Care Home: 41 Birdwood Grove

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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 provide excellent support for people to take part in activities they enjoy and to keep in contact with family and friends.Staff help people to receive the healthcare they need and to take their medication safely.People who live at the home 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 recently been completely refurbished. People now have more room and are able to use the kitchen with support. What the care home could do better: The manager has a plan of improvements she would like to make and should ensure this happens. This 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: 41 Birdwood Grove 41 Birdwood Grove Fareham Hampshire PO16 8AJ 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: 3 1 0 7 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: 41 Birdwood Grove 41 Birdwood Grove Fareham Hampshire PO16 8AJ 01329221623 F/P01329221623 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) : www.hantspt.nhs.uk Hampshire Partnership NHS Foundation Trust care home 3 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 categories: Learning disability (LD). Date of last inspection A bit about the care home 41 Birdwood Grove is a semi-detached property situated in a residential area between Fareham and Portchester and is undistinguishable as a care home from other homes in the street. Hampshire Partnership NHS Foundation Trust (the Trust) manages the service providing the care and support for people living there. The establishment is registered to accommodate 3 people under the age of 65 with a learning disability. Each person has their own bedroom. Communal space includes a large open plan kitchen, dining area and lounge. Information about the service provided at the home is made available to people wishing to live there by providing them with a copy of the homes Service Users Guide and Statement of Purpose. 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 30 July 2009. We spoke to the manager, staff that were working and observed the way staff listened to people who live there. 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 for us. 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 8 August 2007. We received surveys from both people who live in the home and five of the staff team. 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 provide excellent support for people to take part in activities they enjoy and to keep in contact with family and friends. Staff help people to receive the healthcare they need and to take their medication safely. People who live at the home 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 recently been completely refurbished. People now have more room and are able to use the kitchen with support. 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 Care Quality Commission South East Region 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 no-one has moved into the home since the last inspection. The home currently has one vacancy and the manager said she had received a referral. At the time of the visit the manager was working with the person to complete a needs assessment before deciding whether they would be able to offer the person a place. The manager was clear about her responsibility to ensure that they would be able to meet the persons needs before offering them a place in the home. 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 that are available in 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 five staff who work at the home. All five said they are always given up to date information about the needs of the people they support and care for. 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 both people who live in the home during the visit. Both people had a care and support plan, which set out how their assessed needs should be met. The plans were developed with people following an annual review of their needs assessment. Staff have used different methods to help people communicate decisions and participate in the care planning process. These have included using sign language, objects of reference and presenting information in pictorial format. People were also supported to involve other people in the planning process, for example relatives or advocates. 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 and support plan is developed for each identified need and those seen included communication, support to meet spiritual needs, medical care with specific details about the support needed to access health services, support to take part in household jobs, support to manage frustration and aggression and support to access activities and events in the community. The plans were different for each person that lives in the home and contained information specific to the person, for example detailed information about the way one person uses sign language and the signs that are specific to them. Each plan contains details of the desired outcome of the support provided, an action plan as to how the outcomes can be achieved and evaluation sheets that are completed each month. Evidence: During the visit staff demonstrated an excellent understanding of peoples needs and the support that they need. We observed staff communicating with people in the ways detailed in their support plans and supporting people to make decisions about their activities for the day. Each care and support plan contained a comprehensive risk assessment. These assessments 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 were evaluated every month to ensure they were still accurate and were reviewed every six months. Both people who live in the home completed a survey for us with support from their advocate. Both said the staff and manager always listen to them and act on what they say. 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 home provides excellent support for people to take part in a range of activities they have chosen, to maintain contact with family and friends and to plan and prepare healthy meals. This helps to ensure that people live the lifestyle they choose. Evidence: People are supported to take part in a range of activities including attending day services, social clubs, bowling, pubs visits and eating out. People have an individual programme of activities that is planned with them as part of the care and support planning process. The homes staffing rota is specifically planned to enable people to take part in their chosen activities, with additional staff available at weekends and evenings to provide the right levels of support. Both people who live in the home completed a survey for us with support from their advocate. Both said they could do what they want to during the day, in the evening and at the weekend. The manager reported that they have been working with the day service that people attend to ensure that peoples feedback about what they enjoy is reflected in their activity plan as well as being given the opportunity to have new experiences. People are supported to maintain contact with their family and friends, with staff providing support to visit family where necessary. The advocate who supported one person to complete their survey said staff help the person to see their Mum every two weeks and help them to have a great social life. The manager reported that during the summer the social clubs that people attend do not run. In order to support people to maintain contact with their friends the staff have supported people to arrange a weekly event at the home to which friends from the social clubs have been invited. People are supported to plan their own meals and to be involved in the shopping and food Evidence: preparation. Details of the support people need to make choices and to prepare the food are included in the care and support plans. 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 is well met by staff who know their needs and there are good systems to safely store and administer peoples medication. Evidence: The care and support plans contain details of the personal care support people need and how it should be provided. Both people who live in the home completed a survey for us with support from an advocate. Both said staff always treat them well and always listen to them and act on what they say. People are supported to attend a range of health services, including GP, optician, nurse, dentist and hospital clinics. Staff worked closely with the health and social care teams to enable one person who has a history of refusing medical treatments to have surgery. Details of peoples health appointments are recorded, including any advice from the practitioner. People have been supported to complete a health action plan that assesses whether they are receiving the health services they need. Medication is stored in peoples bedroom in a locked cabinet and a record is kept of all medication coming into the home and returned to the pharmacist for disposal. Peoples care and support 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 for the current month were inspected during the visit and had been fully completed. This gives details of the medication people have 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 accessible format and has also been provided to peoples relatives. The manager reported that she has been working with people who live in the home to develop confidence about expressing concerns or complaints. Information has been obtained from BILD (British Institute of Learning Disabilities) about supporting people who dont use verbal communication to complain. There is a log of complaints and none have been received during the last year. Both people who live in the home completed a survey for us with support from an advocate. The advocate added to the survey that both people would express their complaints. The home has procedures covering keeping people safe and how they will respond to allegations of abuse. All staff have completed training in keeping people safe from abuse. Two staff spoken with during the visit demonstrated a good understanding of different types of abuse, signs of possible abuse and the action to take if abuse is witnessed, reported or suspected. The manager and a senior support worker are signatories on peoples bank accounts. Records were available of money held in the home and in peoples accounts. The cash held in the home for both people who live there was checked and found to match with the records. The money and bank account records are checked each month by a senior manager in the Trust. 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 has recently had a major refurbishment, during which people moved out. This has created an open plan communal living area that is more accessible to people who live at the home. People were involved in the choice of layout, furnishings and decoration. The kitchen was specifically designed to make it more accessible for people and enable people to participate in meal preparation and cooking. The bathrooms have been redesigned to make them more accessible for people. All areas of the home seen during the visit were clean and well maintained. Both people who live in the home completed a survey for us with support from an advocate. Both said the home is always clean and fresh. The advocate added for one person that an area of shade in the garden was needed. The manager reported that she was looking into various options to provide shaded areas, which would enable people to use the garden more. The home now has a separate laundry room, away from food preparation and storage areas. There are infection control procedures in place. 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 five support workers have completed the National Vocational Qualification at level 2 or 3 and the other support worker has a learning disability degree. The home has an established staff team and there is a very low turnover of staff. We spoke with two staff members during the visit. Both demonstrated a very good understanding of peoples needs and said the team worked well together to share their skills and strengths to improve the experiences of people who live in the home. The staffing rota is highly flexible and planned to meet the specific needs of people living in the home, for example providing additional staff in the evening and at weekends when more activities are taking place. The home has not recruited any staff since the last inspection. Recruitment records are kept in a locked cupboard in the home and we saw that for one staff member there was confirmation that they had obtained an enhanced criminal records bureau disclosure, written references and identification details. The Trust has procedures on the recruitment of staff and central support for the manager to ensure people are thoroughly checked before they work in the home. The manager reported that she has attended training in the involvement of people who use the service in recruitment and is planning to implement this the next time they recruit staff. 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, but staff are responsible for booking their own training. Staff spoken with said this system works very well, allowing them to fit training courses around their work schedule. Staff were positive about the training, stating that the courses were pitched at the right level and relevant to their role. The training records for two staff members were inspected and indicated they Evidence: had completed a wide range of courses including keeping people safe from abuse, medication administration, moving and handling, autism awareness, mental health, first aid, infection control, fire safety, learning disability and dementia, Makaton sign language and sensory loss. Staff spoken with said there was not any specific training they felt was necessary that they had not been able to access. Staff reported that in addition to formal training courses, they use team meetings to keep up to date with the latest best practice advice. All five staff that completed a survey for us said 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 service provided and ensure shortfalls in the service are identified and resolved. Evidence: The manager has worked at the home since 1992 and has achieved the Registered Managers Award. In the annual quality assurance assessment the manager completed for us and in discussions during the visit the manager demonstrated a clear understanding of the aims and objectives of the provider and how she will ensure these are achieved within the home. Staff spoken with during the visit were positive about the support they receive from the manager and her ability to ensure people living in the home receive the best service. All five staff who completed a survey for us said they regularly meet with the manager for support and to discuss their work. A locality manager visits the home every month and assesses the quality of the service that is being 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 needed 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 the manager completed for us before the visit. This assessment contained clear information about the way the home has improved, how improvements are planned based on consultation with people who live in the home and plans for further improvements. There is an annual survey of people who live in the home, relatives, staff and other stakeholders. The responses to these surveys are collated and used to plan improvements to the service. The home has an annual development plan, which is also completed with input from people who live in the home. The plan is regularly reviewed throughout the year to ensure improvements are being implemented. In addition to these local improvement plans, the Trust has a strategic plan Evidence: to improve the quality of the service provided. The manager reported in the annual quality assurance assessment that the electrical system, fire detection and fighting equipment and gas system are regularly serviced and maintained. These records were sampled during the visit and confirmed the managers report. The home has workplace risk assessments in place that are reviewed annually. These include control measures that people should take to manage any identified risks. 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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