in location. Care Homes for Adults (18-65 years) Page 11 of 25 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Everyone has a plan of care and are involved in this with support from independent advocates and families. People are able to participate in the running of the home as much as they are able. People are able to take risks and are supported by the staff and risk assessments are in place. Evidence: We looked at everyones file and we saw that these contained detailed information about how staff care for the person. These were person centred and were written in the first person, for example I like, I dont like, etc. The records told the staff about what the person likes to eat, what they like to wear, what they like to do during the day and any special needs the person may have. The people who live at the home have limited understanding of their care plan so they are supported by advocates and families. Two (2) of the care plans contained information which was clear and was presented in a more user friendly way, the other two (2) files while containing the same amount of information were not as well Care Homes for Adults (18-65 years) Page 12 of 25 Evidence: presented or as user friendly. It is recommended that all of the files should be of the same quality. During the site visit we spent some time observing the activities around the home. We saw that due to peoples dependency levels their ability to participate in the running of the home is limited. The acting manager told us that people had chosen how their rooms would be decorated, and they are able to have plenty of personal possessions in their rooms which reflect their personality and interests. For example one person likes Elvis Presley and they have posters on their walls and listen to his music. The people who live at the home are supported by advocates and families who look after their welfare and can speak and their behalf if any issues arise. People have TVs in their rooms and can spend time in them as they please. We saw that people have supervised access to the kitchen and one person is able to access the kitchen alone and choose what they would like to eat. People can move around the home freely and can make full use of the communal space and their own private space. Peoples care plans identified areas of risk and how to eliminate these to keep the person safe. The risk assessments are used when the person is both inside the building and when they are outside. We saw that there are detailed instructions for the staff to follow if any issues arise while outside of the building. Care Homes for Adults (18-65 years) Page 13 of 25 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are encouraged and supported to experience opportunities for personal development and be part of the local community. The home actively encourages visits from family members. People are supported to eat healthily and to maintain a healthy well balanced lifestyle. Evidence: People are able to lead a lifestyle of their own choosing. They are supported by the staff to be involved with the local community and one person visits the local church every week. Everyone is encouraged to use the local facilities, however one person does not like to be away from the home for long. They still access the local community and the staff ring a local pub to order their meal so it is ready for when they arrive so they dont have to wait for it or be away from home for too long. One person is a keen football fan and the staff take them to all the home matches. They have been to Wembley to watch football which they really enjoyed. Peoples care plans contain a Care Homes for Adults (18-65 years) Page 14 of 25 Evidence: section called my best day and this details a special event in their lives along with pictures. The people who live at the home have regular holidays and can use Avocets static caravan near the seaside. One person has recently been on a cruise around the Mediterranean. There was a lot of planning involved with regard to this as it was thought they did not like flying, so contingency plans had to be put in place if they found the flight too traumatic. As it was they had no issues with flying and the holiday was a success. The home welcomes visitors and has close links with family members. Some of the people who live at the home go out regularly with their relatives. All of the bedrooms are single and people can spend as much or as little time in their rooms as they wish. We saw that staff always knock on peoples doors before entering their rooms and address people with respect. Peoples dietary needs are assessed and recorded in their care plans, any special diets are adhered to and people are assessed by dieticians and speech therapists where appropriate. The home has a domestic type kitchen and people can access this with supervision. We saw that people were able to help themselves to biscuits and snacks when they wished, however those people on a healthy eating plan or restricted diets are monitored by the staff. People eat out a lot at local pubs and cafes. Care Homes for Adults (18-65 years) Page 15 of 25 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Everyone has a plan of care which tells the staff how they should care for people and their preferences. Medication is handled safely and people are protected by the home procedures and the training of staff. Evidence: We saw that a plan of care has been developed which uses information provided by the placing authority assessment and the homes own assessments. The care plans contain very comprehensive risk assessments and these cover every aspect of the person daily life including moving around the home, personal safety when out of the building, falls, dietary needs and emotional wellbeing. We saw that the staff complete detailed daily notes. The people who live at the home have limited ability to be able to be actively involved with their care plans so people have access to advocates and some families are actively involved on their behalf. Care plans are reviewed regularly by the staff and the placing authority with the involvement of health care professionals, families and advocates. Care Homes for Adults (18-65 years) Page 16 of 25 Evidence: The care plans contain detailed health action plans which are written in the first person for example I can do, I need help with. The peoples health action plans detail any ailments, past illnesses and any family history of illnesses which impact on their health. The health action plan details which health care professional are involved with the persons care and what treatment they need. None of the people who live at the home self medicate, all of the medication is handled on their behalf by the staff. All staff have received accredited training. We saw that medication is handled safely and people are protected by the procedures in place for the staff to follow. Care Homes for Adults (18-65 years) Page 17 of 25 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected by the homes complaint procedure and kept safe from harm by the homes procedures and policies regarding safeguarding of adults. Evidence: We saw that there continues to be a complaint policy and procedure in place and this is displayed around the home. The policy and procedure is also available in the Statement of Purpose and the Service User Guide. The CQC have received no complaints or concerns about the service since it has been registered and the home is not subject to any ongoing safe guarding adults investigation by the Local Authority Safe Guarding Team. There has been one (1) safeguarding referral since people moved into the home. This was due to the home not being able to meet someones needs and keep them safe. This has now been resolved and the person involved has now moved on. All staff have received training about how to recognise abuse and how to report this, this training has been provided by Avocets training department and is part of the ongoing mandatory training the staff receive. Care Homes for Adults (18-65 years) Page 18 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home which is clean, tidy, well maintained and meets their needs. Evidence: The home has recently completed the CQC registration process. It is registered to provide care and accommodation for four (4) adults with a learning disabilities. The home consists of four (4) bedrooms, two (2) on the first floor and two (2) on the ground floor, a lounge, a separate dining room and domestic style kitchen. There are two (2) communal bathrooms and a wet room which is en-suite to one of the ground floor bedrooms. All the equipment used has recently been tested and all of the maintenance certificates are up to date. The home is close to local amenities and the people who live there make full us of these. Care Homes for Adults (18-65 years) Page 19 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are cared by staff in sufficient numbers who are trained and competent to do so. People are protected by the companys recruitment and selection practices. Evidence: People are cared for by staff who are provided in enough numbers to meet their needs. Staff have access to a broad range of training which is provided by Avocets training department. Newly recruited staff undergo a five day induction training before they start working at the home. Avocet provide training about the general needs of the people who live at the home including training about epilepsy, autism, challenging behaviour and diabetes. More specialised training can be provided and this identified during staff supervision and developmental interviews. We looked at the files of those staff who have been recently recruited and these contained references and Criminal Records Bureau (CRB) Checks. These files are held at the head office and are made available for inspection. Care Homes for Adults (18-65 years) Page 20 of 25 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home which is run in their best interest. They are involved with the running of the home as much as possible. Their views and the views of others are used to inform the day to day functioning of the home. Peoples health and safety is promoted and protected as far as reasonably possible by the policies and procedures at the home. Evidence: The manager of the home has submitted an application for registration to the CQC and is awaiting their fit person interview. The home uses the company Quality Assurance system. This includes collating the opinions of all those who have an interest in the care the people who live at the home receive and produce an action plan to address any short falls. A full QA audit has not been carried since the move of premises. This should now be completed as the home has been up and running for over 6 months all be it unregistered. The home uses the companys policies and procedures and these are in place for the Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: staff to use and follow. The home is monitored by senior managers and regular unannounced visit are undertaken to monitor practice and the welfare of the people who live at the home. All staff receive mandatory training in health and safety, basic food hygiene, manual handling, first aid and fire. This is provided by the companys training department. A computerised spread sheet is used to monitor staff training and it is flagged up to the manager when staff need this updating. Care Homes for Adults (18-65 years) Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R 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 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 6 All of the care plans should contain the same detailed amount of information and be presented in well layed out user friendly format. A Full QA audit should be undertaken, a full report should be published which shows how any shortfalls in the service provided will be addressed. 2 39 Care Homes for Adults (18-65 years) Page 24 of 25 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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