Care Home: 25 Old Mill Park

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Key inspection report Care homes for adults (18-65 years) Name: Address: Sense East, 25 Old Mill Park Sense East, 25 Old Mill Park Louth Lincolnshire LN11 0NY     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: Douglas Tunmore     Date: 2 5 0 2 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 27 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 27 Information about the care home Name of care home: Address: Sense East, 25 Old Mill Park Sense East, 25 Old Mill Park Louth Lincolnshire LN11 0NY 01507608052 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: fiona.kennedy@sense.org.uk www.sense.org.uk Sense, The National Deafblind and Rubella Association care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability sensory impairment Additional conditions: The home is registered to provide personal care for service users of both sexes whose primary needs fall within the following categories:- Sensory Impairment (SI) 6 Learning Disability (LD) 6 The maximum number of service users to be accommodated is 6. Date of last inspection Brief description of the care home 25 Old Mill park is one of a number of homes within the county that is operated by SENSE East. It is registered to provide care and accommodation for up to six service users between the ages of eighteen to sixty-four years who have been affected by a dual sensory impairment (deaf/blindness) caused by rubella and who also have a moderate or severe learning disability. The home is located in the market town of Louth, which has a range of services and facilities. It is a domestic style house providing six single bedrooms, one on the ground floor. There are stairs but no lift facility so service users at this home who are accommodated on the first floor need to be able to manage stairs. There is a lounge, dining room, kitchen and sensory/activity Care Homes for Adults (18-65 years) Page 4 of 27 6 6 Over 65 0 0 Brief description of the care home room on the ground floor. The home is fully occupied and there have been no new admissions since the last inspection. Transport for service users is provided in the form of a minibus. The decision to offer a placement is taken by a multi-agency panel. A dedicated intermediate care service is not provided by the home. Care Homes for Adults (18-65 years) Page 5 of 27 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 two star. This means the people who use this service experience good quality outcomes. This was an unannounced visit and it formed part of a key inspection, focusing on key standards, which have the potential to affect the health, safety and welfare of people who use the service. From 1 April 2009 the duties of The Commission for Social Care Inspection (CSCI) will be taken over by the Care Quality Commission (CQC), the new independent regulator of all health and social care in England. Throughout this report the terms we and us refer to the Care Quality Commission (CQC). We took into account previous information held by us including the previous inspection report, their service history and records of any incidents that we had been notified of since the last inspection. Care Homes for Adults (18-65 years) Page 6 of 27 Before we made our visit the provider had returned the Annual Quality Assurance Assessment (AQAA). This gave us information about their own assessment of how well they are meeting standards and their plans to improve aspects of the service. We received one survey from a resident who was supported in its completion, and two staff surveys. The main method used to carry out the inspection is called case tracking, this includes following the care of a sample of two people through their records and assessing their care. We spoke with one staff member, the registered manager and the area manager who was present during this visit. They were informed of the general outcomes of this inspection. The current yearly charges for the service as confirmed by the manager ranges from seven thousand two hundred and twenty pounds to eight thousand six hundred and seven pounds and eighty eight pence. The manager stated that there are no additional charges. Information about the day-to-day operation of the home, including a copy of the last inspection report, is available from the manager. Care Homes for Adults (18-65 years) Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our Care Homes for Adults (18-65 years) Page 8 of 27 order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 27 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 27 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. An assessment of all new residents is completed which ensures that all of their personal care, health care and social needs are met. Evidence: The providers AQAA states that a full assessment is carried out by a fully qualified professional to establish the needs of the Service User before coming into the service. The persons learning disability, physical disability, communication methods and medical issues are considered prior to a suitable placement being offered. A transition plan is formulated and visits are planned before the move takes place including overnight stays, meetings with family and Social Worker and specialists such as Occupational Therapists to ensure a smooth transition takes place. The registered manager confirmed that there has been no new admissions to this home for the last ten years. We looked at two files of people who were being case tracked, which showed that a full pre-admission assessment had been undertaken. It was clear from these files that there are a number of assessment tools available for the presenting disability of any prospective resident. Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: One resident who was supported by a member of staff to complete his survey indicated that he had been shown pictures of the home prior to admission. The manager stated that relatives and health care professionals are also involved in the assessment process. Care Homes for Adults (18-65 years) Page 12 of 27 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. There are detailed care planning which includes risk assessments. People enjoy choices about what activities they want to get involved and have a varied social programme. The actions and care provided by staff ensures that residents privacy and dignity is maintained. Evidence: The providers AQAA confirms that each person has Key Workers who are involved in Service User Planning meetings at which an Individual plan is produced with the Service User, outlining their needs and goals. Individual goals for deaf blind people are also discussed during regular supervisions and team meetings with Key Workers to ensure that goals are achieved. Reviews are held twice a year at which Social Workers, Family members, Key workers Manager and Area Manager are present and review Care Plans, Guidelines and Individual Plans. Two staff surveys were received and a comment made was that privacy and dignity is always respected. This is instilled in us during our training. Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: We looked at two care plans of residents who were being case tracked and found that peoples needs were clearly identified, with support plans relating to the personal delivery of care to individual residents. Care plans were seen to be reviewed on a monthly basis and any changes made were dated and signed by the key worker and the resident if able. A residents survey indicated that he is presented with choices at all times. Care plans were seen to be very detailed and very specific for each persons needs. All care plans evidenced that the Mental Capacity Act 2005 was in use empowering residents in being involved in all aspects of their daily lives. There are a number of methods in use at this home for communicating with people who live there. These include signing (Makaton), British sign language, hand over hand and widget. This type of communication enables people to make choices and communicate there wishes regarding all aspects of their lives to their carers. Observations made during this visit was that carers were seen to use various forms of communication and were sensitive in the way they carried out this task. All activities undertaken by residents are recorded as well as the value of the activity for that individual. A member of staff confirmed that she has received training to assist and support residents. Care Homes for Adults (18-65 years) Page 14 of 27 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 continue to be involved in meaningful and appropriate activities, which include educational and recreational activities. Peoples likes and dislikes relating to food is not recorded although choices of meals is available to them. Evidence: The providers AQAA shows that they offer a wide range of activities that are individual to that person and is carefully planed through the person centred approach. Home, community days are staffed on a 2,1 basis in order to maximise full success.Family impute and contact is paramount in our organisation and we pride ourselves in the excellent relationships we have with the family. One survey from a member of staff stated that wherever possible residents needs are respected and they do have the choice to live their lives how they choose. Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: The home provides a day care centre service, which was visited as part of the inspection process by the inspector. It was found that a wide variety of educational and social activities are undertaken with people in this specially adapted facility. We found that ample carers were available to support people in any activity that they were undertaking. Both activities and educational programmes consist of, literacy, numeracy, communication skills, life skills, cooking and horticulture. Therapys are also available and included hand and feet massage,yoga, and physiotherapy. People are able to access an hydrotherapy pool and go to local leisure facilities as well as ten pin bowling. The manager confirmed that people go on holidays in small groups, with four going to a Pine Lodge in Pickering for four days. Two residents also enjoyed a Tinsel and Turkey holiday and one went on a sailing holiday in Southampton. The home is close to the town centre, and they have a mini-bus for outings. The homes menu was seen and showed that a choice is available and that healthy eating options are also a part of peoples diets. We looked at care plans and found that likes and dislikes of residents had not been recorded. The manager said that this would be undertaken immediately. Care Homes for Adults (18-65 years) Page 16 of 27 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. People benefit from being as involved as possible in identifying their own needs and choices. Clear care plans, created from assessments of need help to ensure that peoples health and welfare needs are fully met. Medication is safely given by staff who know what they are doing. Evidence: The providers AQAA indicates that we promote, dignity, Independence and privacy when providing personal care, Dental and health checks are carried out at regular intervals and any concerns are raised immediately with the Home Manager or Deputy. Due to the disabilities of our Service Users it is not possible for them to self medicate, procedures are in place for the recording and handling of medication and disposal. Two care staff surveys received indicated that individual residents health care needs are met. One comment was staff are always diligent regarding all individuals health and welfare. Another staff survey informed us that they receive training, which is relevant to their role and this keeps them up to date with new ways of working. A second survey Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: confirmed that medication is administered by trained support workers who have undergone medication training. No resident within the home self administers their own medication. The inspector observed one person being given their medication, which was undertaken appropriately with a record made of medication given. Two carers confirmed that they had medication training and that the practise is for two carers to carryout this task. We look at medication sheets and found an accurate record of medication given on the day of this visit. There is a close working relationships with local doctors and physiotherapists. We looked at peoples health care plans and found that there is a record of visits to or from doctors. Care staff accompanied people to these services. Care Homes for Adults (18-65 years) Page 18 of 27 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 benefit and are protected by robust and comprehensive complaints and safeguarding vulnerable adults procedures. Evidence: The providers AQAA informs us that we have a complaints procedure and a raising concerns policy in place which is open to families, staff members, social workers and Service Users, our Service Users are not able to formalise any concerns but rely on advocates. Both staff surveys confirm that they would know what to do if a concern was made to them by a visitor. Any concerns are acted upon immedialtely. The provider has up to date adult protection policies and all staff as part of their induction received abuse training. The home also had a copy of Lincolnshire County Councils adult protection procedures. We spoke with one member of staff who knew about abuse and what they should do if they suspected abuse. She also confirmed that she had undertaken adult protection training. There is an established work force and only one new member of staff had been recruited since the last inspection. The providers training programme was seen and evidenced that safeguarding training had been undertaken by all staff. Care Homes for Adults (18-65 years) Page 19 of 27 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 clean, safe, and comfortable accommodation suited to their needs. Evidence: The providers AQAA tells use that we maintain a clean, warm,homely environment. Each bedroom reflects the individual personality of the Deaf blind person.To the rear of the property there is a well maintained established secure garden that is inviting. Large flowering shrubs offer sensory smells and sights all through the year. People continued to live in clean and comfortable accommodation. There has been a major refurbishment of the home since the last inspection in January 2008. The manager confirmed that maintenance issues are attended to promptly. The home was clean and tidy with no unpleasant odours at the time of the visit. We viewed peoples bedrooms and found that they have been personalised and were clean and tidy. Some bedrooms have a door bell, which activates a light inside the room informing the resident that someone is entering their room. Two bedrooms had been redecorated since the last inspection. There is an attractive accessible garden area, which is made as safe as possible and private. Care Homes for Adults (18-65 years) Page 20 of 27 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. There is a safely recruited, well-trained, established, supported staff team available who have the skills to meet the varying needs of the people living in the home. Evidence: The providers AQAA shows us that there is a 13 day Induction training incorporating skills that are required to meet the needs of our Service Users which must be completed within a timescale, also regular refresher training is required. Further training requirements may be highlighted during supervision and appraisals these can be requested through our Training Department. Recruitment is done through our Head Office and CRB checks must be completed and references received before employment starts.Staff surveys indicate that the provider carried out all checks including references and criminal record checks prior to starting work. They also showed that they undertook an induction covering everything about the job when they started. All staff have undergone the appropriate training required to ensure everybody has the necessary skills. The human resources manager confirmed that all staff go through a vigorous check prior to starting work at this home. All information regarding recruitment records is kept in their personnel files. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: One member of staff confirmed that she has been given training opportunities and had undertaken training relating to those care aspects of deaf and blind people. She stated that she is completing a National Vocational Qualification course level 3 and that she will also be attending a nine week in house course for deputy managers. We looked at the providers training profile, which evidence that training was undertaken in 2008 and planned training for 2009 was documented. Care Homes for Adults (18-65 years) Page 22 of 27 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 and staff benefit from the positive leadership of the manager. Management record systems show that residents health, welfare, safety and choices are promoted. Evidence: The providers AQAA informs us that two members of staff are working to-wards their NVQ level 3, a Quality assurance audit has been conducted by the Sense policy and quality team and will be finalised in October 08, a financial audit has been conducted, Environmental Health, Fire Assessment and Health and Safety audit have all been conducted. Lincolns county Council have conducted a quality assurance visit. The manager confirmed that she had completed her registered managers award. She stated that she undertakes training courses relating to her role as the registered manager of this home. One member of staff stated that the manager is fantastic and that she had learnt a lot from the manager, who is approachable and willing to give me time and support. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: One staff survey confirmed that the manager meets with staff regularly and gives support and discusses how they are working. All staff are being provided with supervision and appraisals in accordance with national guidelines. This evidence came from one member of staff and the manager. We looked at peoples finances and found that an accurate record is kept. Sense have comprehensive health and safety policies, which also included detailed and up to date risk assessments. These included risk assessments covering all aspects of daily living activities. A detailed fire risk assessment had also been carried out. There were regular tests of the fire system as well as regular fire drills to ensure the safety of people. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 26 of 27 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). 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. Care Homes for Adults (18-65 years) Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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