Care Home: 49 King Street

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Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 49 King Street 49 King Street Thorne Doncaster South Yorkshire DN8 5AU     The quality rating for this care home is:   three star excellent 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Christine Rolt     Date: 0 3 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 23 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 23 Information about the care home Name of care home: Address: 49 King Street 49 King Street Thorne Doncaster South Yorkshire DN8 5AU 01405818580 01405743110 eileen.champion@hesleygroup.co.uk 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) : The Hesley Group Ltd care home 6 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 6 Service users aged 16/17 should not be accommodated where there are other service users over the age of 25. Date of last inspection Brief description of the care home 49 King Street is situated in the market town of Thorne, which is approximately 11 miles from Doncaster. It is close to Thorne railway station which provides regular access to Doncaster, Goole, and surrounding areas. There are also two motorways (M18 and M62) nearby. The property is a large detached house. It comprises six bedrooms with ensuite facilities, two lounges, a large dining room, a conservatory, kitchen, cloakroom, utility room and an activities room. There is a large private garden with a terrace overlooking the lawned grounds. There is also a small private car park. To the front of the building there is a secure patio area. The home is within easy walking distance of public transport, shops, the post office, and health facilities. Weekly fees start from £3,558 per week (£185,000 per annum) and are based on Care Homes for Adults (18-65 years) Page 4 of 23 Brief description of the care home peoples individual support needs. This information was supplied during the site visit on 3rd February 2009. Please contact the home for further information. Care Homes for Adults (18-65 years) Page 5 of 23 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: three star excellent 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: The quality rating for this service is three stars. This means that the people who use this service experience excellent quality outcomes. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. This was a key inspection and comprised information already received from or about the home and a site visit. The site visit was from 10.00 am to 3.00 pm. Various Care Homes for Adults (18-65 years) Page 6 of 23 aspects of the service were checked during the site visit. Care practices were observed, a sample of records was examined, a partial inspection of the building was carried out and service provision was discussed with the manager. Some people living in the home were seen throughout the day and chatted to. The care provided for two people was checked against their records to determine if their individual needs were being met. Questionnaires were sent to the home and several were completed. All information, opinions and comments were considered for inclusion in this report. The inspector wishes to thank people living in the home, the staff and the manager for their assistance and co-operation. 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 set out 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 8 of 23 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 9 of 23 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. People only moved into the home after their needs had been assessed and they had been assured that the home could meet their needs. Evidence: The files for two people were checked. The files contained detailed assessments of each persons individual needs and wishes. People said that they had received sufficient information about the home. The homes statement of purpose and generic copies of the service user guide were available in the home. People living in the home each had their personal copy of the service user guide, which was tailor made for them with their photograph and incorporated their personal comments. Care Homes for Adults (18-65 years) Page 10 of 23 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. Peoples assessed and changing needs were reflected in their care plans to ensure that their needs and wishes were met within a risk management framework. Evidence: Care plans contained information of physical, health, emotional and social needs, peoples likes, dislikes, wishes, and preferences. Information also included personal achievements and what each person was currently working on to achieve. Each person had their own personal risk assessment file. All information was constantly reviewed and updated in consultation with the relevant person as the need arose. People said that they were encouraged to be as independent as possible and staff were available for support when needed. Care Homes for Adults (18-65 years) Page 11 of 23 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. People were able to participate in activities both inside and outside the home. Their rights were respected and choices were offered. Evidence: On the day of the visit, the majority of people were taking part in work or leisure activities in the community. Details of these activities were recorded in each persons care plan. People said that they liked living in the home and enjoyed their lifestyles. They also liked the staff and considered that staff treated them with respect. Peoples privacy was respected and they had keys to their rooms and lockable facilities. Contact with family and friends was encouraged where appropriate. Where distance prevented regular visits, people were encouraged to keep in contact by telephone and in one instance by video link. Care Homes for Adults (18-65 years) Page 12 of 23 Evidence: Meal times were flexible and people were encourage to participate in daily living skills including meal preparation. Care Homes for Adults (18-65 years) Page 13 of 23 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People received the personal support they preferred and their physical, emotional health and social needs were met. Evidence: People received the help and support they needed and there was detailed information in their person centred care plans of how their physical, emotional, health and social needs and wishes were to be met. This included health care, eating and drinking, self care, communication, life long learning, leisure, mobility, home contact and finance. There were daily living plans covering all aspects of peoples daily routines. Daily journals stated whether each individual need had been met, activities throughout the day, moods, meal choices, medications administered, night time routine and checks carried out. All records were signed and dated by the relevant staff members. Each person also had a Life Book of events in their life and certificate of achievement. People were consulted about their annual reviews and were encouraged to invite the people they wished to attend their reviews. One person wanted to provide a power point presentation as part of their review and was supported to do this by the staff. Care Homes for Adults (18-65 years) Page 14 of 23 Evidence: Medication was stored correctly and checked monthly. The homes policy was not to write or change any information on the MAR chart but to obtain amended pre-printed MAR charts from the pharmacist. The home kept up to date information in a record book. Medication for refrigeration was kept in a medication refrigerator and records were available to verify that the temperature was monitored. The home also had a controlled drugs cupboard but the manager said that none of the people living in the home was on controlled medication. Care Homes for Adults (18-65 years) Page 15 of 23 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 were protected from abuse and their views were listened to and acted upon. Evidence: The home had a complaints policy and procedure. All staff had undertaken safeguarding training and this was updated regularly. The manager had followed the safeguarding procedure and taken the appropriate action when one person living in the home had hit another person living in the home. There were no other allegations of abuse. Care Homes for Adults (18-65 years) Page 16 of 23 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 provided a safe, clean and comfortable environment for people to live in. Evidence: The home was domestic in character and there were no offensive odours. All bedrooms had en-suite bathrooms. Bedrooms had been personalised by their occupants. People had keys to their bedrooms doors and lockable facilities. The manager said that the home was due for redecoration and refurbishment. Aids and adaptations were available as necessary. There were no health and safety issues. Weekly tests were carried out on the hot and cold water to ensure that it met regulations and the records of these tests was checked during the site visit. Care Homes for Adults (18-65 years) Page 17 of 23 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. Recruitment procedures were robust and staff were trained and competent to provide relevant support to meet peoples individual and joint needs. Evidence: There were sufficient staff on duty to meet peoples needs. This meant that people could follow their individual programmes both in the home and the community. The files for three members of staff were checked. All contained the relevant checks, correspondence and information, which demonstrated that the recruitment procedure was robust. The procedure and length of time for keeping Criminal Record Bureau disclosures was discussed and clarified. There was evidence on file that people had undertaken induction training and that this was relevant to the client group. Training records were also available. The manager confirmed that over two thirds of staff had achieved NVQs in care and that skills training was provided to meet the needs of people living in the home. Care Homes for Adults (18-65 years) Page 18 of 23 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. The home was run and managed in the best interests of people living in the home. Evidence: The Manager was registered and had attained the Registered Managers Award. She kept up to date with current trends and had recently completed Person Centred Planning and the Mental Capacity Act. A quality assurance monitoring system was in place. This included checks and audits of the environment, systems and records within the home, e.g. accident analyses, medication, care plan and financial audits, staff training updates. Reports of visits by the responsible individual were available as required by regulation. People living in the home had their own meetings, which they chaired, had an agenda and kept minutes of. Questionnaires in formats suitable to the people living in the home were given out to seek their views. Questionnaires were also sent to parents and other relevant people before the persons annual review. Care Homes for Adults (18-65 years) Page 19 of 23 Evidence: The personal allowances records for two people were checked against cash held on their behalf. Cash tallied with the records. Certificates were available to verify that systems and equipment within the home had been serviced and maintained within the regulated timescales. Care Homes for Adults (18-65 years) Page 20 of 23 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 21 of 23 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 22 of 23 Helpline: Telephone: 03000 616161 or Textphone: 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 23 of 23 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!