Care Home: 3 & 4 The Rise

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What the care home does well The service is managed well to suit the people who live at the home. People are supported by long standing cohesive staff team who assist them in all aspects of their lives. Care plans and associated documents are clear, informative and up to date. They describe the support to be given and explain the reasons for it. They show who has been involved in reaching these decisions. Where goals are set, there is evidence that these are met, making the process meaningful and beneficial for people. Health care is provided effectively, enabling people with some significant complex needs to receive the best possible advice and treatment for these. The home is clean and comfortable, it provides a safe and peaceful environment for the people living there. The home promotes staffing levels and skill mix of staff in order to help ensure that people`s needs can be met. The recruitment policies and procedures set up in the home should help ensure that people living in the home are supported and protected. People benefit from a well run home, under the leadership of an effective manager who has suitable knowledge, skills and competencies to ensure that the service continues to meet their changing needs. The home is clean and comfortable, it provides a safe and peaceful environment for the people living there. What the care home could do better: One recommendation was made during this visit to the service. There are a number of policies that have not been reviewed for over three years, such as bullying, communicable diseases and infection control and dealing with violence and aggression. There are other policies that have not been reviewed for over ten years. These should be reviewed, and updated where/if required in order to ensure that the information they contain is in line with current good practice. In line with the Care Quality Commission`s currently methodology this random visit was completed instead of a full key inspection. A key inspection reviews all of the `Key` National Minimum Standards. A random inspection is a more focused, targeted visit and no rating of a service is given. The previous rating for this service as recorded at our visit on 15th August & 11th September 2007 was one of `Good`.It should also be noted that if this visit had been a full key inspection it is anticipated by us that the rating would have been denoted as one that continued to provide `good` quality outcomes for those who use the service Random inspection report Care homes for adults (18-65 years) Name: Address: 3 & 4 The Rise 3 & 4 The Rise Shipton Oliffe Cheltenham Gloucestershire GL54 4JQ two star good service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme 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 review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Odette Coveney Date: 1 8 0 6 2 0 1 0 Information about the care home Name of care home: Address: 3 & 4 The Rise 3 & 4 The Rise Shipton Oliffe Cheltenham Gloucestershire GL54 4JQ 01242820654 01242820654 michael.steed@brandontrust.org www.brandontrust.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Michael Wayne Thomas Steed Type of registration: Number of places registered: Conditions of registration: Category(ies) : The Brandon Trust care home 6 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 6 The maximum number of service users who can be accommodated is 6. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Learning disability (Code LD) Date of last inspection Brief description of the care home 3 & 4 The Rise or The Rise is a detached house that is located in the village of Shipton Oliffe situated between Cheltenham and Northleach in Gloucestershire. The home is registered to provide care for up to six people with a learning disability. The home can Care Homes for Adults (18-65 years) Page 2 of 11 Brief description of the care home be described as two chalet style houses that have been transformed into one building with adaptations and equipment provided to meet the needs of the people living there. Currently one double bedoom is used as a single bedroom, allowing a maximum of five people who can be accommodated. The providers are Brandon Trust and Advance Housing manages the property. The weekly charges by Brandon Trust can be obtained from the home within the information provided about the home. Care Homes for Adults (18-65 years) Page 3 of 11 What we found: This unannounced random inspection took place over four hours and was completed in one day. The manager was present during the inspection and participated in the process. Evidence was gained from a whole range of different sources, including: - Information provided by the manager in the Annual Quality Assurance Assessment questionnaire (AQAA), completed prior to our visiting the service, a review of individuals care records, a tour of the home, an examination of some of the homes records, a review of the homes internal quality audit measures and discussion with the registered manager. We also recieved three completed surveys from staff who work at the home. We shared the comments made within these (maintaining individuals confidentiality) with the manager. The Care Quality Commission has not received any complaints in the last 12 months about the services provided at 3 & 4 The Rise. The purpose of the visit was to establish if the home is meeting the National Minimum Standards and the requirements of the Care Standards Act 2000 and to review the quality of the care provision for the individuals living in the home. We also reviewed the one requirement that was made by us when we visited the hone in 2007. We also spoke with the manager about the new Health and Social Care Act 2008 and the responsibilities of the service. The home have applied to us in order be registered under the new legislation, we spoke to the manager Mr Steed about this, he was able to demonstrate to us a sound understanding of the essential standards of quality and safety. We looked at information about the people who use the service and how well their needs are being met. We looked at other records such as the homes policies and procedures, medication procedures and practices. We checked that the staff team had the knowledge, skills and training to meet the needs of the people who use the service. A tour of the premises took place to make sure it was clean, safe and comfortable. We checked what improvements has been made since the last inspection. A discussion took place with the manger to talk about what we had found during the inspection. From the initial pre admission assessments staff had identified needs enabling them to form written care plans. The plans that we looked at were very detailed and person centered, including personal preferences and likes and dislikes. Plans told us that people had specific requests and routines, this is very good practice and helps demonstrate that people are involved in deciding how they wish to receive care. Each person has a My personal plan with person centered assessments and information, which means that staff put the views, wishes, likes and dislikes of each person at the center of all care provided. The information was informative and useful enabling staff members to provide the appropriate care to support health and social needs. The plans showed consistency in assessing, planning and evaluating care as required. Care Homes for Adults (18-65 years) Page 4 of 11 Regular care reviews take place for people living in the home, which can include family members and key workers wherever possible. This allows the opportunity to discuss and evaluate care and any issues or concerns people might have. Risk assessments were examined and showed us that staff were mindful of keeping people safe within their home and out in the community. Individual risk assessments were detailed and well written. The manager told us that the staff were vigilant in empowering people to promote as much independence as possible but at the same time making sure that they do this as safely as possible. There does not appear to be any unnecessary rules in the home and it was clear that the manager and staff are working towards empowering people and encouraging them to maintain independence, autonomy and choice. Daily routines are flexible within the home, people can get up and go to bed when they like, they can go out when they wish and participate in activities they have a particular interest in. This was confirmed through documentation in care files The care plans we looked at gave clear information about individual needs both physically and emotionally. Health Action plans are detailed and work in conjunction with individuals care plans. Records of visits to the General Practitioner and the outcomes are recorded. Specialist referrals and visits to other health professionals including, Consultants, Chiropractors and Dentists are made when required, to help ensure that peoples identified needs are being monitored and met. From records seen by us it was evident that peoples health care needs are closely monitored in consultation with primary health care services and that access to health screening is undertaken when needed. We walked around the inside and outside of the home and viewed the bedrooms and the communal areas including the dining room and lounge. Room sizes are fairly spacious for their stated purpose. All areas of the home were decorated to peoples taste, clean and well maintained. The manager ensures that staffing levels are indicative of the needs and levels of care required and confirmed that levels of staff rise should dependency levels increase. All of the team are experienced members of staff who have a good knowledge of the people living in the home. We observed some staff carrying out their duties and assisting individuals to return from their trip out. Staff were respectful, warm in manner, good humored and sensitive towards the people. At our last visit to the service in 2007 a requirement was made by us that before a person starts work in the home a check must be made if paragraph 4 of Schedule 2 applies and if so this information must be obtained to ensure that people who use the service are protected through robust recruitment procedures. We discussed this with the manager who was able to confirm to us that all staff have been recruited appropriately and robust checks are completed in order to protect the people who live at The Rise. We know that the organisation follows good recruitment procedures. This will help ensure that the right people are employed to work at the home, and people living in the home will be further protected. Records seen by us when we visited the head quarters of the organisation in 2009 contain completed application forms with a full employment history, at least two written references and Criminal Records Bureau (CRB) disclosures. Staff Care Homes for Adults (18-65 years) Page 5 of 11 receive a job description, terms and conditions of employment. We recieved three completed surveys from staff who work at the home all of the told us that they are given up to date information about the needs of people they support and that they are given training that is relevant to their role, which helps them to understand the individual needs of people, keeps them up to date with new ways of working and provides them with enough knowledge about health care and medication. additional comments recorded by staff were: I feel the people who live here have a very high standard of living and are given lots of opportunities to try out new experiences as well as maintaining existing skills. The staff team work well together and are encouraged to use their initiative. Service users have a full active life that suits their individual needs. I have been working at The Rise for a number of years, the manager and deputy work well together and staff are listened to when they raise issues or concerns. I feel valued as a support worker and I think this reflects on the service users happiness and wellbeing. Michael Steed is the Registered Manager for 19 Prospect Place. Michael joined the home in May 2009. Mr Steed has the appropriate qualifications, knowledge and experience the manage this service and to support and empower the people who live and work at Prospect Place. Throughout our visit the manager demonstrated good, effective leadership skills that relate to the aims and purposes of the home. It was evident the management and staff are a stable team that supports a commitment to providing quality of care for the benefit of the people living in the home. Prior to our visiting the service we recieved a completed AQAA. We found this document to be extremely well written and sufficiently detailed with clear information and evidence provided to demonstrate how the National Minimum Standards are met and known at the home, thus ensuring positive outcomes for those who live at Prospect place. Within the AQAA there is a section in which the service can tell us what they believe they do well. Within their completed AQAA some of the areas we were informed about were: The staff team at the home are well motivated, committed and well trained in all areas of care. This includes moving and handling,communication,positive response, diversity of service users, sensory work, feeding and personal care. The team is flexible in their approach to meeting on going and changing needs of service users, and have the respect of other professionals involved in the care of service users. All staff receive training and development to ensure that the staff fulfill the aims and objectives of the home and reflects changing needs of the service users. This includes all mandatory training and refresher: fire, food hygiene, moving and handling,first aid, medication, Sova (safeguarding of vulnerable adults)and specific training to the service users and personal staff development such as communication, sensory impairment,person centred planning,mental capacity act, managing change,healthy eating, risk management. Most staff have at least a level 2/3/4 NVQ in Health and social care or are working towards this. All staff attend a monthly team meeting and receive monthly supervision. Any messages can be left in the communication book of if of a personal nature can be put in a sealed envelope and placed in managers drop. Care Homes for Adults (18-65 years) Page 6 of 11 What the care home does well: What they could do better: One recommendation was made during this visit to the service. There are a number of policies that have not been reviewed for over three years, such as bullying, communicable diseases and infection control and dealing with violence and aggression. There are other policies that have not been reviewed for over ten years. These should be reviewed, and updated where/if required in order to ensure that the information they contain is in line with current good practice. In line with the Care Quality Commissions currently methodology this random visit was completed instead of a full key inspection. A key inspection reviews all of the Key National Minimum Standards. A random inspection is a more focused, targeted visit and no rating of a service is given. The previous rating for this service as recorded at our visit on 15th August & 11th September 2007 was one of Good. Care Homes for Adults (18-65 years) Page 7 of 11 It should also be noted that if this visit had been a full key inspection it is anticipated by us that the rating would have been denoted as one that continued to provide good quality outcomes for those who use the service If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Adults (18-65 years) Page 8 of 11 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 9 of 11 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, 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 40 There are other policies that have not been reviewed for a number of years. These should be reviewed, and updated where/if required in order to ensure that the information they contain is in line with current good practice. Care Homes for Adults (18-65 years) Page 10 of 11 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. 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