Care Home: 7 Eggars Close

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What the care home does well The home provides care in a well maintained pleasant and welcoming environment by a well-managed supported, motivated, trained and qualified staff team who work in a manner that recognises residents rights, aspirations and the need for personal privacy, dignity and independance. A number of outcome areas we assessed as excellent these included, individual needs and choices, lifestyles, concerns complaits and protection, the environment and the manner in which the home is managed.. What has improved since the last inspection? No areas of concern were noted following the last inspection since when the standards mentioned in the previous section of this report have been assessed as excellent apart from concerns complaints and protection (previously excellent) where previously they had received a rating of good. What the care home could do better: Whilst there were no areas of concern noted, menus should be displayed in a manner in which all residents can understand. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 7 Eggars Close 7 Eggars Close Alton Hampshire GU34 2UX     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Peter McNeillie     Date: 2 1 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: 7 Eggars Close 7 Eggars Close Alton Hampshire GU34 2UX 0142080730 0142080730 chris.braddy@mencap.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Olwyn Eileen Fielder Type of registration: Number of places registered: Royal Mencap Society care home 4 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 4. 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 Located in a residential estate a short distance from the shops in the North Hampshire town of Alton 7 Eggars Close is a small residential service providing care and support to four younger adults with a learning disability. The twenty four hour care and support to residents is provided by MENCAP and the building is owned by a housing association that is responsible for the maintenance of the property. 4 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 27 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 was written after taking into consideration a number of sources of information and evidence. These included, the previous report, a site visit to the service, information obtained from examining residents and staff records, personal observations, talks with staff and management, results from an in house quality survey, reports responses to a CSCI pre inspection satisfaction survey and responses by the manager to a CSCI Annual Quality Assurance Assessment (AQAA) prior to the inspection. This unannounced visit took place on 21/11/08 between the hours of 09.00 AM and 01.00PM during which all of the key standards for care homes for younger adults were assessed. The results and findings contained in this report will determine the frequency and type Care Homes for Adults (18-65 years) Page 5 of 27 of future inspections. At the time of our visit weekly charges were six hundresd and thirty eight pounds to one thousand and seven pounds per week. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 27 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 8 of 27 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. The home has a system of assessing and identifying residents diverse needs which ensures residents safety and that their assessed needs can be met. Evidence: Only one resident has been admitted to the home since the last inspection. This person had been a resident at the next door sister home. Consequently the home its staff and management had been involved with the new resident for some time prior to their admission and had contributed to previous assessments and care plan reviews. Residents, staff and the manager in the annual quality assurance assessment (AQAA) returned to CSCI told us as part of the pre inspection process confirmed that prior to a permanent place being offered a detailed assessment of needs and any attendant risks would be carried out in consultation with the resident or their representative. Four residents files were viewed, all included, an initial assessments covering a Care Homes for Adults (18-65 years) Page 9 of 27 Evidence: number of topics personal care support, daily living skills, looking after their physical and mental health as well as areas of risk. Records viewed also confirmed residents,residents representatives and if appropriate external health and social care professionals contributed to the assessments process to ensure the suitability of the placement. All assessments of need and risk are reviewed on a regular basis to ensure care plans are current and relevant. (The following section of this report refers.) On admission all residents receive a handbook which details their assessed support needs and contract arrangements with Mencap. Care Homes for Adults (18-65 years) Page 10 of 27 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. The home has a well-developed system of planning and reviewing care which reflects residents wishes, aspirations, diversity and ensures residents needs are met within a risk management policy and involves residents, residents representatives or relatives in decisions that affect them. Evidence: The care plans of three residents care plans chosen at random were viewed. All of the plans were very detailed and indicated that the residents were involved in there production. The plans contained assessments for all aspects of daily living activities such as bathing and stated what the resident could do for themselves, and what assistance was required by staff as well as any attendant risks present. Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: Areas that present an element of risk are clearly detailed with corresponding guidance for staff to follow to minimize the risk. Where there is recognized challenging behavior, care plans set out the intervention and approach that staff should take. The plans also seen showed evidence of regular review and were also updated as the needs of the residents changed. Case records demonstratetdthat residents rights are upheld and that residents are encouraged and were able to make decisions about how they spend their time and the activities they wish to pursue. Residents have their own meetings to discuss matters about the home and information is provided to each person in an understandable format. Each residents views about life at the home are obtained and recorded in a survey form, which is presented in a pictorial format so that it is easier to understand. To ensure equality and diversity are promote within the service the home manager told us in the AQAA that they did the following. Follow Mencap recruitment policy and operational procedures manual to promote equality and Diversity throughout the workplace. Service users religious and cultural needs are discussed and recorded during the initial assessment. If religious needs are identified these are written into the service users person plan. Mencap are an equal opportunities employer and have polices and procedures in place that encompass discrimination issues. Mencap learning programme covers diversity and equal opportunities. Mencap have an internal diversity course for managers which cover the requirements of the law and advisers skills and methods which we may mainstream equality and diversity into the recruitment process. Care Homes for Adults (18-65 years) Page 12 of 27 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. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service.The social activities family contacts and the provision of varied and nutritious meals were well managed and reflected residents interests and choices. Evidence: In consultation with residents staff have developed a individual programme of activities and opportunities for personal development including accessing the community based on the residents abilities,choices and aspirations. At present programmes includes unpaid voluntary work,attendance at a day centre(two residents),swimming,a drop in group,pubs,discos,library,take away meals,and karting and holidays of their choice supported by staff to which Mencap Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: contribute three hundred pounds per resident per annum. A written daily menu based on residents likes and dislikes was displayed. The homes staff and management recognised that alternatives to a written menu is of importance for some residents with a learning disability who may find the addition of pictures would be beneficial to their understanding and assist in them making meaningful choices. To assist residents we were informed a menu is being developed in an alternative format. Care Homes for Adults (18-65 years) Page 14 of 27 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. Satisfactory arrangements are in place, ensuring the personal emotional, health care and medication needs of residents are met. Evidence: From our observations and comments made by staff and residents we concludes that choice was being exercised by residents in all aspects of their lives, these would include providers of personal services, bedtimes, clothes, food, gender of carer, GP, dentist optician and key worker. Records seen indicated that any special medical or health or social care needs would be provided following consultation with the appropriate professional, these might include the local; learning disability team, sensory specialists, doctors, district nurses, physiotherapists, occupational therapists, speech and language therapists, and care managers. Records were kept of appointments with all health and social care professionals and included details of any advice and treatment given. All residents are registered with Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: one of three local medical practice where approximately fifteen plus doctors are available which allows a choice about the gender of the doctor consulted. A procedure that ensures residents who wish may assume responsibility for their own medication was in place, records viewed confirmed no resident was responsible for their own medication following a risk assessment. Medication records viewed confirmed that all prescribed drugs and medicines, which are securely stored and administered in accordance with a medication policy and procedure by trained staff. The record of drugs and medicines administered to residents and unwanted drugs disposed of were complete and accurate. Care Homes for Adults (18-65 years) Page 16 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has clear policies and procedures in place which ensures residents are able to complain and are protected from abuse. Evidence: The complaints procedure, which is produced in a written and pictorial format is also included in the service users guide and includes information on how to contact The Commission for Social Care Inspection (CSCI), was seen. We were informed there has been only one complaint since our last visit which was dealt with promptly. CSCI have received no complaints about the service. All members of staff spoken with of stated they felt happy in discussing any concerns, complaints with management (either in house or external) on behalf of any resident and were confident any issues raised would be dealt with promptly and fairly. The homes corporate adult protection policy is works in tandem with the procedure produced by Hampshire County Council, which is based on National Guidelines and the document No Secrets and is designed to safeguard residents from abuse. Management and staff stated and records confirmed all had all received training in recognising various types of abuse and the procedure to follow should they witness or be made aware any resident being abused. Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: Staff receive training in dealing with any challenging behaviour where there may be physical contact. This training is accredited by the British Institute of Learning Disability. Specific strategies for staff to follow for recognised behaviour are recorded in individual residents care plans. There are procedures for dealing with any residents monies held by the home for safekeeping, which include a system of recording and obtaining receipts. We checked the recods of residents monies held. In all case the records agreed with the money viewed the receipts. Care Homes for Adults (18-65 years) Page 18 of 27 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. A safe, well maintained, clean and suitably furnished home is provided for residents which meets their needs. Evidence: The home, which blends in with neighboring properties and has no stigmatizing signage, is situated in a pleasant residential area in Alton within walking distance of shops and other local amenities. The position of the home is of real benefit to the residents and ensures they have daily access to the outside community. Parking is available to the front of the property. All areas of the home were clean and free from unpleasant odors and obvious hazards, furniture was comfortable, homely and in a good state of repair and met the residents needs. All communal areas were accessible by the residents including established and safe garden. As part of the initial pre admission assessment, personal or communal aids to assist residents mobility would be provided. There is a rolling programme of maintenance to ensure that the building is well maintained, decorated and kept safe for the resident and staff. Care Homes for Adults (18-65 years) Page 19 of 27 Care Homes for Adults (18-65 years) Page 20 of 27 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 needs are met by sufficient numbers of well trained and supported staff who are recruited and selected using a procedure designed to protect all residents. Evidence: The planned daily staffing levels for the home each at least two members of staff on duty at all times during the daytime hours and one member of staff and one sleeping member at night plus a telephone on call back up in the event of emergencies. At the time of our visit, in our view the number of staff available was adequate to meet residents needs, a view supported by the manager and care staff. To ensure staff were recruited and selected in a manner that protects residents we viewed three staff recruitment and training files. All of the records viewed included evidence that all staff are recruited and selected in accordance with a corporate equal opportunities robust recruitment and selection procedure designed to protect residents. This involves the completion of an application form, the signing of a rehabilitation of Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: offenders declaration, an interview, and satisfactory Criminal Record Bureau (CRB), Protection of Vulnerable Adults (POVA) and reference checks. Following their appointment, records seen confirmed all staff are subject to an in house and corporate induction and training programme, which involves courses that include , first aid, moving and handling, POVA, food hygiene, fire safety (including evacuation), handling medication, equal opportunities and the protection of vulnerable adults. All staff are also expected to undertake a National Vocational Qualification (NVQ) training course. Currently 50 of staff have been trained to at least NVQ level two and one of this number to NVQ level three. Care Homes for Adults (18-65 years) Page 22 of 27 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 management of the home ensures the health, safety and welfare of residents and staff are promoted and the home is run in the best interests of the residents whose views about living in the home are formally sought through their representatives. Evidence: From our observations, records seen and staff comments we formed the view that the service is well managed by a manager who has had many years management and residential experience, is qualified to N.V.Q. level four and is very committed to delivering an excellent service which is resident focused that takes into consideration residents independance, rights, wishes, choices and aspirations. The highly motivated care staff who fully were aware of their responsibilities and the limits of their authority,informed us that they had regular staff meetings and supervision, felt well supported by the manager who they described as available and approachable and open to ideas that might improve the service. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: As part of the homes quality monitoring system residents and residents representatives are invited to participate in satisfaction surveys. Surveys provided to residents are available in both a written and pictorial format to ensure understanding. The views expressed in responses are seen as key in highlighting areas that may require change or improvement. Currently surveys are not sent to staff,advocates or visiting health and social care professionals.We discussed this with the registered manager who gave a verbal undertaking to raise this deficiency with her external managers. We were informed that a staff forum exists where staff can express their views but this was not specific to this service. Evidence was seen that the manger strictly monitors compliance with the corporate policies and procedures in place that cover all aspects of the home operation including health and safety where corporate health and safety policy is in place to ensure the day-to-day safety of staff and residents. Procedures include, weekly health and safety checks, the regular servicing of equipment, staff training in the techniques of moving and handling infection control, control of substances hazardous to health (C.O.S.H.H.) first aid, health and safety, reporting accidents and procedures to follow in the event of fire (including evacuation). As part of the health and safety arrangements and to protect residents we were informed that all of the hot water supplies to baths were fitted with thermostatic controls are set at 43 degrees centigrade and all radiators and hot pipes covered. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 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 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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