Care Home: 7 Newgate Lane

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What the care home does well People are supported to plan a healthy menu that takes into account their likes and dislikes.People receive personal care in the way they prefer.The home is well maintained. People`s bedrooms and the areas they share are comfortable and safe.Staff working in the home have been thoroughly checked. This helps to keep people safe. What has improved since the last inspection? Care plans and risk assessments have been reviewed and updated. This means staff now have good information about how to meet people`s needs.People are supported to take part in a range of social activities they enjoy.People are supported to take their medicine safely.Staff now have a good understanding of what to do if there is an allegation of abuse.Staff meet regularly with their manager. This helps to ensure they have the support they need to do a good job. What the care home could do better: We have not made any requirements. The manager needs to make sure the improvements that have been made are continued. Key inspection report Care homes for adults (18-65 years) Name: Address: 7 Newgate Lane 7 Newgate Lane Fareham Hampshire PO14 1BQ two star good service The quality rating for this care home is: 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: Craig Willis Date: 0 2 0 3 2 0 1 0 This report is a review of the 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 stars – excellent  2 stars – good  1 star – adequate  0 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. They reflect the things that people have said are important to them: 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 mission of the Care Quality Commission is to make care better for people by:  Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice  Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983   Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Information about the care home Name of care home: Address: 7 Newgate Lane 7 Newgate Lane Fareham Hampshire PO14 1BQ 01329667041 01329667041 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): www.c-i-c.co.uk Community Integrated Care Name of registered manager (if applicable) Mrs Julia Deborah Grey Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 4 4 0 0 care home 4 learning disability physical disability Additional conditions: The maximum number of service users who can 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 1 9 1 0 2 0 0 9 A bit about the care home 7 Newgate Lane is a care home that offers care for up to four people who have a learning disability and sensory disability. The property is owned by Knightstone Housing Association and is managed by Community Integrated Care. The home is situated in a residential area near to the town of Fareham and the village of Stubbington. The home has easy access to local recreational and health care facilities. 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 How we did our inspection: This is what the inspector did when they were at the care home We visited the home on 2 March 2010. We spoke with staff that were working during the visit and observed the way staff listened to people who live there. While we were in the home we looked at some of the records that staff keep. We also completed a random inspection on 19 October 2009. This was to check whether the home had done the things we said were necessary after out last key inspection. What the care home does well People are supported to plan a healthy menu that takes into account their likes and dislikes. People receive personal care in the way they prefer. The home is well maintained. Peoples bedrooms and the areas they share are comfortable and safe. Staff working in the home have been thoroughly checked. This helps to keep people safe. What has got better from the last inspection Care plans and risk assessments have been reviewed and updated. This means staff now have good information about how to meet peoples needs. People are supported to take part in a range of social activities they enjoy. People are supported to take their medicine safely. Staff now have a good understanding of what to do if there is an allegation of abuse. Staff meet regularly with their manager. This helps to ensure they have the support they need to do a good job. What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Craig Willis CQC South East Citygate Gallowgate Newcastle Upon Tyne NE1 4PA 03000 61 61 61 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 http:/www.cqc.org.uk/. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535. 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 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. There are good systems to assess peoples needs before they move into the home. This helps to reassure people that the home will be able to meet their needs. Evidence: No one has moved into the home for several years and the manager reported that she did not expect there to be a vacancy in the immediate future. Community Integrated Care has procedures in place for the referral and admission of new people into the home, although these were not inspected during the visit. 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. The home has good systems to develop and review care plans and risk assessments. This means that there is accurate, up to date information about peoples needs available so staff can provide support in the way people need and choose. Evidence: Following the last key inspection of the home in September 2009 we made requirements about the need for care plans and risk assessments to be kept up to date. At this visit we looked at the care plans and risk assessments of two people who live in the home. Both people had a set of care plans and risk assessments that had been rewritten since the last key inspection. The care plans we looked at set out what peoples identified needs are and how staff should provide support to meet these needs. The plans contained detailed information about the way people communicate their needs and choices. The plans also set out how peoples conditions affected them, for example the support people need because of a visual impairment. The care plans and risk assessments had been completed in November 2009 and were scheduled for a review in May 2010. The details in the plans are reviewed with the person each month by their key worker. Staff spoken with demonstrated a good understanding of peoples needs and the support they need. Staff reported that since the review of the plans it was easier to find information when they needed to. One new member of staff spoken with reported that the plans had been a useful part of their induction. During the visit we observed staff following the plans in relation to communication and supporting people to make decisions. Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to take part in social activities they enjoy and plan what is on the menu. This helps people to live the lifestyle they choose. Evidence: People have an individual activity plan that they are supported to take part in as well as attending various sessions at a local day service. Activities recorded for people included going out for a walk on local beaches, having lunch out in local cafes, shopping and visiting relatives. People are supported to use local community facilities, such as the library, shops and barbers. Staff spoken with during the visit reported that the recent recruitment to staff vacancies meant it was now easier to support people to take part in the activities they have planned. The home has a menu that is planned each week. The menu is planned with input from people who live in the home, either directly or by taking their likes and dislikes into account. The menu and mealtimes are flexible to fit round activities and tastes. A record is kept of meals that people eat. During the visit one person who lives at the home was being supported to understand what was for lunch and when it would be ready. 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. There are now good systems to safely manage medication. This helps to ensure people receive the medication they have been prescribed. People are supported to attend the health services they need. Evidence: Following the last key inspection we assessed that a previous requirement about ensuring people receive the medication they have been prescribed had not been complied with. Because the service had not complied with the requirement we served a statutory requirement notice. We completed a random inspection of the home on 19/10/09 and found that the home had complied with the statutory requirement notice and were following safe medication practices. During this visit we inspected the medication systems and records and found that the action to address the concerns had been sustained. We looked at the medication administration records for all four people who live in the home and found that they had been fully completed. They gave a record of all medication that people had been supported to take and details of why any medication was missed, for example if people refused it. Medication was safely stored in a locked cabinet and controlled drugs were stored in a suitable controlled drug cabinet. Since the concerns about the medication practices at the home the service has introduced a system of daily checks of medication. The medication records matched the medication held in the cabinets. Records were available of medication returned to the pharmacist for safe disposal and all medications were within their expiry date. Staff have received training in the administration of medication. Peoples care plans contained details of the personal care support they need and how it should be provided. Staff spoken with during the visit demonstrated a good understanding of peoples needs and how they should be met. Peoples personal records contained details of regular health appointments, including GP, community nurse, optician, dentist and chiropodist. Evidence: Since the last inspection each person has been supported to complete a health assessment. This helps to identify whether there are any services that people need that they are not currently receiving. One person has a catheter fitted and receives care from the community nurse team. There were details in the persons care plan about signs of a problem and contact details of the nurse team. Staff spoken with demonstrated a good understanding of this persons needs. 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 home has good systems to investigate complaints and respond to any allegations of abuse. This helps to ensure that people are confident any concerns will be effectively resolved. Evidence: Following the last key inspection we made a requirement that everyone working at the home must have a clear understanding of the procedures for keeping people safe from abuse. During this visit we found that the home had obtained copies of Community Integrated Cares safeguarding policy and a copy of the Hampshire County Council safeguarding procedures. Staff have completed training in abuse issues and the safeguarding procedures. During the visit we spoke with two staff members. Both staff were aware of different types of abuse and the action they must take if abuse is witnessed, reported or suspected. The home has not received any complaints since the last inspection. The complaints procedure is provided to people in audio and picture format to help their understanding of it. 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 well maintained and provides a clean, comfortable and safe environment for people. Evidence: We looked at all of the shared areas and one bedroom during the visit. On the day of the visit the lounge was being re-decorated and there are plans for all other communal areas to be re-decorated as well. All of the external walls of the home have been painted since the last visit. The decorations were being carried out in a way that minimised disruption to people living in the home. Each person has their own bedroom and shares the use of the lounge, dining room, kitchen, bathroom and garden. There is a separate laundry room with machines capable of washing soiled clothing. All areas seen were clean and well maintained. One person who lives in the home showed us their bedroom, which had been personalised with furniture, pictures and personal items. 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. Staff are thoroughly checked before working in the home, receive good training and are well supervised by the manager. This helps to ensure that the staffing arrangements are suitable to meet peoples needs. Evidence: The manager reported that 4 of the 8 current support workers have completed the National Vocational Qualification (NVQ) in care at level 2 or 3. New staff will be enrolled on the NVQ course after they have been working at the home for six months and have completed the initial induction and training. The home has a staffing rota and generally operates with 3 staff in the morning, 2 in the afternoon / evening and 1 asleep overnight. Staff spoken with said they thought the recent recruitment of new staff had helped to ensure staffing levels were sufficient to meet peoples needs. We looked at the records of 3 members of staff who have started working at the home since the last key inspection. All three had evidence that a Criminal Records Bureau disclosure and two written references were obtained before they started work. People had supplied identification documents which were also kept on file. The home has a training programme and staff records indicated people had completed courses in non-violent crisis intervention, food hygiene, first aid, fire safety, moving and handling, medication, protecting people from abuse, infection control, nutrition and menu planning, person centred planning, risk assessment and care planning. Staff spoken with said they found the training useful and relevant to their role. Following the last key inspection we made a requirement that staff must receive regular supervision. Records seen in staff files demonstrated that they had a one to one meeting with the manager each month to discuss their performance. Staff spoken with confirmed that they met with their manager for supervision and support. 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 and there are now good systems to assess the quality of the service provided and plan improvements. Evidence: Since the last inspection a new manager has been appointed to the home and has been successful in her application for registration with the Care Quality Commission. Staff spoken with said they felt well supported by the manager and reported that the home had improved significantly over the last six months. Following the last key inspection Community Integrated Care developed an action plan to deal with the identified shortfalls and ensure that the improvements were maintained. A senior manager visits the home each month to assess the quality of the service provided. Reports of these visits are sent to the manager and contain a list of actions that are required. Progress with the actions is reviewed at the following visit. The manager completes a monthly audit of records in the home and submits this to head office. The home has a development plan to ensure improvements are maintained and built upon. The home has workplace risk assessments in place. These identify hazards faced by people living in the home and staff and actions that are required to manage the hazards. We inspected a sample of the servicing and maintenance records. These demonstrated that equipment in the home is being regularly serviced and maintained to ensure it is safe. Are there any outstanding requirements from the last inspection? Yes  No  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 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 Description 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 Description 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 Helpline: Telephone: 03000 616161 or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. 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