Care Home: 9 Powderham Road

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What the care home does well The people living in the home said that they like living there and they are obviously proud of their home. One person said that they had chosen to move there because they wanted to be more independent. The home provides those living there with good opportunities to develop independent living skills and in the past they have enabled people to move on to supported living accommodation. The home provides a wide range of activities from domestic skills to work experience and everyone progresses at their own place with whatever help and support they require. The people living in the home are involved in the running of the home and are consulted about any decisions that have to be made. They are included in the interview process for new staff and help choose the furnishings and decoration for the home. Staff said that they receive good training and feel supported in their role. What has improved since the last inspection? No requirements were made at the previous inspection. There are currently discussions being held about the refurbishment of the home. What the care home could do better: Medication records must be signed by the person administering the medication at the time it is given. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 9 Powderham Road 9 Powderham Road Newton Abbot Devon TQ12 1EU     The quality rating for this care home is:   two star good 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: Susan Samways     Date: 0 2 1 0 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. 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. 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 28 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.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: 9 Powderham Road 9 Powderham Road Newton Abbot Devon TQ12 1EU 01626352581 01626352581 swafforn@roc-uk.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Robert Owen Communities Name of registered manager (if applicable) Miss Sarah Diane Wafforn Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home 9 Powderham Road is a care home operated by the charity Robert Owen Communities, a large local provider of residential, day and supported living facilities for adults with learning disabilities. The building is a spacious, detached house in a residential street very close to Newton Abbot town centre. It is thus close to shops and all other usual town facilities. The service users accommodation is arranged in twoflats on the ground and first floors, each with its own lounge, dining room/kitchen and bathroom. There is another room in the basement which is used for meetings. There is a garden and terrace at the side of the house and a car parking area. The home caters for young adults with a learning disability, providing a home for as long as it is suitable for the residents to remain there. The home also develops residents skills and encourages them towards greater independence as appropriate. 10 Over 65 0 care home 10 Care Homes for Adults (18-65 years) Page 4 of 28 Brief description of the care home Fees are negotiated on an individual basis with sponsoring local authorities, and are from £811.35 per week. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The last inspection for this service was completed on 3rd October 2006. This was an unannounced inspection which took place over one day. Unfortunately the registered manager was on annual leave so could not be present. A senior carer was on duty and the deputy manager was spoken to on the telephone. Other staff were spoken to and an agency member of staff was also on duty. Time was spent in discussion with the senior carer and in looking at care records and other documentation. Staff records were not available for examination as none of the staff on duty were permitted access to them. Care Homes for Adults (18-65 years) Page 6 of 28 A lot of the inspection time was spent in the company of some of the people who live in the home. They were involved in household tasks such as making drinks, cooking meals, going shopping and doing housework. They were very welcoming to someone who had never been to their home before and who had turned up unexpectedly which made the inspection a very pleasant one. Prior to the inspection the Annual Quality Assurance Assessment, completed by the registered manager, had been received. This provided information about how the national minimum standards had been met, what had improved since the last inspection and future plans for 9 Powderham Road. 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.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 28 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 28 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. All those wishing to live in the home will have a comprehensive assessment, be invited to visit the home and be provided with sufficient information prior to deciding whether this is an appropriate home for them. Evidence: The files for three people living in the home were examined. They were found to have very detailed assessments of the people concerned looking at all areas of the persons life and identifying the care and support they would need. Part of the assessment is establishing what the person hopes to achieve by moving into the home. One person said that they had moved there because they wanted to be more independent. Prospective residents are encouraged to visit the home, to meet the staff and other people living there and to have any question they might have answered, as part of the decision making process. Relatives, carers and relevant professionals are also welcome to visit. Those already living in the home are kept informed and are consulted before anyone new moves in. Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: Assessments are regularly reviewed with the person concerned and any other relevant parties. Everyone living in the home has their own copy of the homes handbook which provides information about the home and what it provides and the terms and conditions for living there. Care Homes for Adults (18-65 years) Page 11 of 28 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. Care plans are written and reviewed with the involvement of the person concerned and reflect their personal goals. Evidence: Each person has a comprehensive care plan, based on the completed assessment, which they are fully involved in developing. The care plan is written from the point of view of the person concerned and covers different aspects of the persons life such as daily routine, personal care, health, domestic skills, activities and behaviour. Regular reviews of the care plan take place, with or without the care manager or family involvement, but always with the person concerned. The files for three people living in the home were examined. Each had detailed care plans which had been reviewed. Most of the care plans and reviews had been signed by the person concerned. Each file also contained risk assessments for different activities they may be doing or for aspects of the persons behaviour. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: Care plans are kept in the homes office but those living in the home are encouraged to keep copies in their own bedrooms. Every month each resident has a formal chat with their key worker. This is an opportunity for them to read and discuss any entries made into their personal and medical notes, any changes they would like to make in what they are doing and any decisions that need to be made. Periodically the manager or deputy manager will complete the key worker chat with the resident for quality assurance purposes. Records are kept of these meetings copies of which were seen in the files examined. Care Homes for Adults (18-65 years) Page 13 of 28 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 living in the home are supported to develop independent living skills. Evidence: Each person has one day at home during the week when they do independent living skills. Staff are available to support them to do their household and personal tasks such as laundry, washing, attending appointments or leisure activities, shopping and cooking. Each person takes their turn to prepare and cook meals for the others in their flat. On the day of the inspection one person was cooking lunch while in the other flat someone was preparing the evening meal. Both said that they enjoyed cooking. Residents are encouraged to access the local and greater community, going to the shops, leisure centre and cinema. They are also supported to attend church if they wish and one person has made a positive decision to join a particular church. Some Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: are able to access local amenities independently while others have staff support and training to do so. One person was seen getting ready to go shopping unaccompanied. They made sure that they knew what they were going to buy, checked that they had sufficient money and staff prompted them to take their mobile phone with them so that they could seek assistance if they needed it. When ready, people are also encouraged to develop work skills. One person is doing work experience in an office. Another has done voluntary work in a local charity shop. All those living in the home are in touch with their families and they are encouraged to maintain contact with them but they have choice whether they do so or not which is recorded. They can use the computer in the home to send e-mails to friends and family. Residents are offered a choice of holiday. Residents are supported with relationships with one another. Care Homes for Adults (18-65 years) Page 15 of 28 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. Personal and health care support is provided in a way that the person prefers and requires. Evidence: The senior carer stated that personal care is provided in a sensitive and flexible way to suit as far as possible the person they are caring for. People are encouraged to be as independent as possible so help is only provided for those activities that the person is not able to do or is learning to do for themselves. This was confirmed by those spoken to during the inspection. The people living in the home were observed to get on well with the staff. The staff were seen to give gentle guidance with regard to things such as the appropriate clothes to wear, food to eat and keeping their rooms tidy. Residents are able to go to bed when they choose but are asked to keep noise levels down between 10.30pm and 7.30am. The home has good working relationships with the local learning disability team, GP Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: surgery and other health professionals. Everyone living in the home is registered with a GP, dentist and optician. The key worker ensures that appointments are kept and that support to attend is provided if requested. A chiropodist visits the home every 6 8 weeks for those who require attention for their feet. If assessed as being able those living in the home are encouraged to be responsible for their medication. They have lockable storage in which to keep their medication which is signed out to them when delivered to the home. Staff take responsibility for all other medication. Medication records were checked during the inspection. Not all records had been signed and this needs to be addressed by the manager. Care Homes for Adults (18-65 years) Page 17 of 28 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 rights of the people living in the home are protected through a satisfactory complaints procedure and staff training regarding the protection of vulnerable adults. Evidence: The home has a complaints procedure, which is also in picture form, explaining how to make a complaint and who to make the complaint to. This was seen to be on display in the home. This is rarely used as any concerns raised by people living in the home are dealt with promptly. Any problems can be discussed at the monthly key worker chats or at the regular residents meetings. In addition a senior manager from the organisation that owns the home visits regularly to talk to the people living there, seek their views about the home and listen to any issues they may raise. All staff have had training regarding the protection of vulnerable adults although some may need a refresher session. This training raises the awareness of staff to what constitutes abuse and the action they should take if they suspect abuse may have taken place. All those living in the home have their own bank accounts and draw their weekly allowances in person from the bank. Any money kept on behalf of a resident is kept locked in the staff office. This is kept to a minimum and all transactions are recorded. Any money held is checked daily by staff. Care Homes for Adults (18-65 years) Page 18 of 28 Care Homes for Adults (18-65 years) Page 19 of 28 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 clean, hygienic, safe and furnished in a homely way. Evidence: The home is divided into two flats for groups of five residents to share. Each has communal space including a kitchen. It is situated in the town of Newton Abbot within easy walking distance of local amenities. It is a safe, comfortable and homely environment. The people living in the home are able to have their rooms according to their personal taste. Two of the rooms were visited during the inspection at the instigation of the occupants. These were decorated and furnished in very different ways and the people concerned took an obvious pride in them. Everyone has a key to their own room. Everyone is encouraged and supported to keep their own rooms clean and share in the responsibility for keeping the communal areas clean and hygienic. People living in the home said that the home is always clean and fresh. Discussions are currently taking place regarding the refurbishment of the building. Those living in the home have been consulted about this which was confirmed by residents spoken to during the inspection. Care Homes for Adults (18-65 years) Page 20 of 28 Care Homes for Adults (18-65 years) Page 21 of 28 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. There are sufficient staff to meet the needs of those living in the home. Staff recruitment procedures and training programmes safeguard people living in the home. Evidence: Staff turnover at the home is low but when new staff are employed they have a six month probationary period during which they have a thorough induction programme. This covers the needs of the people living there and all the policies and procedures governing the work they do. The probationary period enables the member of staff and the manager to assess their suitability for the work they are required to do. The home has a good recruitment procedure which involves the people living in the home. They have a place on the interviewing panel. They agree between themselves who will take part in the interview and what questions that person will ask. As the registered manager was on leave at the time of the inspection it was not possible to examine any of the staff files as, understandably, the other staff do not have access to them. However, the manager had stated in the information provided prior to the inspection that two references are obtained and police checks and checks Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: against the register of those barred from working with vulnerable adults are made before anyone commences employment. The deputy manager was spoken to on the phone. He confirmed that agency staff had had to be used to cover for vacancies over the previous six months. The agencies used try to send the same staff to provide continuity which is less disruptive for the people living in the home. He also said that there are good training programmes for staff. Seven of the ten permanent staff have NVQ Level 2 in Care or above and another is working towards it. Care Homes for Adults (18-65 years) Page 23 of 28 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 run in the best interests of those living there. The management style is open and receptive to the views of those living there, the staff and others involved with the home. Evidence: The registered manager has NVQ Level 4 and the Registered Managers Award and has managed the home for over nine years. She states that she has an open and inclusive management style and certainly the staff on duty on the day of the inspection seemed happy with the way that the home was being run. The way that the home is run is constantly being monitored through team meetings, residents meetings and reviews of the ways in which policies and procedures are being implemented. Detailed records are kept of activity within the home and the care and support of the people living there is regularly reviewed and updated. Safe working practices are employed. Risk assessments are regularly reviewed. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: Individual members of staff have taken on responsibility for fire safety, health and safety and first aid. Care Homes for Adults (18-65 years) Page 25 of 28 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 26 of 28 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 1 20 13 The registered manager 31/08/2009 must ensure that medication records are kept accurately Medication records must be signed by the person administering the medication and at the time it is given. This ensures that the person requiring medication has been given it and reduces the risk of errors being made. 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 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: 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. 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