Care Home: 5 George V Avenue

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What the care home does well The home provides a welcoming homely environment. A variety of activities are provided including regular annual holidays. People lead busy social lives going out on trips, attending day centres, clubs and socializing with their friends. People are actively encouraged to expresses their wishes, this is then considered, risk assessed and arranged if possible, with appropriate support provided, for example going to pop concerts. The ethos of the home is about providing a good quality of life for those who live at the home and this is reflected by the approach taken with providing care and the promotion of choice. People have an active voice within the home. Care plans clearly show, residents are actively involved in the production of these documents; they are personal and individual. There are practices in place, which monitors resident`s health, with appropriate action taken to ensure that health care needs are met. People attend the doctors for their annual health checks and are supported to attend hospital appointments. People are supported to maintain an appropriate level of independence with looking after their money and have the freedom to spend it as they wish. The building is well-maintained with the registered providers continuing to look at improving the environment. The registered providers ensure they keep their knowledge and skills up to date by attending training courses and respond quickly and appropriately to any requirements made. What has improved since the last inspection? Training has been undertaken in person centred planning and has enabled more involvement from the residents. Policies and procedures are updated at least annually. Ongoing maintenance of the premises. What the care home could do better: It is recommended that the registered providers access training in relation to the Mental Capacity Act and Deprivation of Liberty. Key inspection report Care homes for adults (18-65 years) Name: Address: 5 George V Avenue 5 George V Avenue Westbrook Margate Kent CT9 5QA     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Sandra Crosby     Date: 1 4 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: 5 George V Avenue 5 George V Avenue Westbrook Margate Kent CT9 5QA 01843227003 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Margaret Lydia Parish,Mr Kevin George Rackley,Mr Benjamin Albert Parish,Mrs Amanda Jane Rackley Name of registered manager (if applicable) Mrs Amanda Jane Rackley Type of registration: Number of places registered: care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 5. 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 Brief description of the care home 5 George V Avenue provides long term care for up to five people with learning disabilities. The home is a large semi-detached property that has been extended. It is situated close to the local amenities and is on the bus route. The Registered Providers live in the home, contributing to the family atmosphere. Residents attend a variety of Care Homes for Adults (18-65 years) Page 4 of 26 5 Over 65 0 Brief description of the care home clubs and activities. The home also has its own minibus. The fees are £349.00 to £383.70 per week. Care Homes for Adults (18-65 years) Page 5 of 26 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: This report contains the findings of the homes key inspection and takes account of information obtained from various sources. The key inspection visit was initially unannounced and no one was home. The inspector telephoned the provider/manager and visited the following day Tuesday 13 April 2010 between 09.30 and 12.00 to view documentation, and again on Wednesday 14 April 2010 between 15.45am and 17.00 to meet and speak with the people who live at the home. The Annual Quality Assurance Assessment (AQAA) documentation provided up to date comprehensive information about the service, together with information about improvements made in the last twelve months. The aim of the visit was to carry out an inspection against the key standards of the National Minimum Standards for Older Persons in accordance with the Inspecting for Better Lives (IBL) process. Care Homes for Adults (18-65 years) Page 6 of 26 Judgements have been made for each outcome area in this report and these have been made using the Key Lines of Regulatory Assessment (KLORA), which is guidance used to ensure that a fair and proportionate judgement is made in each outcome area. More information about KLORAs can be found on the Care Quality Commissions (CQC) website. The findings of this inspection were discussed with the registered providers and overall indicate that this home is providing sustained good quality outcomes provision for the residents and in line with CQC ratings agenda this service has achieved an excellent 3* rating. Care Homes for Adults (18-65 years) Page 7 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our Care Homes for Adults (18-65 years) Page 8 of 26 order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 26 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 10 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are provided with the information they need about the home to enable them to make an informed decision about using the service. The home undertakes pre admission assessments of prospective residents to help ensure it is the right place for them. Evidence: The Statement of Purpose and Service User Guide documentation was viewed and showed that these documents are regularly amended. The Service Users Guide has been produced in picture format and large print in simplified language. A contract seen as part of the person centred care plans, these have also been produced in picture format. The pre-assessment documentation tool was seen. A completed pre-assessment was seen for a person who has recently stayed at the home for a short period of time. This contained comprehensive information, that would inform a person centred care plan. Care Homes for Adults (18-65 years) Page 11 of 26 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 have person centred care plans that are individual and provide information on how to meet the persons needs. People are supported to make choices and decisions about their everyday life. Evidence: People have person centred care plans that are individual and provide information on how to meet the persons needs. People are supported to make choices and decisions about their everyday life. The registered provider/manager has completed person centred planning training. A person centred care plan was viewed for one person living at the home. It was individual and comprehensive and showed that the people living at the home are actively involved in the production of the person centre file. The individual files contained, details of care needs, risk assessments and personal goals and achievements. The AQAA documentation states that the new format has made residents want to be more involved and is much clearer for staff to understand. Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: People living at the home stated they are actively supported to make decisions and choices. The daily records confirm that people are actively supported to fulfil their wishes, with recognition of potential risks being recorded. Any possible limitations and potential risks are acknowledged and recorded appropriately. People stated they felt well cared for and treated with respect and dignity. This service is consistently providing good outcomes enabling this to be viewed as an excellent service in line with Inspecting for Better Lives. Care Homes for Adults (18-65 years) Page 13 of 26 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. People are able to exercise choice and control over their daily lives as far as is practicable and to maintain links with friends and relatives. Leisure activities are appropriate and individual. People enjoy the meals which are of good quality. Evidence: All of the residents spoke with the inspector, as a group and individually. They confirmed that they continue to have very active social lives, attending day centres, clubs, days outs, special trips, socializing with friends and going on holiday. Two of the residents were going on a day trip to London to visit the Art Gallery this week. One resident told the inspector about the annual holiday this year where they would be staying in a Station Masters house by a steam railway in Lincolnshire. Residents also talked about previous holidays and outings. Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: Other activities include: music club, visits to the local pub and restaurants, bowling, the theatre, disco. They also attend clubs, which teach; computer skills, woodcraft, leather craft, arts and crafts, newsletter skills, travel training, swimming, exercise classes, healthy living and personal care. The home also benefits from having its own new minibus, which is used daily. Family and friends are encouraged, where appropriate, to maintain contact and to be involved. Residents talked about their families visiting and the visits they made with their families. There is a varied balanced diet offered, with alternative offered when appropriate, such as dislikes the meal, or has an activity to attend. Some evenings they may enjoy a take away or go to a restaurant for a meal. All of the residents have nutritional assessments completed and are weighed regularly. One person said very nice food. Care Homes for Adults (18-65 years) Page 15 of 26 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 needs are promoted with good liaison with other health care professionals. Evidence: Through the regular observations and assessing of health care needs by the registered persons, service users have received the appropriate treatment when required. Records provided evidence of accessing a variety of healthcare professionals when appropriate and needed. The learning disability community nurse, who has, in conjunction with the service users, written individual health action plans. The medication audit showed practices continue to a good standard and found no errors. The registered provider/manager had at the last inspection visit reviewed and amended the homes care of the dying policy to bring it into line with current practices. The AQAA documentation states that policies in place include privacy and dignity and equality, medication and dying and death The observations made during the visit showed that the resdients are treated respectfully and with dignity. They are encouraged to be themselves and to allow their Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: own personalities to be expressed. Care Homes for Adults (18-65 years) Page 17 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are confident their concerns will be listened to. There are systems to protect people from abuse. Evidence: The home has produced its complaints procedure in three different formats to meet the individual needs of the people. The Commission and the home have not received any new complaints. The registered provider/manager acknowledges all concerns raised however small. The home has a safeguarding policy. When meeting with residents they were able tell the inspector who they would go to if they had a problem or were upset about something, this included telling the registered provider/manager. There has been no changes made to the procedures for handling peoples money. People confirmed they have their own money to spend each week and showed the inspector some of things they like to buy with it, such as painting by number sets, DVDs, disco lights, CDs etc. Care Homes for Adults (18-65 years) Page 18 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The building is well maintained providing a homely environment for service users. The home was clean and free from offensive odours. Evidence: The AQAA documentation indicates improvements that have been made in the last twelve months include decoration and alterations to three bedrooms and the first floor hallway decorated. A tour of the premises was conducted with the residents. The registered providers continues to strive to improve the standard of accommodation provided. There is a maintenance programme identifying both small and major tasks to be undertaken. The home provides a large communal room, which is a lounge and dinning room, providing more than the minimum space required. There is an enclosed rear garden where the people enjoy BBQs. Each bedroom has been personalised by the resident with their possessions and is fitted with a style of lock that people can use independently. Residents confirmed that when their bedrooms are decorated they help to choose the colour including the wallpaper and paint. It was observed that the bedrooms are of a good size, individual, well appointed with furniture, and personalised. There are bathrooms and toilets situated next to every bedroom. Care Homes for Adults (18-65 years) Page 19 of 26 Evidence: The home is set over three floors and would not be suitable for those with impaired mobility. Care Homes for Adults (18-65 years) Page 20 of 26 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. Sufficient care hours are provided by appropriately trained carers. Evidence: Two of the registered providers work full-time to provide the care required; they also live within the home. The lifestyle structure is similar to a family unit. A family member provides holiday relief cover. The AQAA documentation indicates the providers update their training on a regular basis and continue to find new courses which will refresh their knowledge. A planned course on Periodic Service Review, is to be undertaken and the registered provider/manager hopes that this will assist with the quality assurance checks. The registered provider/manager confirmed that mandatory training is to be updated this year. People are well supported by a staff team that recognises and responds appropriately to their diverse needs and human rights. This service is consistently providing good outcomes enabling this to be viewed as an excellent service in line with Inspecting for Better Lives. Care Homes for Adults (18-65 years) Page 21 of 26 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. People benefit from a well run home, the management style ensures their welfare & safety whilst living in a family atmosphere. The home has quality assurance procedures to assess and maintain standards. Evidence: The registered providers are appropriately qualified and continue to develop professionally through training. They also research changes that are happening with legislation, such as the Mental Capacity Act and how this will impact on the people living in the home. Records, documents, policies and procedures have been produced and implemented to meet the needs of a small home. The AQAA documentation states the registered providers ensure the home remains financially viable and that certificates and licenses are obtained and displayed and that the home complies with the Care Standards Act and Regulations. There is an open, friendly and inclusive atmosphere within the home, everyone feeling free to give their opinions and suggestions. The provider/manager welcomes this and Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: acts upon after full discussion with everyone. The AQAA documentation states Residents opinions are always paramount and I take every opportunity to ask what they want from the service and try to provide that for them. Residents spoken with spoke highly of the providers of the service. The AQAA documentation indicates that the registered provider/manager ensures that the home is risk assessed during normal daily routines and ensures risks are minimised. A formal recorded risk assessment is made annually on the whole building, ensuring the home complies with health and safety legislation and protects residents, staff and visitors. The registered providers lives at the home and is actively involved in providing care and has daily conversations with the residents, this forms the core of their quality assurance procedure, as any issues are acted upon promptly. The registered provider/manager stated that they had started work on this years current quality assurance programme. This service is consistently providing good outcomes enabling this to be viewed as an excellent service in line with Inspecting for Better Lives. Care Homes for Adults (18-65 years) Page 23 of 26 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 24 of 26 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 1 23 Registered provider/manager to access training in relation to the Mental Capacity Act and Deprivation of Liberty Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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