Care Home: 55 Berryscroft Road

What the care home does well The home operates a structured admission procedure when a vacancy becomes available. Needs assessments are undertaken and form the basis of well maintained care plans, that are person centred and regularly reviewed. Good arrangements are in place to meet the health care needs of the residents. The medication policy in place is safe and ensures that the residents receive their medication as prescribed. The residents benefit from excellent leisure activity arrangements. Individual activities reflect choice, hobbies, and interests. Staff support residents to follow a healthy eating plan and the manager stated that there is access to dietician support if required. Mealtimes are sociable and encourage all residents to be involved. The staff team have the qualifications and the skills necessary to meet the assessed needs of the current residents living in the home. l The home is very well managed by the registered manager who is also the provider. He has a sound understanding of the needs of the people he cares for. Quality assurance monitoring systems ensures that the home reflects on the care being provided and makes improvements accordingly. The health, safety, and welfare of the residents and staff are promoted and protected. What has improved since the last inspection? The requirements and recommendations from the last inspection have been met. The paving in the rear garden has been repaired and the front and rear garden are now maintained on a regular basis. The staff recruitment policy in place has been reviewed and protects the residents living in the home. A smoking policy has been introduced and during a discussion with a resident it was obvious that this has been discussed in the home. The shared room has been refurbished and redecorated. What the care home could do better: The home continues to provide a good service for the people living there and all resident stated that they enjoy living in the home. They all felt well supported by the staff team. There are no requirements or recommendations as an outcome of this inspection. Key inspection report Care homes for adults (18-65 years) Name: Address: 55 Berryscroft Road Laleham Staines Middlessex TW18 1ND     The quality rating for this care home is:   two star good 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: Mary Williamson     Date: 2 0 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 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) 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 26 Information about the care home Name of care home: Address: 55 Berryscroft Road Laleham Staines Middlessex TW18 1ND 01784459404 01784459404 brandhomesltd@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Brand Homes Ltd care home 6 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 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: Learning disability (LD). Date of last inspection Brief description of the care home 55 Berryscroft Road is small care home for six people with learning difficulties who are younger adults. Mr J Brand is the Proprietor and Manager and operates the care home with an emphasis on a domestic and homelike atmosphere. The house is set in a residential street in Laleham close to public amenities. The house offers four single bedrooms and one twin bedroom and shared communal and laundry facilities. There is a medium sized rear garden with a seating area and barbeque. The house has a friendly atmosphere and all residents participate fully in the running of their home. The current range of fees are £445 to £890 per week. 6 Over 65 0 Care Homes for Adults (18-65 years) Page 4 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: two star good 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 a TWO STAR rating. This means that people who use the service experience GOOD quality outcomes. This was a key inspection. The inspector Mary Williamson arrived unannounced at 10.30 am on 19th May. All the residents were attending day care and the house was empty so the inspection was re-arranged for the following day 20th May at 15.00 hrs. It took place over four and a half hours and was completed by 19. 30hrs. The people who live at 55 Berryscroft Road prefer to be called residents which is the term used throughout the report. A tour of the premises was undertaken and records relating to the care of the residents and the management of the home were examined. Some examples include care plans, risk assessments, medication records, menus, staff employment files, staff training profiles, and health ans safety procedures. Care Homes for Adults (18-65 years) Page 5 of 26 It was possible to meet and talk with all the residents in the home. They had returned from day care and were busy preparing their lunch boxes for the next day and their evening meal. Some residents invited the inspector to view their rooms and undertake conversation in private. It was also possible to meet the staff on duty and gain some feedback about their experiences of working in the home. 55 Berryscroft Road is a sister home to 29 berryscrotf Road and essentially mirror images of one another. Both homes share staff, have the same policies and procedures, and both services were inspected on the same day. An Annual Quality Assurance Assessment (AQAA) was completed by the manager and sent to the Care Quality Commission prior to the inspection. This provided us with detailed information regarding the home and some numerical information we also require. The CQC would like to thank the manager, residents and staff for their assistance, and hospitality during this inspection process. Care Homes for Adults (18-65 years) Page 6 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. Care Homes for Adults (18-65 years) Page 7 of 26 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 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 9 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents have the information they need to help them make a decision about where they live. All residents have a needs assessment undertaken prior to admission to establish if the home is suitable to meet their individual needs. Contracts of occupancy are in place for all the people living in the home. Evidence: The home has a statement of purpose and service user guide in place. This is available to all residents and their relatives to help them in their choice of home. A copy is included in residents files in a format they can understand. All residents have a needs assessment undertaken prior to being admitted to the home. The current group of residents have been living in the home for many years, and the home is more than capable of meeting their needs. There have been no new admissions to the home since the last inspection. The manager stated that in the event of a new resident being admitted a full needs assessment would be undertaken, several visits offered, and a trail period agreed to establish the suitability of the placement and the reaction of the people living in the home. Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: Individual contracts of occupancy are in place. These outline the accommodation offered, the care provided, the fees payable and the method and frequency of payment. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Well maintained care plans are in place and maintained to a good standard. They are person centred and reflect residents needs and goals. Residents are supported to make choices enabling them to be as independent as possible. Good risk assessments promote independence at home and within the community. Evidence: Individual care plans are in place for all the residents. These are person centred and include all aspects of daily living. Care plans are written on information gathered form the pre admission needs assessment, full participation from residents, information obtained from relatives and advocates, and any contribution from the multidisciplinary team. The care plans sampled are well maintained, contain daily records, reviewed regularly and updated accordingly. Residents are encouraged and supported to make decisions regarding all aspects of their daily lives. A resident stated I can have a lie in at the weekends when I do not Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: have to get up for day care. Residents have a choice of the food they eat, the clothing they wear, if they wish to bath or shower, the gender of staff undertaking personal care, how they spend their leisure time, and where they go on holiday. One resident stated that he can go to vote locally, and another resident chooses to smoke in the back garden. Risk assessments are in place for all identified risks both within the home and for community participation. These form part of the care plan. Risk assessments are written to promote independence, and do no restrict residents in anything they do. These are reviewed and updated accordingly. 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. Residents are able to take part in appropriate activities that meet their individual and collective needs. Family and community links are maintained, and the diverse needs of the residents are supported. Dietary needs are being met and residents choose a menu that is nutritious, and flexible to meet their individual lifestyles. Evidence: Individual activity programmes are in place which form part of the care plan. All the residents attend formal day care settings during the week. Residents stated that they enjoyed this arrangement and that they looked forward to seeing their friends. Activities are based on interests and hobbies and include going to the cinema, bowling, swimming, horse riding, trips to the coast, going to the pub, shopping, and picnics. Residents spoke of the holidays they had enjoyed at Butlins, Wales, and Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: Bognor Regis, and were looking forward to planning another one this year. They also spoke of holidays that were arranged by various clubs they attend. Family links are maintained and residents are supported to visit their family and friends. Visitors are always welcome in the home at any reasonable time. Relatives are invited to reviews of care when appropriate and are also consulted for their views as part of the quality assurance process. A relative stated that our daughter receives the best of care and are very happy with the home Menus are planned by residents usually at residents meetings. Staff support residents in choosing fresh produce and food that is in season. The choice of food offered is nutritious, wholesome and appetising. A resident was observed cooking the evening meal of stir fry prawns. This was enjoyed by the group who sat together in the dining room in a relaxed and unhurried atmosphere. All residents had positive comments regarding the catering arrangements. They also prepare their own packed lunches to take with them to day care. There is opportunity for individuals to make themselves drinks and snacks when they want to. Special diets are catered for and there is also access to a dietician if necessary. A resident spoke of the support she receives to follow a weight watchers diet. All staff working in the home have a current food hygiene certificate. 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. Residents receive personal care as agreed in a way they prefer. Appropriate arrangements are in place to meet the health care needs of the residents. The medication policy in place protects the residents living in the home. Evidence: Staff provide flexible personal support for residents as agreed and outlined in individual care plans. Privacy and dignity is observed and residents are treated with respect at all times. All the residents looked well cared for. Some had been to a club the previous evening and were keen to show off their various painted finger nail patterns. All the residents are registered with local GPs and are well supported by them. A resident stated that it was possible to attend the doctors surgery when required. Another stated that she visits the dentist for regular check ups. Chiropody treatment is available at the health centre. Residents that require psychology or psychiatric support can attend the rescorce centre by appointment. The home has a medication policy in place and all staff that administer medication Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: undertake training in medication safety awareness. Boots the Chemist provide the medication for the home in blister pack format. They will also undertake occasional audits of medication. Medication is stored safely. Currently there are no residents in the home that self medicate. The manager stated that a risk assessment would be introduced for this if required. 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. The complaints procedure and the safeguarding adult procedures in place protect the residents living in the home. Evidence: The home has a complaints procedure in place. This forms part of the service user guide and is available to all residents and their relatives on admission to the home. A resident stated I have been here for a long long time and if I am not happy about something I tell the manager, a relative survey stated that there is no cause to complain. There have been no complaints since the last inspection. The home also has a copy of Surreys Multi Agencies Policies and Procedures on Safeguarding Vulnerable Adults in place. The manager has attended training in these procedures and has cascaded this to the staff team. Staff confirmed that they were aware of the safeguarding procedure and would not hesitate to report an incident of suspected abuse if necessary. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is suitable for its stated purpose. Residents live in a safe, clean and comfortable environment. Communal facilities are good providing residents with ample space to meet their assessed needs. Bedrooms are personalised and suit individual needs and choice. Evidence: A tour of the premises was undertaken. The home is well maintained, and decorated to a good standard, providing residents with a comfortable and safe environment to live. Some residents invited the inspector to view their bedrooms. These are tastefully decorated and have been personalised to reflect individual personalities and choice. Communal facilities include a comfortable lounge equipped with items appropriate to the age of the residents. A dining room which overlooks the rear garden and a kitchen that is domestic in nature. The laundry facilities are located in the utility room and are appropriate for the needs of the home. Infection control policies and procedures are adhered to. Care Homes for Adults (18-65 years) Page 19 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. Residents are supported by a competent and skilled staff team in sufficient numbers to meet their assessed needs. The staff recruitment procedure protects the residnets living in the home, who also benefit from a well supervised staff team. Evidence: Staff are employed in sufficient numbers with the skills necessary to meet the assessed needs of the current residents. There are two staff on duty when residents are in the home and this can be increased to accommodate appointments, or other events. There is also a member of staff that sleeps in. The staff team are well established and some of the have been working in the home for several years. Two staff confirmed some of the training they had undertaken. All staff undertake induction training. NVQ is currently in progress with two staff undertaking NVQ level 2. Other staff have achieved this. Some training is done in house and some undertaken externally. Staff recruitment procedures are in place. These have been reviewed since the last inspection. Two staff employment files were seen. These are well maintained and include a Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: completed application form, two written references, an employment history and a current CRB (Criminal Records Bureau) disclosure. Formal staff supervision takes place at least six times a year and recorded on file. Annual staff appraisal is also in place 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 good 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 by an experienced manager/ provider in the best interest of the residents. The health, safety, and welfare of the residents and staff are observed to protect the people living there and promote safe working practice. Evidence: The home is well managed by the registered manager who is also the provider. He has owned the home for over twenty years and has considerable experience in the provision of care for the residents living there. One resident stated that he has been living in the home from the beginning and that he considers the manager his friend. The manager has an NVQ level 4 and his RMA (Registered managers Award). There is also a deputy manager in post and a well established team of staff to manager the home in the managers absence. Residents were happy interacting with staff and all felt well supported by the management arrangements in place. Systems are in place to monitor quality assurance. Residents meetings take twice monthly, when views can be aired, home events planned, and any issues concerning Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: life in the home discussed. Regular audits of care plans, medication administration, and health and safety all form part of quality assurance monitoring. Questionnaires are distributed to relatives and other stakeholders for feedback which is acted upon when necessary. A relative stated We are very satisfied with the home and our daughter is very happy here. Health and safety is observed. All staff undertake health and safety training as part of their induction training. Discussion with staff confirmed the training they had undertaken. COSHH procedures are also observed. The AQAA indicated that all the required safety certificates are in place and updated when required. Fire safety is observed and all staff undertake fire safety awareness training. A risk assessment has been undertaking for residents that smoke. All staff receive formal staff supervision at least six times a year which is recoded on individual staff files. Accidents and incidents are reported appropriately and acted upon. 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 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). 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