Care Home: 54 Leylands Road

What the care home does well Individual needs and choices are considered for all people living in the home. People who use this service experience a meaningful life and are encouraged to achieve goals. Independence is encouraged. People who use the service receive personal and health care support in a person centered way and all needs are clearly recorded in a care and support plan. Complaints are listened to and people are protected from abuse. People live in safe and comfortable surroundings. There are robust recruitment procedures in place and needs are met by a well trained and motivated staff. Staff spoke clearly about the homes ethos of recovery and independence. The home is well managed and run in the best interests of the people who live there, whose opinions are sought and acted on. What has improved since the last inspection? There is a comprehensive pre admission assessment. Systems have been put in place to improve communication with service users. Key workers have one to one meetings with the people they are allocated to work with on a regular basis. An Equality and Diversity Toolkit has been been developed for use in staff meetings. There is an Equality and Diversity Policy/Strategy and an Anti Discriminatory Practice Policy in place. Bi-yearly satisfaction surveys for people who use the service have been introduced. What the care home could do better: The home is functioning well in all areas. Key inspection report Care homes for adults (18-65 years) Name: Address: 54 Leylands Road 54 Leylands Road Burgess Hill West Sussex RH15 8AL     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: Sheila Gawley     Date: 1 4 0 5 2 0 0 9 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 25 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) 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 Care Homes for Adults (18-65 years) Page 3 of 25 Information about the care home Name of care home: Address: 54 Leylands Road 54 Leylands Road Burgess Hill West Sussex RH15 8AL 01444870546 01444254740 leylands54@sussexoakleaf.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Sussex Oakleaf Housing Association Ltd care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 6 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: Mental Disorder, excluding learning disability or dementia (MD) Date of last inspection Brief description of the care home 54 Leylands Road (previously registered as Peppers) is a care home registered for up to six service users in the category of mental disorder (excluding learning disability or dementia), one of who can be in the category of mental disorder over 65 years of age (excluding learning disability or dementia). The registered provider is Sussex Oakleaf Housing Association Limited, for whom the Responsible Individual is Tracey FaradayDrake. The registered manager is Mr Prabhooraj Unmar. The current scale of monthly charges range are approximately £1063 to £1093. Additional charges are made for personal items. 54 Leylands Road is a detached property, with accommodation Care Homes for Adults (18-65 years) Page 4 of 25 Over 65 0 6 Brief description of the care home provided over two floors. In addition there are gardens that can be easily accessed by the residents. The home is located in a residential area of Burgess Hill, with easy access to nearby bus and train services. The Service Users Guide and Statement of Purpose can be located at the home, and are accessible to Service Users, staff, relatives and anyone else interested in the service. Care Homes for Adults (18-65 years) Page 5 of 25 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 site visit as part of the inspection process was carried out on 14/05/09. It was undertaken by a lead inspector from the Commission for Social Care inspection. Prior to the visit all files held by the commission, complaints and safeguarding issues were reviewed. The home had sent us their Annual Quality Assurance Assessment for the inspection, which gave us the information we needed on the home and any documents required on the day were made available. People who use the service spoken to stated that they are happy in the home and that they enjoy the food which they mostly shop for and cook themselves. All appeared happy were well dressed and the atmosphere in the home was relaxed. There is a varied lifestyle in the home based on individuals choices and needs. Trips Care Homes for Adults (18-65 years) Page 6 of 25 and holidays are planned according to peoples choices. Staff spoken to on the day stated that they were happy working in the home and that the management was supportive and staff training is in place. Care Homes for Adults (18-65 years) Page 7 of 25 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 order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 25 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 25 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 wishing to use the service are confident that their needs will be met in the home. Evidence: There is a comprehansive assessment process in place. People are first visited and assessed to ensure the home can meet their needs. Information is sought from health professionals and social workers. People are then invited to visit for a meal, an overnight stay and a weekend to determine the suitability of the home for them and the other people who live there. People are admitted on a trial basis. Evidence of this process was seen in care plans. Care Homes for Adults (18-65 years) Page 10 of 25 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. Individual needs and choices are considered for all people living in the home. Evidence: The routines of daily living are discussed with residents on admission and individual preferences catered for where possible. The home encourages the individual to pursue activities of their choice. People are encouraged to be independent and most shop and cook for themselves. Risk assessment is in place for this. Hot and cold drinks drinks are available throughout the day. Care and support plans are holistic and are developed with the input of the person who uses the service, People who use the service have monthly one to one meetings with their key worker. All people who use the service are given the opportunity to access the community. They are within walking distance from the local shops. People who use the service have choice and control over their daily lives. Family involvement is encouraged. People can bring their own personal possessions into the Care Homes for Adults (18-65 years) Page 11 of 25 Evidence: home. People are risk assessed and allowed freedom to make decisions. People can manage their own money if assessed as being able to do this, the home holds allowances for people securely. Care Homes for Adults (18-65 years) Page 12 of 25 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 who use this service experience a meaningful life and are encouraged to achieve goals. Evidence: People who use the service can be involved in a range of activities. each person has a weekly programmer of care and outings in their care plan. People have trips to local areas of attraction and have overnight stays in hotels. There have been trips to London and to France. The home has some holiday funds and the people who use the service contribute to Holidays. People who use the service are enabled to go to the local shops to do their own shopping. There are details of upcoming activities on the notice board. There has been a recent photographic competition and the homes garden won a recent best garden competition and was featured in the local newspaper. The garden is tended to by one Care Homes for Adults (18-65 years) Page 13 of 25 Evidence: of the people who uses the service with the aid of a volunteer. Staff knock on bedroom doors and request permission to enter. Advocacy services are made available and details are on the notice board. People buy food of their choice and each person has fridge and freezer space of their own. Two people who use the service who cannot do this on their own are supported to do this and there is a menu in place. People can eat a time they choose. A roast is cooked on Sunday for all to eat together. People who use the service are encouraged to clean their own rooms and to do their own laundry. People spoken to all stated that they were happy with the lifestyle in the home. Care Homes for Adults (18-65 years) Page 14 of 25 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. People who use the service receive personal and healthcare support in a person centered way and all needs are clearly recorded in a care and support plan. Evidence: The AQAA stated that plans are flexible and been agreed with individuals and are based on their needs. There are comprehensive guidelines, policies and procedures in place to support our service users. All residents have a plan of care which is drawn up following full assessment. Two people who use the service were case tracked. Their care plans were inspected and these contained information on health, mental health, personal, and social need. Needs are individually identified, aims and objectives are set and actions are implemented. Changing need is recorded. Each plan had a personal profile in place. There was evidence review and social services review, and daily records. External healthcare professionals are involved in the development of the support packagefor people who use the service. Risk assessments are in place in relation to burns, scalds, walking to shops, aggressive outbursts, nutrition, Care Homes for Adults (18-65 years) Page 15 of 25 Evidence: medication,moving and handling and epilepsy. Weight is recorded monthly and action is taken as indicated. Triggers that may escalate challenging behavior are identified as are actions to be taken. People access health services in the town, one person was out for an eye appointment on the morning of the visit. People visit the chiropodist in town but one person prefers to have the chiropodist visit the home and a chiropodist visits six weekly. All health professional visits such as those from the general practitioner (GP) or community Psychiatric Nurse (CPN) are recorded. There is psychiatric review of all people in the home. Care is carried out in a person centered way and staff are asked to sign that they they have read the care plan and therefore are aware of the persons needs and preferences. Medicines are received, administered, and returned correctly. There is a weekly medicines audit. Each person has a drug profile and a medication care plan. All medicines are checked by two staff. Medicine administration charts (MAR) inspected were up to date. The decision on who administer the medicine and whether a person can self medicate is made in consultation with the psychiatrist. There are not any people self medicating at present. There are policies and procedures in place for the management of medicines. There is a controlled drug cupboard but the home does not have any controlled drugs at this time. Care Homes for Adults (18-65 years) Page 16 of 25 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. Complaints are listened to and people are protected from abuse. Evidence: There is a complaints procedure in place and it is included in the Statement of Purpose. Complaints are recorded and acted on. People who use the service spoken to stated they would be able to tell their key worker or the registered manager if they had a problem and that it would be fixed. The opinions of people who use the service are actively sought. Staff have attended safeguarding adults training and staff spoken to demonstrated an awareness of procedures and were observed treating people with respect. Advocacy services are on display and are particularly sought to help people with their benefit payments. Monies for people who use the service are held separately, securely and are receipted and recorded. Care Homes for Adults (18-65 years) Page 17 of 25 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. People live in safe and comfortable surroundings. Evidence: The home was neat, clean and free from offensive odours. There is a comfortable sitting room and conservatory, domestic in decor and furnishings. The home is in keeping with the local community and has pleasant well maintained gardens. People who use the service are free to come and go as they wish within a risk assessed framework and are offered a key to their room if they wish. The laundry is sited away from areas of food preparation and has facilities suitable to this client group. There is not a lift therefore a person assessed as not being able to manage the stairs would not be admitted to the home. Radiators are not covered and the manager stated that this does not pose a risk to this client group. He will include this in the risk assessments. The statement of purpose is clear on the facilities and client group the home aims to help. There is also not a call bell system and the manager stated that for the size and category of the people who use the service this is not a risk. Care Homes for Adults (18-65 years) Page 18 of 25 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. There are robust recruitment procedures in place and needs are met by a well trained and motivated staff. Evidence: People who use the service all expressed satisfaction with the staff team and commented They Look after us really well, Staff all friendly and helpful, I am happy here, If I had a problem I would speak to my key worker Staff rota show sufficient staff on duty at all times to offer the support needed. Staff turnover is low. There were records of staff meetings, supervision, training and annual appraisal available for inspection. There is a training programme in place which was seen and which staff spoken to confirmed. Three staff have attained National Vocational Qualification (NVQ) level 3, one has NVQ level 2 and one has completed NVQ Level 4. Induction is in place. Two staff files were inspected and they contained all the documentation required and showed that criminal records Bureau clearance and a check against the POVA list were made prior to employment. Staff are given Job Descriptions and information about their own and others roles and responsibilities. All staff are given a Staff Handbook Care Homes for Adults (18-65 years) Page 19 of 25 Evidence: and a copy of GSCC Code of Practice.Staff training and access to information. Recruitment policies and procedures are in place to support this process. Two staff were spoken to they have worked here for a number of years, both confirmed that there was good training and support. They spoke confidently of the care and support offered to individuals and the ethos of the home which promotes recovery and independence. Staff were observed interacting with people in a respectful and meaningful manner. All people were asked for permission before rooms were entered. Care Homes for Adults (18-65 years) Page 20 of 25 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 is well managed and and the management and staff listen to the people who use the service and involve them is all aspects of the home. Evidence: The registered manager is a registered nurse in mental health, he has experience of working with people with mental health needs and has been at the home 8 years. He has a management qualification as well as the registered managers award. The AQAA stated that the manager manages within a restricted budget. He is responsible for this budget and he devolves several areas of this to staff to give them added responsibility, job development and job satisfaction. Written evidence of this was seen. He gave a knowledgable account of the organisation and its future plans, including the pilot recovery schemes the organisation is running and the training staff need to achieve this. The home is well run and the people who use the service and staff benefit from the management approach and leadership skills, staff and residents said they felt well supported. Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: People who use the service attend regular meetings and minutes are recorded and kept. They are supported to prepare and to attend their support plan meeting and they are kept informed of developments and changes happening in the organisation. The AQAA states that a bi-yearly satisfaction survey is carried out at local level and a yearly one organisation wide. The outcome of these surveys are taken into consideration to improve the service. The results of these surveys were not seen on the day. People who use the service have the opportunity to express their views to a Senior Manager during Regulation 26 visit. The home promotes access to advocacy ervices particularly in relation to helping people to claim their benefits, details of these services were seen on the notice board. People who use the service have one to one meetings with their respective key-worker and other staff. Staff spoken to confirmed these meetings. Family Group meetings take place with people who use the service. Policies are discussed at meetings for people who use the service and comments and contributions are fed back to the Senior Management Team. Minutes of these meetings were available for inspection. People who use the service are encouraged to be independent, they mostly shop and cook for themselves, this was observed on the day. Those spoken to confirmed that their wishes are listened to. Support plans show that individual needs and choices are assessed and met. Care plans are in place for managing medication needs and managing money. Money for people who use the service is well managed, held securely and correctly receipted. Policies and procedures are in place to ensure the health and safety of people who use the service are met as is a comprehensive staff training programme. The registered manager ensures that staff are aware of the policies and procedures and has a system where they sign that they have read them. Contracts are in place for utilities maintenance. Care Homes for Adults (18-65 years) Page 22 of 25 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 23 of 25 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 24 of 25 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). 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