Care Home: 3 Gerard Road

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What the care home does well Prospective residents get useful information before deciding to move into the home. The home gathers a good level of information about prospective residents to ensure that it will be able to offer them a suitable service. The residents are protected as their care needs and their preferences for how these are met are well documented. The residents are encouraged to take risks and the freedom to exercise choice. The residents have a wide range of interested and opportunities for activities. Friends and family members are encouraged to visit the home. The residents eat a balanced andvaried diet Support with personal care is tailored to individual needs and preferences, which are thoroughly documented. Staff get clear guidance about how to handle medications and these are thoroughly recorded and regularly reviewed. Support is promptly adapted to meet residents changing needs. Residents well-being and rights are well protected. The home is decorated, furnished and maintained to a good standard and is well suited to this resident groups needs and lifestyle. Staff have clear roles and responsibilities. Residents are supported by an effective staff team. Residents benefit from well supported and supervised staff. What has improved since the last inspection? Staff members receive additional fire safety training. What the care home could do better: There were no areas of development identified at this inspection Key inspection report Care homes for adults (18-65 years) Name: Address: 3 Gerard Road 3 Gerard Road Weston Super Mare North Somerset BS23 2RE     The quality rating for this care home is:   three star excellent 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: Jacqueline Sullivan     Date: 1 6 0 4 2 0 1 0 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) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: 3 Gerard Road 3 Gerard Road Weston Super Mare North Somerset BS23 2RE 01934641038 01179699000 terry.cook@brandontrust.org www.brandontrust.org The Brandon Trust Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Terry Cook Type of registration: Number of places registered: care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is 5 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 category: Learning disability (Code LD) Date of last inspection Brief description of the care home 3 Gerard Road is a smaller home in a residential area close to the centre of Westonsuper-Mare. The resident group is aged between mid-40s and late 60s. Most residents have day care but the home also arranges regular activities, particularly for those who do not want to attend day centres. Each bedroom is single and one is on the ground floor. There is a choice of lounge and dining facilities. The attractive back garden has a patio area with outdoor seating and a raised, sloping lawn area that is accessed by a short flight of steps. Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 5 Brief description of the care home Current fee levels are between eight and nine hundred pounds. The service plans to change to supportive living in the near future. 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: three star excellent 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: . Care Homes for Adults (18-65 years) Page 6 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. Care Homes for Adults (18-65 years) Page 7 of 27 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 8 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 9 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents get useful information before deciding to move into the home. The home gathers a good level of information about prospective residents to ensure that it will be able to offer them a suitable service. Evidence: The homes Statement of Purpose and service user guide is available on DVD for the residents. The hard copy of both documents are regularly updated to ensure that the residents have appropiate information. In the AQAA the manager stated that There is a drive towards empowering each individual to choose whether Gerard Road is their home of choice. This is being done through independent advocacy as part of the planned move towards supported living within the home. No new residents have been admitted since the last inspection. Previously admitted residents had informative assessments on their files and care plans had been based on identified needs. Discussion with senior and information in the care files and care Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: documentation showed that the team has a lot of knowledge about individual residents needs and how they should be met. The existing resident group is able to meet prospective residents before they move in. Prospective residents may visit as often as they need to before deciding to move in for a trial period. Residents contracts were in the form of a pictorial agreement supported by brief and clear written information. Care Homes for Adults (18-65 years) Page 11 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents are protected as their care needs and their preferences for how these are met are well documented. The residents are encouraged to take risks and the freedom to exercise choice. Evidence: As noted at the last inspection,each persons care records are in a clear order so that essential information is easily accessible. A personal profile has been drawn up on each person, which summarizes their needs and what is most important to the person themselves. These include information on their preferred daily routines, what staff can do to enable the person to make decisions for themselves, the persons preferred style of communication, and clear guidelines about how staff can support socially acceptable behaviour. Each resident has a personcentred plan, which gives clear and useful information on what the person needs from staff. This information is phrased positively to promote a Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: respectful approach. Difficult issues are tackled with honesty and tact. The actions that staff should carry out to meet each identified need are clearly listed. It is clear from reading these documents what is important to the residents themselves. The staff team are regularly looking at ways that they can make residents care documents even more accessible to them. Residents are involved in some aspects of the running of the home and the team plans to look at ways of expanding this further. Risk assessments show how the need for protection has been balanced against the right to freedom, and how each risk can be minimized. Discussion with staff and observation of practice revealed that staff understand the risk assessments and are applying them consistently. Confidential information is kept securely. Staff were careful to discuss confidential issues in private and their comments to residents were made in a way that promoted the persons dignity. The senior staff member was able to show us the considerable work that has taken place to ensure that peoles views have been sought about the move to supportive living. these meetings included advocates,social workers, the residents and their representatives. The senior stated that We are all on a journey together. Care Homes for Adults (18-65 years) Page 13 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents have a wide range of interested and opportunities for activities. Friends and family members are encouraged to visit the home. The residents eat a balanced ,varied diet Evidence: On the day of the inspection the residents had just left to go to bristol with the staff. The senior said that they like the car journey. the senior was able to show us the wide range of activities that the residents do in this very homely environment. Some of the older residents choose not to attend day centres but staff ensure that each person is offered some sort of interesting activity every day. Residents have regular outings and holidays, either in small groups or with staff. The home has Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: produced a pictorial version of the day centres timetable for those people who attend. Holidays include visits to Disney land. there are many pictures about the activities and the daily tasks, which show people doing each of the tasks. In the AQAA ther manager stated that We have person centred plans which identify peoples preferred pattern of support and their likes and dislikes and dreams, together with how to get there. Care Homes for Adults (18-65 years) Page 15 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. Support with personal care is tailored to individual needs and preferences, which are thoroughly documented. Staff get clear guidance about how to handle medications and these are thoroughly recorded and regularly reviewed. Support is promptly adapted to meet residents changing needs. Evidence: In the AQAA the acting manager stated that We have clear and comprehensive records in care plans of health care needs and how to meet these. We have completed North Somersets Traffic light system, Initial health assessments and all have had an initial health care assessment. Individuals care plans and PCPs ( person centred plans) reflect individuals preferred methods of support. We discuss with the people we support any proposed intervention and reasons for this. We looked at the medical records for the residents and saw they were well maintained. the staff member told us how each resident has had a detailed health Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: check by medical professionals before the move to supportive living. The residents health needs were well known to the staff member we spoke with. Evidence in the care documentation confirmed that the staff team pay detailed attention to the residents health needs. Care Homes for Adults (18-65 years) Page 17 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents well-being and rights are well protected. Evidence: As noted at the last inspection, n complaints have been received by CSCI or the home. Staff advocate on residents behalf to ensure that their views are taken into account. Their was a great deal of evidence in the residents files that their views had been taken into account about the planned change. Staff also consult families in an effort to gauge residents feelings and wishes. A staff member told the inspector about the training they receive, and discussion with them showed that they are well aware of residents rights. We looked at the staff files and saw that all staff have had training in safeguarding adults, and this training is repeated every year. A staff member spoken with demonstrated a clear understanding of the potential for abuse and the need to report any concerns. Care Homes for Adults (18-65 years) Page 18 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. The home is decorated, furnished and maintained to a good standard and is well suited to this resident groups needs and lifestyle. Evidence: On entering this home the overall impression is of a pleasant, comfortable and homely place which is very comfortable to be in. There is a large lounge at the front of the house with plenty of comfortable seating and a table for meals or activities. The kitchen is also large enough to allow several people to eat their meals in there. There is a quiet lounge at the back of the house which has comfortable seating and a small dining table. This range of communal rooms allows residents a choice of where they sit to relax or to eat. It also allows people to spend time in smaller groups. On the day of the inspection the door to the kitchen was being repaired. The senior worker explained that there is little to be done in the house when it moves to supportive living shortly. A lot of work has been done to the garden which has a patio with plenty of seating and parasols, a greenhouse, a small pond, and a lawned area reached by a short flight of steps. The garden looks particularly attractive and is a safe and pleasant space for residents. Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: In the garden the residents have planed a tree to rememeber Mr Cook who was the manager there who sadly died last year. This was a testomany to the good work that he completed in the house. The senior explained how much he was missed and the huge impact his death had on the home. All bedrooms are single and at least 10 m squared. All the residents were outThe two residents who showed the inspector their bedrooms evidently feel that this is their own space to use as they wish. Staff had helped them to personalise their rooms. The two rooms were very different and reflected the tastes of their occupant. Two bedrooms have been redecorated and recarpeted since the last inspection, and two more are being refurbished in the near future. None of the bedrooms has an ensuite facility. There is a bathroom and separate toilet upstairs and a shower room with toilet downstairs. The upstairs bathroom is being refurbished soon. All areas of the home looked and smelled clean and fresh. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff have clear roles and responsibilities. Residents are supported by an effective staff team. Residents benefit from well supported and supervised staff. Evidence: As noted at the last inspection,staff recruitment practices are thorough and the required checks are carried out on each person before they start work. Staff have detailed, clear job descriptions and effective guidance about the standards that are expected of them. There are at least two staff on duty throughout the day often more. One member of staff is on sleeping-in duty at night. As stated at the last inspection, staff training records showed that each staff member has good opportunities to attend relevant training. Training includes first aid, manual handling, safe handling of chemicals and risk assessments, food hygiene, fire safety, Makaton, person-centered planning, advocacy, and LDAF (Learning Disabilities Award Framework) foundation courses. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: The majority of the staff have NVQ 3 ( National Vocational Award) or NVQ 2. The recorded dates of staff one-to-one supervision sessions show that staff have this type of support from the manager every four to six weeks. There are also regular staff meetings. The staff member on duty confirmed that they felt supported by their manager and that staff morale was high. The impact of losing such a prominent figure in their lives had been well managed. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from a well run home which puts their interests at the heart of decision-making. Evidence: As previously stated, since the last inspection the manager has sadly died and a new Acting manager has responsibility for this home and two other similar homes in the area. The senior who we met at the inspection has day to day responsibility for the running of the home. She presented as extremely competent and warm. It was evident from discussion that she knew the residents very well and cared about their well being in the move towards supportive living. Brandon Trust has its own quality assurance system, and the home draws up a yearly business plan to address areas where it feels improvements could be achieved. The residents interests are very much at the heart of the process. It was evident from discussions with the staff member on duty and evidence in the residents files, meetings and communication books that the residents interests are well looked after by the staff team and the residents have the opportunity to express their wishes. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: There is a good range of policies and procedures, which are regularly reviewed and which emphasize residents rights. As noted at the the last inspection, staff carry out a routine health and safety check of the premises every month. Any problems are recorded and repairs are requested promptly. All seven of the staff hold a current first aid certificate. The staff team has formal fire instruction once a year and fire safety is discussed every six months in staff meetings. 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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