Care Home: 3 Tensing Close

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What the care home does well People`s needs are set out in clear care and support plans. People are involved in making decisions about their lives. The plans help staff to provide the care and support that people need.Staff support people to take part in activities they enjoy and to keep in contact with family and friends.Staff support people to take their medication safely and to visit health professionals.People feel staff treat them well, listen to them and act on what they say.Staff are well trained. This helps to ensure they have the right skills to meet people`s needs.There are always enough staff working. This means people are able to do the things they want to. What has improved since the last inspection? The home has been re-decorated and a new kitchen and carpets have been fitted. The home is now more homely for people.The manager now keeps records of the checks that are completed on all staff before they start work. What the care home could do better: We have not made any requirements or recommendations following this inspection. The manager has a plan of improvements she would like to make and should ensure they are completed. The plan has been made after listening to people who live in the home. Key inspection report Care homes for adults (18-65 years) Name: Address: 3 Tensing Close Fareham Hampshire PO16 7QE three star excellent service The quality rating for this care home is: 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: Craig Willis Date: 0 7 0 9 2 0 0 9 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should:  Be safe  Have the right outcomes, including clinical outcomes  Be a good experience for the people that use it  Help prevent illness, and promote healthy, independent living  Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home:  3 stars – excellent  2 stars – good  1 star – adequate  0 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. They reflect the things that people have said are important to them: 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 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 Information about the care home Name of care home: Address: 3 Tensing Close Fareham Hampshire PO16 7QE 01329822170 01329822170 dstratton@nhs.net www.hantspt.nhs.uk Hampshire Partnership NHS Foundation Trust care home 3 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 3 0 learning disability Additional conditions: The maximum number of service users to be accommodated is 3. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Learning Disability Date of last inspection A bit about the care home 3 Tensing Close is a detached bungalow situated in a quiet residential area on the outskirts of Fareham. People have their own bedroom and share the use of a lounge, dining area, kitchen and garden. Hampshire Partnership NHS Foundation Trust manages the care provision and a housing association undertakes the housing management. Summary This is an overview of what we found during the inspection. The quality rating for this care home is: three star excellent service Our judgement for each outcome: Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home How we did our inspection: This is what the inspector did when they were at the care home We visited the home on 7 September 2009. We spoke to the manager, staff that were working and two people who live at the home. We also observed the way staff listened to people. While we were in the home we looked at some of the records that staff keep. Before we visited the home the manager completed an annual quality assurance assessment. The manager used this to tell us about the work staff were doing with people who live in the home. We also looked at the last inspection report from 11 September 2007. We received surveys from all three people who live in the home and three staff. What the care home does well Peoples needs are set out in clear care and support plans. People are involved in making decisions about their lives. The plans help staff to provide the care and support that people need. Staff support people to take part in activities they enjoy and to keep in contact with family and friends. Staff support people to take their medication safely and to visit health professionals. People feel staff treat them well, listen to them and act on what they say. Staff are well trained. This helps to ensure they have the right skills to meet peoples needs. There are always enough staff working. This means people are able to do the things they want to. What has got better from the last inspection The home has been re-decorated and a new kitchen and carpets have been fitted. The home is now more homely for people. The manager now keeps records of the checks that are completed on all staff before they start work. What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Craig Willis CQC – South East Citygate Gallowgate Newcastle Upon Tyne NE1 4PA 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 4. The report of this inspection is available from our website http:/www.cqc.org.uk/. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535. 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 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. There are good systems to assess peoples needs before they move into the home. This helps to reassure people that the home will be able to meet their needs. Evidence: The manager reported in the annual quality assurance assessment that one person had moved into the home since the last inspection. The home did not have any vacancies and the manager did not anticipate any vacancies occurring in the near future. Hampshire Partnership NHS Foundation Trust has procedures in place for the referral and admission of new people to the home, although these were not inspected during the visit. There is a guide to the services provided at the home. This is provided in an easy read format with pictures and symbols to help people understand the information. We received completed surveys from three staff who work at the home. All three said they always receive accurate information about the needs of the people they support and care for. We also received a completed survey from a reviewing officer for Hampshire adult services. This person said that the homes assessment arrangements ensured that accurate information is gathered and the right service is planned for people. 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. People receive excellent support to make decisions about their lives and develop detailed plans about how they want to be supported. This gives staff the information they need to provide care and support in the way that people want. Evidence: We looked at the records of two people who live in the home during the visit. Both people had a set of care and support plans that set out how their assessed needs should be met. The plans were developed with people following their initial needs assessment and annual review of their needs. The plans include a personal profile that gives detailed information about the way people communicate, make decisions, express their emotions and details of spiritual and cultural needs. A care or support plan is developed for each identified need and those seen included communication, management of epilepsy, support to meet spiritual needs, support to manage verbal aggression and detailed information about how personal care should be provided. The plans are evaluated every two months with the person to ensure that the support being provided is right to meet their needs. During the visit staff demonstrated a good understanding of peoples needs and the support that they need. We observed staff supporting people to make decisions about the activities they were going to participate in. Each plan contained comprehensive risk assessments. These identified hazards in the activities that people participate in and contained details of the support needed from staff to manage the risk of harm. The risk assessments are evaluated every two months to ensure they are still accurate. Three people who live in the home completed a survey for us. Two people said that staff always listen to them and act on what they say and one person did not answer the question. Evidence: The reviewing officer from Hampshire adult services who completed a survey for us said the home always supports people to live the life they choose wherever possible 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 supported to take part in a range of activities they enjoy, to maintain contact with family and friends and to plan healthy meals. This helps to ensure people live the lifestyle they choose. Evidence: People are supported to take part in a range of activities they have chosen. These include attending a local day service, social clubs, church groups and services, eating out and spending time with family and friends. People have an individual programme of activities that is planned with them. Three people who live in the home completed a survey for us. Two said they always made decisions about what they do each day and one person did not answer the question. All three people said they could do what they want to during the day, in the evenings and at weekends. People are supported to maintain contact with their family and friends, with extra support being provided to one person to ensure their relative feels welcome when they visit. People are supported to plan the menu at a weekly meeting. Choices are made using a set of picture cards and staff provide support to plan a balanced diet. These menus are displayed in pictorial format in the kitchen. 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. Peoples personal and health care needs are well met and there are good systems to safely store and administer peoples medication. Evidence: The care plans inspected contained details of the personal care support people need and how it should be provided. One of the plans contained very specific information about the support the person needed to have a bath. Three people who live in the home completed a survey for us. All three said staff treat them well. People are supported to attend a range of health services, including GP, optician, physiotherapy, audiologist and chiropodist. Staff have provided additional support to one person who has a history of refusing medical treatments. Staff were working with the health team to ensure their health needs were met. Details of peoples health appointments are recorded, including any advice from the practitioner. People have been supported to complete a health action plan. This assesses the health services people receive and identifies any additional services that may be necessary. Both people whose records we inspected had been supported to have a functional vision assessment. This identified any problems with the environment as a result of peoples visual needs and enabled the service to make environmental changes. Medication is stored in peoples bedrooms, in a locked cabinet. A record is kept of all medication coming into the home and returned to the pharmacist for disposal. Peoples care plans contain details of the support they need to take medication, including procedures for administering medication that has been prescribed to be taken as required. The medication administration records of two people for the previous month were inspected and had been fully completed. These gave details of the medication people had been supported to take, who provided the support and details of why any as required medication was administered. 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. There are good systems for dealing with complaints and responding to allegations of abuse. This helps to give people confidence that any complaints will be taken seriously and responded to. Evidence: The home has a complaints procedure, which is provided to all people living in the home in an easy read format to make it easier to understand. The procedure is also provided to peoples relatives. Two complaints have been received in the last year, both concerning maintenance of the property. Both complaints were investigated and found not to be substantiated. The complaints records are checked each month by a senior manager of the Trust. Three people who live in the home completed a survey for us. One said they know how to make a complaint, one did not answer the question and one said they were not sure. The reviewing officer for Hampshire adult services who completed a survey said the home always responds appropriately to any concerns that are raised. There are procedures in place covering keeping people safe and how the home will respond to any allegations of abuse. Staff have completed training in abuse issues and the safeguarding procedures. A staff member spoken with during the visit demonstrated a good understanding of different types of abuse, signs of possible abuse and the action they would take if abuse is witnessed, reported or suspected. Records were available of money that was held in the home on behalf of people. This was checked for one person and the records were found to match the cash held. The money was individually stored in a lockable cabinet in peoples bedroom. 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 well maintained and provides a clean, comfortable and safe environment for people. Evidence: The home was in the process of being extended during the visit, to provide additional ensuite bathrooms, more office space and a new utility room. People who live in the home have been consulted about the works and have been supported to choose new furnishings and decor. Since the last inspection a new kitchen has been fitted, new carpets laid and all areas redecorated. All of the communal areas were seen during the visit and all were clean and well maintained. All three people who live in the home that completed a survey for us said the home was always clean and fresh. The manager reported that the visual assessment completed with people had identified some changes that were needed in the environment. These had been passed on to the architect and incorporated into the building work being undertaken. The home has infection control procedures in place and staff are provided with suitable protective clothing and equipment. 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. The home has a highly trained staff team that are thoroughly checked and deployed in a manner designed to meet peoples different needs. This helps to ensure peoples needs are met by the staffing arrangements. Evidence: Four of the six support workers have completed the National Vocational Qualification at level 3 and the other two are due to start the award. During the visit we spoke with one of the support workers, who demonstrated a good understanding of peoples needs. The homes staffing rota is flexible to meet peoples needs, for example additional staffing is provided on one Saturday a month to support people to attend a social club. Following the last inspection we made a requirement that the records of the checks that are completed on staff before they start work must be held. Two staff have started work at the home since the last inspection. We inspected the records for both of these staff and both had confirmation that an enhanced criminal records bureau disclosure had been carried out, identification documents and two written references. These documents were all received before the person started working in the home. The written references were verified by phone to confirm their authenticity. People who live in the home have been involved in the recent recruitment process, with one person asking a question about specific skills they wanted the successful candidate to have. The home has a training programme in place, with access to all training courses provided by the Trust. The manager has an overview of all training staff complete so she can monitor whether people are due to complete refresher courses. Staff spoken with were positive about the training and felt that courses were pitched at the right level and relevant to their role. The training records for two staff members were inspected and indicated they had completed a wide range of courses including keeping people safe from abuse, medication, mental health, autism, health and safety, fire safety, resuscitation, communication, dementia, sensory loss, eating and drinking difficulties, physical interventions, infection control, medication, epilepsy and moving and handling. The Evidence: records for a new member of staff indicated that they were already booked on a number of the courses listed above. Three staff completed a survey for us. All three reported that they receive training that is relevant to their role, helps them understand and meet peoples individual needs, keeps them up to date with new ways of working and gives them enough knowledge about health care and medication. 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. There are excellent management systems in place to assess the quality of the service provided and ensure shortfalls in the service are identified and resolved. Evidence: The manager has been in post for over two years and has achieved the National Vocational Qualification in care at level 4 and the Registered Managers Award. During the visit the manager demonstrated a clear understanding of the aims and objectives of the Trust and how she will ensure these are achieved in the home. The manager also provided a clear assessment of the service in the annual quality assurance assessment and identified the improvements that she needs to make. Staff spoken with during the visit said they received good support from the manager, who was open to different ideas about how the service could improve. All three staff who completed a survey for us said they regularly meet with the manager for support and to discuss their work. One staff member added that they feel supported and a valued member of the team. The reviewing officer from Hampshire adult services who completed a survey for us said the manager has the right skills and experience to support peoples social and health care needs. The manager reported that she attends regular training to keep up to date with changes in legislation and to develop her management skills. A locality manager visits the home every month and assesses the quality of the service provided. Reports of these visits are made and sent to the manager and the Responsible Individual within the Trust. The reports contain a list of any actions that are required and an update of the actions that were required in the previous report. There are regular audits of the service including a property hazard report, an infection control audit and the annual quality assurance assessment completed by the manager. There is an annual survey of people who live in the home, relatives and other stakeholders. The responses to these surveys are collated and used to plan improvements to the service. The home has Evidence: an annual development plan, which is also completed with input from people who live in the home. The plan is reviewed throughout the year to ensure the actions are being implemented. The manager reported in the annual quality assurance assessment that equipment in the home is regularly serviced and checked to ensure it is operating safely. During the visit we sampled records for the servicing of the gas system, fire safety systems and portable electrical appliances, which confirmed the managers report. The home has workplace risk assessments in place that are reviewed annually. These contain details of actions staff must take to manage the identified risks. Additional risk assessments have been completed to cover the building works that are taking place. Are there any outstanding requirements from the last inspection? Yes  No  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 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 Description 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 Description 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 Helpline: Telephone: 03000 616161 or 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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