Care Home: 45 Horsebrook

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Annual service review Name of Service: 45 Horsebrook The quality rating for this care home is: The rating was made on: two star good service 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 We do an annual service review when there has been no key inspection of the service in the last 12 months. It does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection or annual service review.   Has this annual service review changed our opinion of the service?   Yes You should read the last key inspection report for this service to get a full picture of how well outcomes for the people using the service are being met. The date by which we will do a key inspection: Name of inspector: Roy Gregory Date of this annual service review: 2 0 1 1 2 0 0 9 Annual Service Review Page 1 of 5 Information about the service Address of service: 45 Horsebrook Calne Wiltshire SN11 8HG 01249811222 Telephone number: Fax number: Email address: Provider web address:   www.selfunlimited.co.uk Self Unlimited Name of registered provider(s): Conditions of registration: Category(ies) : learning disability Number of places (if applicable): Under 65 Over 65 6 0 Have there been any changes in the ownership, management or the No service’s registration details in the last 12 months? If yes, what have they been: Date of last key inspection: Date of last annual service review (if applicable): Brief description of the service 45 Horsebrook provides care and accommodation for up to six service users with a learning disability. It is operated by Self Unlimited. The property is owned by Westlea Housing Association. The service was first registered in 2003. It is a semi detached building on two floors. Each service user has a single room with an en suite shower and toilet. There is also a bathroom on the first floor. The communal space includes an open plan lounge and dining room. Service users take an active role in the household routines. There is a domestic type kitchen with a separate laundry area, both of which are reported as upgraded during 2009. The home has its own vehicle to help people access the community. As well as attending local colleges, people at the home have close connections with Self Unlimiteds larger project at Rowde, near Devizes. This provides various social, therapeutic and work-based day activities. Some administrative and managerial support is also provided through the Self Unlimited service at Rowde. Annual Service Review Page 2 of 5 Service update since the last key inspection or annual service review: What did we do for this annual service review? We looked at all the information we have received about the service, or asked for from it, since the previous annual service review. This included: The Annual Quality Assurance Assessment (AQAA) that the service sent to us. This is a self-assessment that focuses on how outcomes are being met for people that use the service, and how the service intends to develop. It also contains some statistical information. Notifications sent to us by the service, concerning notifiable events. Discussion with managers from Self Unlimited regarding possible future plans for their local services. Surveys returned to us by five people who live at 45 Horsebrook. Four of them received staff assistance to complete the surveys, where external support would have been preferable; one person had family support to the task. Two members of staff returned surveys. The previous key inspection report (October 2007), and the previous annual service review (September 2008). What has this told us about the service? The service sent us their annual quality assurance assessment (AQAA) when we asked for it. The AQAA gave all the required information. It showed the management have ways of monitoring how the service is provided and considers how it may be further developed. They take account of feedback that they obtain directly from the people that receive a service. The key issue for 45 Horsebrook presently is one of staffing. There is a need to appoint a team leader, as is acknowledged in the AQAA. When the service seeks registration under the Health and Social Care Act 2008, it will be necessary to have a registered manager in place. Also, the home has only a small permanent staff group, and the AQAA shows none of these has obtained NVQ (National Vocational Qualification) to level 2 or higher. Owing to the small staff numbers there is some reliance on agency staff. The AQAA did not identify staff qualifications as an area for development. Responses to our survey from members of staff and people that live at the home suggest the staffing and management issues are impacting on quality of life. A staff member pointed out that when agency staff cover weekend shifts, they are unable to support people by use of the homes provided transport, owing to lack of insurance cover to drive it. However, in answer to can you do what you want at the weekend? all but one of the people living in the home replied yes, the other saying usually. The issues for service users were more to do with ongoing quality. Only one person said that staff always treated them well, and none answered always in response to do the carers listen, and act on what you say? This level of response contrasted with the Annual Service Review Page 3 of 5 surveys people sent us last year, when they had also been more inclined to add positive detail additional to the tick box format of the survey. The members of staff who responded to our survey saw the strengths of the service as keeping people comfortable and safe, and supporting their attendance at college courses and other day activities. They were not in agreement about sufficiency of staff, or the support they received to carry out their role. A question in the survey for people living in the home concerned whether the home is kept fresh and clean. It is of some concern that all answers to this were sometimes (3)or usually (2), given that the home has had an outbreak of diarrhoea and vomiting since the previous inspection. This might be another reflection of levels of staff availability and management oversight, or of a need for training in this area - which could include people living in the home as well as staff. The AQAA shows that the service has received and upheld one complaint in the past year, however, two people indicated in their surveys that they did not know how to raise a complaint. All people were placed on college courses at the time of the AQAA and one had a parttime voluntary job. People were involved in different ways in the local community and in decision-making within the home. They had been supported to obtain and use bus passes and some people chose to use house and room keys of their own. There was some evidence of efforts to pursue an increasingly person-centred approach to support planning and how the home functions for individuals, with recognition of diversity indicators. The service has not demonstrated since the previous annual service review that all matters arising have been managed well. People have been able to achieve some good outcomes. Whilst the manner in which they will be supported in the future is being actively looked at by the provider, day-to-day the home would benefit from more direction and consistency and our current good rating may not acccurately reflect the current nature of the service. What are we going to do as a result of this annual service review? Subject to any changes in registration and inspection practice following implementation of the Health and Social Care Act 2008, our current plan is to do a key inspection by 1st October 2010. In view of issues highlighted in this annual service review, which has replaced the key inspection that would have taken place at this time (as a result of policy changes made by the Care Quality Commission), the next key inspection may be brought forward. Furthermore, we may inspect the service at any time in response to concerns about the quality of the service or the safety of the people using the service. Annual Service Review Page 4 of 5 Reader Information Document Purpose: Author: Audience: Further copies from: Annual service review CQC General Public 0870 240 7535 (national contact centre) Our duty to regulate social care services is set out in the Care Standards Act 2000. The content of which can be found on our website. 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