Care Home: 82 Normandy Street

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What the care home does well Residents are supported to enjoy an independant lifestyles, undertake activities of their choice, treated with dignity and respect, encouraged able to participate in a employment opportunities and that the social activities, family contacts are well managed and reflected residents choices. The home provides a good reliable service to residents by a well managed, stable, well trained, supported, committed and qualified staff team who are recruited in a manner that protects residents. What has improved since the last inspection? All previous requirements relating to the environment have been complied with. What the care home could do better: No requirements have been made as a result of this visit. However, repairs to the property should be carried out quicker to preserve and maintain an environment that meets the current regulations. Key inspection report Care homes for adults (18-65 years) Name: Address: 82 Normandy Street 82 Normandy Street Alton Hampshire GU34 1DH     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: Peter McNeillie     Date: 0 9 1 1 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 27 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 27 Information about the care home Name of care home: Address: 82 Normandy Street 82 Normandy Street Alton Hampshire GU34 1DH 01420549002 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: www.together-uk.org Together Working for Wellbeing care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 6 The registered person may provide the following category/ies of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding learning disability or dementia (MD) Date of last inspection Brief description of the care home Number 82 Normandy Street is a service owned and managed by Together Working for Wellbeing. The home is registered to provide accommodation care and support for up to six persons under the age of 65 years who have mental health needs. The three storey semi-detached building is situated in a residential area in the North Hampshire town of Alton on a main bus with easy access to shops and other community facilities. Individual accommodation is arranged over two floors, each with a communal bathroom. Other communal areas include a comfortable sitting room, dining room, Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 6 Brief description of the care home kitchen and laundry facilities with a well-maintained garden and small car park at the rear of the premises. Care Homes for Adults (18-65 years) Page 5 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: 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: This report was written after taking into consideration a number of sources of information and evidence including a site visit to the premises, previous reports, examining residents and staff records, talking with residents, staff, management, and responses to a pre inspection CQC satisfaction survey by residents, staff and health care professionals. Additional information was provided by the manager in her responses in the homes pre inspection Annual Quality Assurance Assessment. (A.Q.A.A.) During this inspection which took place on 09/11/09 between the hours of 09:15am and 12:15pm all of the designated key standards for younger adults were inspected. As a result of this visit no requirements or recommendations have been made. The results and findings contained in this report will determine the frequency and type Care Homes for Adults (18-65 years) Page 6 of 27 of future inspections. Care Homes for Adults (18-65 years) Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 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 9 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 well-developed system of assessing and identifying residents needs which ensures residents safety and assessed needs can be met. Evidence: There has been just one admission since the last inspection. We were informed that all admissions are carried out in accordance with an admissions policy that requires that no resident is admitted without a full assessment of needs and attendant risks being carried out; this included the prospective resident prior to a permanent place being offered visiting the home on a number of occasions including overnight and weekend stays. During these visits a detailed assessment of residents needs and risks would be carried out overseen by the manager or a member of senior staff. To check compliance with their own policy and procedure, we viewed the record of the last person admitted. Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: This included a number of topics including personal care support, daily living skills, looking after their physical and mental health as well as areas of risk. External health and social care professionals also contributed to the assessments process. All assessments of need and risk are reviewed on a regular basis. Care Homes for Adults (18-65 years) Page 11 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. There is a clear and consistent care planning system in place which ensures residents needs are met within a risk management policy that involves residents in decisions that affect them. Evidence: After talking with the manager, staff and residents we formed the view that staff saw themselves more as supporters and enablers not carers and were there to assist residents in achieving their personal goals, aspirations and independence within a risk taking framework. A view with which the residents, staff and manager agreed. This is reflected in the care plans which are referred to as Recovery Plans We viewed all of the residents recovery plans. All contained details on how assessed needs were to be met, how any risks were to be managed and confirmation that residents were consulted when the plan was formulated. Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: All of the residents spoken with who confirmed they were aware of and had contributed to their recovery plan are capable of looking after themselves with regard to day to day personal care. It was clear to us that residents were masters of their own destiny and were totally responsible for the success of the placement and whether the recovery plan was viable or relevant. Residents right and the opportunity to take risks is seen as fundamental. Residents were supported to make decisions for themselves within a risk assessment framework with the help of staff if required. If following a risk assessment, any type of restriction was indicated, this would not be implemented without the full consent of the resident. Care Homes for Adults (18-65 years) Page 13 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. The social activities family, contacts and the provision of varied and nutritious meals were well managed and reflected residents interests and choices. Evidence: Any decision taken that affects individuals always seeks to empower the individual by taking into consideration the individual residents choices,wishes,aspirations and independence. These were reflected in the manner in which the home is run and day to day life conducted. This is in line with the staffs perception of themselves as enablers first and carers second. Regular residents meetings take place where any matters that affect living in or the running of the home are discussed. No subject is taboo as long as all of the residents Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: agree. There is an expectation in the home that residents take responsibility for keeping the home clean and tidy on a rota basis and to prepare their own meals with assistance if required. Residents are responsible for choosing daily menus. The homes management in recognising the individuality of residents has enabled each resident to prepare a personal daily menu which reflects their preferences and choices for which they carry their own shopping. Shopping is stored in personal storage, including individual containers in the fridge. In producing menus staff offers guidance to assist the building of a balanced meal. Residents are responsible for choosing and arranging their own social activities with help, support and encouragement from staff. Residents confirmed they were not forced to participate in any activity unless they wished to do so. The range of activities currently being undertaken include, dining out, trips out, work, a, pubs, gym, swimming, cinema, wok and college. All service users have regular weekly contact with their families and any restrictions are reviewed and monitored regularly. Visitors can also be entertained in the house by individual residents as long as it does not interfere with the others living in the home. Residents spoken with told us during our visit and in a CQC pre inspection survey, they liked living in the home, were treated with respect and could do what they chose. Responses to our survey and the AQAA confirmed to us the home takes issues of equality and diversity seriously. They told us within the service they do the following: Each service user treated as an individual, cultural, spiritual, religion and all other needs assessed upon arrival and reviewed and evaluated at key work meetings and in house reviews. All service users treated as individuals, all service users have own rooms with a key, privacy and dignity respected at all times. Care Homes for Adults (18-65 years) Page 15 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: All residents are independent with regard to their personal care needs and only require prompting with regard to personal hygiene. Should assistance is required staff and management informed the inspector this would be delivered in private, however, residents told us they could take care of themselves. Residents informed us were able to see the doctor of their choice or any other health and social care professional when they needed to. The records viewed indicated that apart from doctors, district nurses, physiotherapists, occupational therapists, and the local community mental health team other specialists would be consulted as required. This was confirmed by a health care professional in their response to our pre inspection survey when they wrote: Works well with the local CMHT (community Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: health care team) and psychiatric services, contacting the appropriator clinician with any concerns. Records were kept of appointments with GPs, dentist, optician, chiropodist and any other external health and social care professional and included details of any advice and treatment given. All drugs are which securely stored are administered disposed of and recorded in accordance with an in house medication policy and procedure by trained staff. Records of administration and disposal of unwanted drugs and medicines viewed were complete and accurate. Currently two residents are self-medicating following a risk assessment. Care Homes for Adults (18-65 years) Page 17 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 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 clear policies and procedures in place which ensures residents are able to complain and are protected from abuse. Evidence: The complaints procedure, which is also included in the service users guide included information on how to contact CQC The was available, as was the record of complaints. No complaints have been received by CQC since the last inspection. Residents spoken with of stated they felt confident in discussing any concerns, complaints with management either in house or external and were confident any issues raised would be dealt with promptly and fairly. Staff responses mirrored that of the residents. The homes adult protection policy is designed to safeguard residents from abuse. The policy and procedure works in tandem with the procedure produced by Hampshire County Council and is based on National Guidelines and the document No Secrets. Management and staff who were spoken with confirmed they had all received training in recognising various types of abuse, this was confirmed by records viewed. All were able to demonstrate they knew the procedure to follow should they witness or suspect the abuse of any resident. 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 good 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 is situated in a residential area within walking distance of Alton town centre, close to shops and communal facilities. A situation residents described as Very convenient Great. From the outside there is nothing to distinguish it from its neighbours, there are no discriminatory signs and nothing to indicate it is a care home. Residents told us they liked this idea as they did not wish to be seen as different. Following the last inspection two requirements were made; 1) The provider must ensure the lounge is reasonably decorated and free from tobacco/cigarette stains. 2) The provider must ensure that bedroom ceilings, walls and furnishings are free from mould and damp . Both of these requirements have been complied with. Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: All areas of the home were clean and free from unpleasant odors and obvious hazards apart from water damage to the ceiling in the entrance hall and lounge following a burst pipe. As the damaged area has now dried out, the manager informed us she had been chasing external management to have the damage rectified. As this matter is clearly in hand and a verbal assurance of the manager she would continue to get the matter resolved as a matter of urgency, we are not making a requirement on this occasion but would expect the damage to be attended to within six weeks from the date of this report. Residents who are responsible for the day to day cleaning told us the home is always clean and smells fresh. Furniture was comfortable, homely and in a good state of repair and met residents individual and collective needs. All communal areas were accessible by residents including the well-tended garden. Residents commented how satisfied they were with the accommodation and how much they liked their rooms. An infection control policy and procedure was in place as were disposal aprons, gloves, antiseptic hand soap and a washing machine fitted with a high temperature programme. 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: In our view, (with which the residents agreed) at the time of the inspection, staff numbers and the deployment of staff was sufficient to meet the residents needs. As previously stated in this report all residents are able to attend to their own personal care. The manager informed us the planned staffing level for the home is two staff at all times at all times during the day and evening and one staff sleeping in at night plus telephone back up for emergencies. She also informed us staffing could be raised if residents needs increased or a particular days programme required additional staff. As part of this inspection, we viewed three staff training files selected at random. Records viewed confirmed that following their appointment all staff are subject to an in house induction and a training programme that include first aid, handling Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: medication, food handling, moving and handling, safeguarding and infection control. Following completion of their induction programme All staff are expected to undertake a National Vocational Qualification N .V. Q.) Course. Information provided by the Manager indicated that 100 of has been trained to NVQ level 3. Those responsible for this result are to be commended. We did not view staff recruitment files on this occasion as no staff has been employed since the last inspection when it was found that all staff is employed in accordance in accordance with a robust equal opportunities recruitment, and selection procedure, which is designed to protect residents. This involves the completion of an application form, the signing of a rehabilitation of offenders declaration, an interview, and satisfactory Criminal Record Bureau (CRB) disclosure, Protection of Vulnerable Adults (POVA) and reference checks prior to starting work. 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 good 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: At the time of our visit the manager who had been previously registed in a service owned and managed by the registered provider was in the process of completing an application to become registered for this service. From the evidence seen we were satisfied that the service is well managed by the Manager who has a number of years managing similar services, is qualified to National Vocational Qualification level in care and management at level four and is a registered NVQ assessor.. Comments made by residents confirmed they can speak to the manager and all care staff at any time and they are always willing to listen and give them time. This view that was also echoed by the staff who described the manager as available and approachable. Staff also that confirmed that there is a clearly defined management structure and that operates an open door policy which encourages them to share any Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: concerns or ideas they have for the betterment of the service. It was also evident from our observations that the manager has enthused the highly motivated staff team who were all fully aware of there responsibilities, worked within clear lines of accountability and guidelines and recognized and promoted the ability of the individual residents not the disability. As part of the homes quality monitoring system, residents residents representatives and health and social care professionals staff and social care professionals are invited to participate in satisfaction surveys. The views expressed in the surveys are seen as key in highlighting areas that may require improvement or attention and the future betterment of the service. A health and safety policy was in place as were records of weekly health and safety checks, the servicing of equipment, staff training in the techniques of moving and handling, first aid, health and safety, the procedures to follow in the event of fire (including evacuation) and accidents. We were informed that the hot water supplies to baths were fitted with thermostatic controls set at 43 degrees centigrade and all hot pipes and where appropriate radiators were covered or risk assessments were in place to protect residents from burning. 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: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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. 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