Care Home: 42 Robin Hood Road

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What the care home does well Support plans for people who live at the home are person centred, ensuring there is detailed and comprehensive information recorded about their specific care needs, identified areas of risk and provide guidelines for staff as to how their support needs are to be met. The registered manager and the staff team understand the principles of providing person centred care. The healthcare needs of people are well documented. The practice at the home ensures that where appropriate people are supported by staff to attend appointments. Medication practices and procedures in the home are good so as to ensure people`s health and welfare. People are able to make choices and decisions about how they spend their day and are supported by staff to develop their life skills. People who use the service are able to express their concerns and are protected from abuse. The service has a very low incidence of complaints and safeguarding referrals. Training of staff in safeguarding is regularly arranged by the home. Although people who live at the home were unable to verbally tell us they are happy living at Robin Hood Road, we were able to observe their non verbal cues and to watch and listen to how staff interacted with people. This was undertaken in a respectful and dignified manner and staff were observed to have a good rapport with each person. There is an annual quality assurance system in place. The purpose of the review is to validate service improvements and assess the service progress. What the care home could do better: The home continues to provide an excellent service to the people who live there. The management team at the home know what improvements are needed and are continually working on putting these in place. Random inspection report Care homes for adults (18-65 years) Name: Address: 42 Robin Hood Road 42 Robin Hood Road Brentwood Essex CM15 9EN 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: Michelle Love Date: 2 8 0 4 2 0 1 0 Information about the care home Name of care home: Address: 42 Robin Hood Road 42 Robin Hood Road Brentwood Essex CM15 9EN 01277233671 01277233671 pat@outlookcare.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Patricia Linda Saich Type of registration: Number of places registered: Conditions of registration: Category(ies) : Outlook Care care home 4 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 4 Personal care to be provided to no more than 4 service users with a learning disability. Date of last inspection Brief description of the care home 42 Robin Hood Road provides care for up to four adults with a Learning Disability. The premises are a semi detached `Edwardian Style` house situated in a residential area in Brentwood. All service users have a single bedroom and use of a large communal lounge and kitchen/dining area. The garden is situated to the rear of the property and is well maintained. A sensory garden has been designed and built. The home is situated approximately half a mile from Brentwood Town Centre and within easy reach of other local facilities. The home is easily accessed by public transport. Care Homes for Adults (18-65 years) Page 2 of 10 What we found: This was an unannounced random inspection. The visit took place over one day by one inspector and lasted a total of 2.5 hours. The purpose of the site visit was to monitor compliance to the Outcome Groups relating to Personal Care and Healthcare, Concerns, Complaints and Protection and Conduct and Management of the Home. As part of the process a number of records relating to people who live in the home, support staff and the general running of the home were examined. Prior to the site visit, surveys for people who live at the home and support staff were requested to be sent to the home for distribution. The response was positive and we received 3 completed surveys from people who live at the home and 3 from support staff. We also looked at all the information that we have received, or asked for, since the last key inspection, including the Annual Service Reviews undertaken on 11th April 2008 and 15th April 2009. Prior to this inspection, the manager submitted an Annual Quality Assurance Assessment (AQAA). This is a self assessment document, required by law, detailing what the home does well, what could be done better and what needs improving. Information given in this document has been incorporated into this report. At the time of the site visit there were 3 people living at Robin Hood Road. One member of support staff and the acting deputy manager were noted to be on shift and the registered manager was on site. Practices and procedures for the safe storage, handling and recording of medication were examined as part of this inspection. We looked at the Medication Administration Records (MAR) for each person. These showed that records were of a good standard with no unexplained gaps or omissions. Each person was noted to have their own medication folder. This contained an assessment of capacity pertaining to their medication, risk assessment and PRN (as and when required medication) protocols. Medication audits are undertaken each week and these showed a good level of compliance consistently attained each week. The temperature of the medication storage area was not being monitored at the time of the site visit. We discussed this with the registered manager and during the site visit a thermometer to record the temperature was purchased therefore we have not made a requirement. An additional medication audit is completed as part of Regulation 26 visits by a member of the organisation. Each person has a comprehensive and detailed individual Health Action Plan which provides an audit trail of visits to and/or by a healthcare professional. Information recorded includes the date, specific health need, what I need to happen, the plan to keep me healthy, who will help me and review date. In addition each person has a personal health information file which acts as an aid to support staff and other health professionals when people who live at the home are admitted to hospital. Information includes the persons name, date of birth, GP contact details, medical condition, about me, how I communicate, about my health, likes and dislikes, personal care and mobility. There is also a laminated sheet detailing specific information about the person e.g. appearance when content and appearance when distressed pertaining to their face, jaw movement, eyes, skin, vocal sounds, speech, habits and mannerisms, known triggers for distress and body observations. A healthcare planner for 2010 detailing appointments, included the name of the healthcare professional or service, details of the visit, outcome Care Homes for Adults (18-65 years) Page 3 of 10 and next appointment date. Records showed that people have access to a range of healthcare professionals and services as and when required and these include Community Nurse, GP, Dentist, Optician and Consultant Psychiatry. People who live at the home are supported by staff to attend appointments and other healthcare checks. We looked at the support plan for one person who lives at Robin Hood Road. The support plan was seen to be detailed, comprehensive and person centred. Information recorded related to the individuals strengths, abilities, personal preferences and the areas where they require specific support. We were advised by the registered manager that where objects of reference and pictorial guides have been utilised to aid peoples communication, a new communication tool is in the process of being formulated through the use of an extensive photographic album of current everyday objects and activities undertaken by each person. This will ensure there is a consistent approach by support staff to enable people to make informed choices throughout the day. In addition we noted that each person had a Life Skills Book detailing a specific task and information required to support the person through simple steps to achieve the activity, progress made, changes to be made and people involved. The support plans included comprehensive risk assessments detailing the identified risk and actions to be taken to reduce the risk. The service has a can do attitude and risks are managed proactively so as to assist people to lead the life they want and choose. Records showed that the support plans were reviewed regularly and amended where the persons care needs had changed so as to ensure information recorded was accurate. Evidence showed that the support plans and risk assessment profiles can be easily used as a good source of information by newly appointed staff and/or others who are not familiar with the individual person. This will enable them to deliver a personalised and consistent quality of care and support. The registered manager advised that support plans will change in the future as the format is to be entirely pictorial. Information relating to how people can make a complaint or raise concerns was displayed in the office and in the hallway. This was seen to be provided in a written and pictorial format however it is acknowledged that despite making the procedure as user friendly as possible, some people may not understand the procedure and are very reliant on staff for support, guidance and advocating on their behalf. The AQAA told us that within the last 12 months there have been no complaints and this was confirmed by the registered manager. We were advised that the home has received several letters and verbal compliments from healthcare professionals and others. These included, on a first visit to assess [name of staff] for their NVQ (National Vocational Qualification), I was extremely impressed with their communication skills with the service users and the work they are putting in with them. They could teach some other support workers how to do it. Their enthuisasim for the job is first class and a credit and I am extremely impressed with the activity board and life skills book. I am also impressed how staff encourage the service users to engage in day to day activities to maintain their independence and skills. The AQAA details that the organisation also have a DVD on how to make a complaint and this has been watched by people who live at Robin Hood Road. In addition staff also carry complaint cards while out in the local community and these can be provided upon request. The AQAA details that people who live at the home have regular contact by an independent advocate from Batias at their 6 monthly review or when needed. Care Homes for Adults (18-65 years) Page 4 of 10 There is a Serious Incident Reporting and Action To Be Taken if Abuse is Alleged or Suspected procedure in place in the office and the hallway. Staff working within the home have up to date SOVA training (Safeguarding of Vulnerable Adults) and know how to respond in the event of an alert and to whom the alert should be raised. No safeguarding referrals have been raised since the last key inspection. Records showed that people are empowered and supported to follow their personal interests, hobbies and daytime activities of their choice. An activity planner for each person was readily available and this showed that people have the opportunity to participate in hydro therapy, trampolining, in house life skills, sensory, 1 to 1 opportunities, cafe for lunch out, jazz music, spa day once monthly for one person, meals out at the local pub and cinema. A diary for each person was in place detailing how people spend their day and this confirmed the above was taking place each week. There is no vehicle at the home to enable people to access the local community. The registered manager advised us that a hire car is leased Friday to Tuesday once monthly and at other times a taxi and community support transport is utilised. We were advised that steps are being taken to source a vehicle for one person, whereby their mobility component of their benefits will be used to provide finance for this. Two staff surveys recorded the current transport arrangements for people in the home are not always appropriate e.g. people having to wait for long periods for the transport to arrive and in some instances events/planned trips have had to be cancelled. Consideration should be given to review the above if this is an issue. The AQAA details that parties and social events are held frequently giving people the opportunity to meet up with friends and to form relationships. Out of 3 staff surveys returned to us, all confirmed that on some occasions there are not enough staff on duty to meet the needs of people in the home and this has an impact as people are unable to access the community. Comments included we do not have enough staff for the service users e.g. if the manager is not here then staff can not go out with the service users as they are 2 to 1. Consideration should be given to review the above if this is an issue. People are involved with menu planning and are encouraged to choose from pictures and objects of reference. We were advised by the registered manager that the home won the Gold Award in Healthy Eating in June 2009 and people who live at the home and support staff were presented with a certificate by the Major of Brentwood. This award was championed by Essex County Council and means that the ingredients used in the home are low in saturated fats, low in sugar and salt and low in additives, therefore encouraging people to have a healthier lifestyle while enjoying everyday foods at the same time. The home is well managed and people who live at the home benefit from a strong management and staff team. It was evident at the site visit that the registered manager knows the needs of people in the home well and that people who live there and support staff find her approachable. The manager has attained The Registered Managers Award and NVQ Level 4. The manager told us there is a good staff skill mix at the home with many people having extensive experience in care. The organisation have strategies in place for monitoring the quality of the service provided at Robin Hood Road. This includes a member of the organisation visiting Robin Hood Road once monthly as part of its obligation to undertake Regulation 26 visits and to compile a written report. We requested records of these visits and noted there was Care Homes for Adults (18-65 years) Page 5 of 10 evidence to show these are being undertaken regularly. The registered provider has an annual quality assurance system in place that includes obtaining the views of people who live at the home, their relatives and/or representatives and other stakeholders. Comments were positive and included staff work hard to meet peoples needs, This is a good home with involved staff-like all services there are occassional ups and downs however there is a strong and competent leader to keep things rolling, Robin Hood Road is well organised, well run. Staff contact relevant professionals for support when required and staff provide the care and support I need. Records were also available to show that regular meetings with people who live at the home and staff meetings are conducted each month. People who live at the home are also involved in a Service User Forum every 3 months. Records showed these are used to discuss forthcoming events e.g. Fun Days, Outlook Cares 20th Anniversary Celebrations, Christmas Party. In addition people have been invited to join the staff recognition panel whereby the organisation and people who live within the service are supported to nominate staff for their hard work and to choose what staff should receive e.g. gift or money. Corporate health and safety policies and procedures are in place and regular health and safety audits are undertaken by a member of the organisation. The last audit for the home was conducted in February 2010 and this was seen to be detailed and comprehesive. A thorough action plan was in place detailing tasks to be completed and the date for compliance. The home has corporate policies and procedures and codes of practice in place and these are easily accessible for support staff. What the care home does well: Support plans for people who live at the home are person centred, ensuring there is detailed and comprehensive information recorded about their specific care needs, identified areas of risk and provide guidelines for staff as to how their support needs are to be met. The registered manager and the staff team understand the principles of providing person centred care. The healthcare needs of people are well documented. The practice at the home ensures that where appropriate people are supported by staff to attend appointments. Medication practices and procedures in the home are good so as to ensure peoples health and welfare. People are able to make choices and decisions about how they spend their day and are supported by staff to develop their life skills. People who use the service are able to express their concerns and are protected from abuse. The service has a very low incidence of complaints and safeguarding referrals. Training of staff in safeguarding is regularly arranged by the home. Although people who live at the home were unable to verbally tell us they are happy living at Robin Hood Road, we were able to observe their non verbal cues and to watch and listen to how staff interacted with people. This was undertaken in a respectful and dignified manner and staff were observed to have a good rapport with each person. There is an annual quality assurance system in place. The purpose of the review is to validate service improvements and assess the service progress. Care Homes for Adults (18-65 years) Page 6 of 10 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 7 of 10 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 8 of 10 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 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 9 of 10 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. Care Homes for Adults (18-65 years) Page 10 of 10 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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