Care Home: 3 Water Meadows

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What the care home does well 3 Water Meadows is a homely and well maintained house, and is conveniently located on the edge of Cullompton in Devon. It is also close to a larger unit for adults with more complex needs, owned by the same organisation, where clinical specialists in head injury rehabilitation are based. This means that on-going clinical input for people is easily accessed. The routines at the home are flexible but offer structure for people. Rehabilitation is person centred so that people`s individuality is respected. What the care home could do better: At the last inspection in 2007, a requirement was made in relation to risk assessing the potential of heat transfer injuries from unguarded radiators. We saw that a cover was missing from the bathroom radiator, and we were told by two members of staff that it was being repaired. One of the bedrooms has a covered radiator, but the other does not, although the radiator is partially covered by furniture and staff told us that it was rarely used. We looked at the person`s care records which showed they were moderate to high risk of falls but there was no record as to how the decision had been taken not to fit a protective cover. Random inspection report Care homes for adults (18-65 years) Name: Address: 3 Water Meadows 3 Water Meadows Cullompton Devon EX15 1QS three star excellent 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: Louise Delacroix Date: 2 0 0 5 2 0 1 0 Information about the care home Name of care home: Address: 3 Water Meadows 3 Water Meadows Cullompton Devon EX15 1QS 0188434287 01884836229 Telephone number: Fax number: Email address: Provider web address: www.birt.co.uk Name of registered provider(s): Name of registered manager (if applicable) Mrs Christine Mary Chitty Type of registration: Number of places registered: Conditions of registration: Category(ies) : The Disabilities Trust care home 2 Number of places (if applicable): Under 65 Over 65 0 0 learning disability physical disability Conditions of registration: Date of last inspection Brief description of the care home 2 2 3 Water Meadows is a three bedroomed house situated in a residential area of Cullompton. The house has a lounge, a kitchen / dining room and a toilet on the ground floor and on the first floor there is a bathroom/ toilet, two bedrooms and an office/sleep-in room. There is garden at the front of the property and a small-enclosed garden to the rear. The home provides rehabilitation care for two people who have an acquired brain injury. The staff support people to re-establish their independent living skills and the home is seen very much as a step onwards for people from The Woodmill, which is the main unit situated not far from the home. Prospective service Care Homes for Adults (18-65 years) Page 2 of 9 Brief description of the care home users may also come from their own homes after a detailed pre-admission assessment. Whilst the home has its own staff team it is also able to make use of the multidisciplinary staff team based at The Woodmill. The weekly cost is #1262.50, with additional charges for chiropody, hairdresser, toiletries, newspapers/magazines, activities and travel. Care Homes for Adults (18-65 years) Page 3 of 9 What we found: The inspection was unannounced and took place over two hours and fifteen minutes. The inspection was a routine random inspection, which means that we focused on particular areas of care rather than inspecting all the key national minimal standards. We met the two people living at the home and two staff members who work with them. We looked at records relating to peoples care and medication administration; we saw how notifications are logged, and looked to see how well the home is maintained. We reviewed the one requirement made at the last key inspection in 2007. We also spoke to a third staff member who carries out quality assurance checks at the home. Prior to the inspection, people living and working at the home completed surveys for us, which gave them the opportunity to comment on the service. We have incorporated peoples responses into the report. The service also completed an Annual Quality Assurance Assessment for CQC, which provides us with details about the home, including what the home does well and areas for improvement. Choice of Home People told us in their surveys that they were asked if they wanted to move to the home, and that they had received enough information before they moved in to help them make a decision about the homes suitability. One person, who has moved to 3 Water Meadows since the last inspection told us they had settled well, and gave us examples of places that they had visited in the local area. We looked at care and assessment records for both people living at the home. We saw that records of need were detailed and kept under regular review to reflect changing needs or levels of risk management. People living at the service told us either in person or by survey that they were satisfied with the care and support they receive at the home. One person told us in their survey that the home had a friendly manner. Individual needs and choices We inspected care records and found they were person centred and reflected peoples current health care needs. People living at the service told us in their surveys or through our conversations with us and staff that they can make decisions as to how they structure their day, which allows for a flexible and personalised service. This is a reablement service and people are supported to make choices and participate in setting personal goals. We heard from staff how these goals are adjusted to meet changing needs and level of risk, and we saw examples of regular reviews involving the person and a multidisciplinary team of staff. We saw that personal records were stored in a manner that protected confidentiality. Lifestyle People living at the home told us about how they liked to spend their time, and we saw records that reflected these interests. Our discussions with staff also showed us how the service enabled people to participate in their interests. We also saw from records and Care Homes for Adults (18-65 years) Page 4 of 9 heard through our conversations with people living at the home how they are supported to keep in contact with people who are important to them. The home does not have regular access to transport, which some staff told us restricted peoples opportunity to access the local area, as the use of public transport was restrictive. A person living at the home told us they could visit Exeter by catching the bus. Records show that people living at the home make day to day decisions and we heard how people had the opportunity to attend work placements or training programmes, although they also had the option of not attending. People told us how they were encouraged to cook, and to be involved in choosing what was cooked. A staff member explained how they supported people to make choices by looking through cookery books and selecting three dishes to encourage people to make informed choices. One person told us that the home provided good food and a balanced diet. Personal and health care support Written records and discussions with staff demonstrated that peoples health care needs were being monitored, and advice was sought appropriately. People living at the home also told us about changes in their physical and mental health, and the effect on their mood. We saw clear guidelines for staff regarding peoples health care needs, and a staff member told us the protocol regarding on-call support and administering medication for seizures. We looked at how medicines were stored and administered. We saw that medicines were stored securely and that a good system of recording was in place. Staff were clear about their responsibilities, and we heard staff being updated about medication changes during a handover. Concerns and complaints In their survey, one person living at the home said they did not know how to make a complaint but in discussion they were clear that they would know how to make a complaint and who they would go to. Staff showed us a book where complaints could be recorded, as confirmed in the homes AQQA none were recorded. One staff member told us in their survey they did not know what to if someone has concerns about the service. Based on these responses, the service may wish to re-visit the complaints procedure so that everyone is confident about the complaints process. CQC have received no complaints about the service since the last inspection. One person did share a concern with us, which staff had acknowledged in discussion with us, later a third staff member advised us that the person had been offered a solution, which would help resolve their concern. They explained how the person would be supported with this possible change. Environment The three bedroomed house was clean and fresh, which people told us in their surveys was always the case. One person said that the home had a happy clean environment. Fixtures and fittings were in a good state of repair and the house is regularly decorated by staff with the involvement of people living at the home i.e. influencing colour schemes. Peoples private spaces were personalised and the garden provides an attractive space to Care Homes for Adults (18-65 years) Page 5 of 9 relax. Since the last inspection, the bathroom has been adapted to provide a walk-in shower room, this improves the accessibility for one of the service users. Staffing There is a small staff team for this two person care home and we were told that no agency staff are used but staff told us there were either always or usually enough staff to meet peoples needs. People living at the home told us in person or by survey that staff treat them well and listen and act on what they have to say. Surveys from two staff members told us that training provided was relevant to their staffing role and met peoples needs. Another staff member told us about their training and induction, and we saw evidence of this in their training records. We looked at one staff recruitment file and we saw that the services recruitment process was robust, which helps prevent applicants unsuited to working with vulnerable people gaining employment at the home. Conduct and management of the home People who live at the service were happy with the support they receive and how the home was run. Two staff members told us that they felt well supported in their job, but a third person said they sometimes got enough support. We heard that staff have access to supervision. What the care home does well: 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 set out on page 2. Care Homes for Adults (18-65 years) Page 6 of 9 Are there any outstanding requirements from the last inspection? Yes R 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 42 13 (4)(c) A risk assessment for individual uncovered radiators in the home must take place, and action taken to guard the radiator if the risk is medium or high. 08/07/2007 Care Homes for Adults (18-65 years) Page 7 of 9 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 1 42 13 There must be a written risk assessment for individual uncovered radiators, and action must be taken to guard the radiator if the risk is medium or high. This is to protect people from harm. 22/06/2010 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 42 Broken radiator covers should be fixed and replaced as soon as possible. Care Homes for Adults (18-65 years) Page 8 of 9 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. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 noncommercial 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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