Care Home: 32 Albert Road

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What the care home does well Clients enjoy staying at the home and they are well supported when they are there to maintain their independence in their daily lives. One client told us,`I like it here and the staff are really good`. Care plans are helpful and written in a person centered way.They show clearly what sort of care and support clients need. Clients are supported well by the staff to meet their needs when they stay at the home. Clients can enjoy a varied and well cooked choice of meals. Staff have done a range of training. This helps them gain a good understanding of the clients. The home is well run and is run in the best interests of the clients who stay there. What has improved since the last inspection? This was the first inspection of the service since it was registered to provide a `short break` service. What the care home could do better: Ensure that cleaning products that may be hazardous to health are stored more securely. Key inspection report Care homes for adults (18-65 years) Name: Address: 32 Albert Road 32 Albert Road Clevedon North Somerset BS21 7RT     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Melanie Edwards     Date: 1 2 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: 32 Albert Road 32 Albert Road Clevedon North Somerset BS21 7RT 01275341753 01179699000 nancy.kitson@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) Ms Nancy Ruth Kitson Type of registration: Number of places registered: care home 4 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 4 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 32 Albert Road nursing home is part of the Brandon Trust, and offers care and support services for people with learning disabilities and physical disabilities. It is a small home with capacity for nine residents. The service currently provides for four people for short breaks at the home. 2 9 0 6 2 0 0 9 4 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: Please note due to their disabilities some of the clients have communication difficulties. We met three of the clients staying at the home. We met the manager, the deputy manager and two support workers. We talked to them about the work they do and what they do to assist and support clients. Staff were observed assisting clients with their needs. We looked at a selection of records relating to the daily running and management of the home. We looked at the service users guide, the statement of purpose,one care plan, one assessment record, two medication records, menus, the complaints book, staff duty records, staff training records, three employment records, supervision information, accident records, fire records and information about quality assurance in Care Homes for Adults (18-65 years) Page 5 of 27 the home. We walked around the environment both inside and outside. We have used the aqaa, an annual quality assessment document that all homes are required to complete to help form the judgments in the report. We found the home was operating within the required conditions of registration which we impose. The conditions of registration set out the type of care and the needs of clients as well as the numbers of clients who may stay at the home. 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. 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 7 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 8 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is useful information for people to find out about the service provided at the home. Clients needs are assessed when they stay at the home. Evidence: We read a copy of the service users guide and statement of purpose to find out what information is available to read about the home and the short break service it offers people. The statement of purpose is informative. There is a DVD version of the service users guide for people who may prefer this. We saw photos included in the service users guide. The aims and objectives of the short break service at the home and the type of care to be provided are clearly explained in both documents. The name and contact details of the Brandon Trust along with experience of staff are included. The service users guide and statement of purpose contain a range of useful information about the home. To find out how each clients needs are assessed, we looked at one clients assessment Care Homes for Adults (18-65 years) Page 9 of 27 Evidence: records. We saw that there was an informative assessment written about the clients physical, mental health and social needs. In the assessment we read information about the likes and dislikes of the person and their preferred choice of social and therapeutic activities. The assessments are written in a person centered style. This way of writing about clients helps staff to see the person as a unique individual. We saw evidence written in the records that showed assessments records and care plans are regularly evaluated and updated. This helps to show the care and support clients needs when they come to the home for a short break is clearly identified and can be provided. We read some useful information in the aqaa document about how people are helped to chose if the service is right for them:We work closely with individuals, families, social workers and the community Learning Disabilities team prior to admission. There are a series of visits and stays arranged and feed back given. Clients have Individual support plans and risk assessments. We encourage and support people to be involved in everyday tasks. We have ongoing staff training. Care Homes for Adults (18-65 years) Page 10 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Clients care plans show how they will be cared for and supported when they stay at the home. Clients are well supported in their daily lives while they stay at the home. Evidence: To see how well the needs of clients are planned and identified we read one assessment record and care plan. We saw a detailed assessment had been carried out of the physical, mental health and social needs of the person. We also saw in the assessment information about the likes and dislikes of the person and their preferred choice of social and therapeutic activities. The assessment had been written in a person centered style, this helps staff to see the person as a unique individual with their own wishes and aspirations. We saw evidence recorded in the assessment that it had been regularly evaluated and updated. This information is used to guide staff to support the clients correctly when they stay at the home. Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: To find out how well clients are supported during their short break at the home we read one care plan. We saw detailed information written setting out how to help the client with their range of care needs. The staff who we met demonstrated in discussion and through observations that they had a good understanding of the needs of the clients who use the short break service. We saw staff talking to clients in a warm and friendly way. This helps to show how clients are helped to feel relaxed and are well supported by staff. We read some useful information in the aqaa document about how clients individual needs are respected and promoted:Each person has an individual plan which will be developed as we get to know individuals better. People are encouraged to make choice in relation to all aspects of their personal care and social activities. Each person has a risk assessment. People make choices independently. Care Homes for Adults (18-65 years) Page 12 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Clients are well supported to continue to take part in a range of social activities during their stay at the home. Clients are well supported to continue to be a part of the community. Clients are well supported to have personal relationships. Evidence: Clients are well supported to continue to do the social and therapeutic activities that they enjoy doing when they are at home. The clients go out in the community to a variety of different community activities including part time work. We saw detailed information in the care plans about potential risks the person may face while staying at the home and while in the community. The care plans set out Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: what to do to minimize risks to the clients. We were told that the home has an open policy about visitors. There are clients who have friends and family who come to the home to see them during their stay. We looked at the clients menu choices to see if clients eat a varied and well balanced diet. The meal choices we saw were well balanced and varied. We read some useful information in the aqaa document about clients lifestyles while they stay at the home:We work closely with work, learning and leisure providers. We ensure where possible people access local community services. We support people to access usual social activities whilst on a short break. We encourage people to bring own music, films, books, hobbies with them. We support people to maintain contact with family and friends when on a short break. People encouraged and supported to participate in day to day household activities and to prepare own meals and refreshments. Care Homes for Adults (18-65 years) Page 14 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. Clients are being well supported with their needs during their short breaks at the home. Clients medication is being looked after and administered safely. Evidence: We saw staff helping and supporting the clients we met in a patient manner. This helps to show us that clients are well supported when they stay at the home. We discussed with the staff the care needs of the clients. The staff demonstrated that they had a good understanding of clients range of needs. We looked at the way that clients medication is given to them, stored and disposed of to see if this is done correctly. We looked at the medication administration charts of two clients. We saw that medication administration charts were legible, up to date and had the signature of the staff giving out the medications. This helps demonstrate medication is given to clients safely. We saw information written by the staff to explain the ways that clients take their medications as well as what they are for. This Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: information should mean clients are given medication in the way that suits them best. The stock of medication we saw was satisfactorily organised. We saw that staff sign in medications in a record, to show that medicines have arrived at the home and that they are stored safely. We read some useful information in the aqaa document about clients personal and health care needs while they stay at the home:People get up when they are ready unless there are time restrictions eg going to work. People are encouraged to be as independent as possible with personal care. We have aids available. As we are a short break service, people access their own health services but will be supported by staff to access local services if need arises. Medication supplied by persons GP and stored and administered following Brandon Trust policies and procedures. Care Homes for Adults (18-65 years) Page 16 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to make complaints about the service. Clients are well protected from abuse. Evidence: We spoke to the staff on duty about how they may help clients to make complaints. The staff conveyed to us that they advocate for clients if they need to and ensure their views are made known to the manager. We saw procedures and guidance information on the subject of safeguarding clients from abuse. This helps to keep vunerable adults safe while they stay at the home, if staff can get hold of the right information to ensure the safety and protection of the clients. The staff do training to help them better understand issues around the safeguarding of clients from abuse. The staff we met were able to tell us what they would do if they had concerns for a clients welfare. They conveyed they would follow the correct course of action. We read some useful information in the aqaa document about how clients can make complaints and how they are kept safe while they stay at the home:We report and record any incidents and accidents. We follow safeguarding policy. We encourage Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: people to voice any concerns. Any issues are dealt with promptly and appropriate action taken. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment is suitable for the short break service that is currently provided at the home. Evidence: 32 Albert Road is in a residential area of the town of Clevedon. The home is a short distance from the main shopping area of the town. The home is near to bus stops,a train station, local shops, coffee shops, pubs and a church. This means clients can be part of the community easily if they want to be. The home is a four storey building and since the home became a short breaks service up to four clients use the ground floor. There is a lift in the home to help people with reduced mobility. We found the home looked clean in all areas that we saw. The environment looked to be mostly adequately maintained. The bedrooms we saw looked clean and satisfactorily maintained. All bedrooms are for single use. We saw that rooms had been decorated in different colours. We saw clients sitting in the lounge looking really relaxed in their environment. We saw bathrooms near to communal areas and bedrooms. We saw that the Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: bathrooms and toilets were clean. We saw hand towels and soap to help reduce risks from cross infection. We read some useful information in the aqaa document about the home environment:We have a clean, warm welcoming home. Each person has their own room. We are close to local shops and the seafront. We have a separate laundry room. We have a separate sluice room with two washing machines and two driers. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Clients are well supported by a sufficient number of staff when they stay at the home. The staff are well supervised in their work and this to benefits the clients. Staff do training to support them in to care for clients who stay at the home. Clients are protected by the homes recruitment procedures. Evidence: We checked the staff duty rota for the month of April to find out how many staff are on duty to support clients who are staying at the home. There are a minimum of two staff on duty for a day shift.There are senior support staff and the deputy manager who work full time at the home. The numbers of staff on duty is flexible depending on how many clients are currently staying at the home. We observed that the staff who were on duty have built up warm and very positive relationships with the clients who come and stay at the home. We saw the recruitment information of three staff to see if the home carries out employment safety checks before they recruit new members of staff. We saw written Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: confirmation that all new staff have a criminal records bureau check undertaken to confirm that they are suitable to work with vulnerable people. We also saw evidence that two references are taken up before a person can start work at the home. Staff have been on a number of study days in subjects relevant to the needs of clients. Study days that staff have been on include a range of topics designed to help them support the clients effectively. The staff do regular training in food hygiene, first aid and fire safety. The majority of the staff have done The national vocational qualification in care awards to level two and level three. The manager and the deputy manager supervise the staff in the home. We saw evidence that the staff are well supported. This clearly benefits clients if staff are supported. We read some useful information in the aqaa document about the staff team who support the clients while they stay at the home :All staff bar one have either a nursing qualification or National Vocational Qualifications level two or three in care . All staff have mandatory training and have relevant training to meet needs of people we support. Person Centred Planning training is currently being given to all staff. We have kept a consistent staff team. We have minimal sickness absence. The staff are known to the people who regularly use the service. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The short break service provided at the home is well run. There are systems in place to monitor the quality of the service in the home. Clients health and safety is generally protected. Evidence: Ms Kitson is a qualified nurse specialising in caring for people who have learning disabilities. She has a number of years of experience working with people who have very complex needs. She is registered with us as the manager of the home. This demonstrates Ms Kitson is considered suitable and qualified to fulfill the role of registered manager. Ms Kitson has the additional responsibility of running two supported living services. We saw the records of the monthly monitoring visits of the home that are carried out by a representative of Brandon Trust. The records we saw demonstrate that the designated individual responsible for the visits spends time consulting with people and Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: their representatives and observing staff. We saw in the staff training records that staff have done regular training in health and safety subjects including first aid and moving and handling practices. This should help protect clients if staff are knowledgeable and trained in health and safety. We saw records that showed staff are checking the temperature of all high risk cooked food before food is served to make sure it is hot enough and safe. The fire logbook record showed the required weekly and monthly tests of the fire alarms and the fire fighting equipment were being carried out and were up to date. We saw a record of the regular checks of the environment. These checks show a member of staff audits the health and safety of the home environment on a regular basis. However we did notice that the cupboard used to store cleaning products was not being kept securely. We advised that these products need to be kept secure as they can be a health and safety risk . We read some useful information in the aqaa document about how the home managed: The Manager is a qualified nurse and is completed the registered managers award in 2005. We are within budget without compromising the quality of the service. We send anonymous questionnaire to service users families. We have internal quality audits. We have Health and Safety guidelines that are monitored. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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