Care Home: 90 Brackenborough Road

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 90 Brackenborough Road 90 Brackenborough Road Louth Lincolnshire LN11 0AQ two star good service The quality rating for this care home is: 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: Ken Hague Date: 1 1 1 2 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. 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 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. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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. Internet address www.csci.org.uk Information about the care home Name of care home: Address: 90 Brackenborough Road 90 Brackenborough Road Louth Lincolnshire LN11 0AQ 01507600590 F/P01507600590 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Northern Life Care Limited T/A U.B.U. Name of registered manager (if applicable) Mr Paul Smith Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 5 0 care home 5 learning disability Additional conditions: Conditions of Registration. The placement of any service user in the home must not exceed a period longer than six months. Date of last inspection A bit about the care home 90 Brackenborough Road is a care home owned by Northern Life Care Ltd. There is a registered manager in post. The care home is a detached house situated on the very edge of the town of Louth, which has been adapted by the company to provide respite care for service users with a learning disability. The home has enclosed gardens at the rear. Car parking is available on the road outside the property and there is a small car park directly at the front of the home. It is a two-level building; access to the first four is via a staircase. There are no facilities for service users with a physical disability to use the top floor of the care home, although there are facilities on the ground floor to enable wheelchair users to be offered services and respite care. The accommodation consists of a communal lounge, dining room, kitchen and utility room. On the ground floor there are three bedrooms and two bathrooms. On the upper floor there are two bedrooms and one bathroom. Lincolnshire County Council have contracted with Northern Life Care Ltd to provide respite care for people with learning disabilities. There is no other care home offered as an alternative choice. The garden has an attractive patio area for residents to sit in. The building and garden are on level ground and accessible for wheelchair users. The owners of the home visit regularly and work closely with the manager and the staff working in the home. Information about the day-to-day operation of the home, including a copy of the last inspection report, can be found in the home statement of purpose and service user guide. These documents are made available to all new potential residents and explain the resources and services offered, by the care home. A dedicated intermediate care service is not provided by the home. 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 The visit took place over 6 hours. The care notes for three residents were read Two members of staff, told the inspector their views of the care provided by the home. The owners of the home sent information to the inspector which explained how they help residents. It is normal procedure to obtain written feedback from residents prior to the visit using a document called have your say.” There were 9 reports returned from residents. What the care home does well The home provides a comfortable, safe home for people to live in. Assessments and care planning processes are in place. Residents have detailed care plans, which tell staff how the resident’s needs are to be met. Residents meetings and care reviews are held where residents tell staff their opinions of the home. The home offers, a number of social and leisure activities. The food offers residents choices and meets resident personal dietary needs. What has got better from the last inspection 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 Ken Hague CPC1 Capital Business Park Fulbourn Cambridge CB21 5XE If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home has a thorough assessment process therefore ensuring identified needs are met by the care home. Evidence: The care records of three residents were studied. All of these residents were taking respite care at the home. The individual files of the three residents contained a detailed assessment carried out prior to them coming to stay at the home. Assessment identified residents care needs and social needs. They reflected the choices and wishes of residents in how these needs were to be met by the home. A detailed risk assessment had been carried out at each assessment where a risk was identified the management of that risk was included in the care plan. A new assessment was found to be carried out each time the resident came into the home for respite care. Care records were filed in a consistent manner. Each individual residents file contained an index which allowed you to quickly find the assessment. The registered manager stated all residents have a multi disciplined assessment before they are offered respite care. Staff confirmed this statement to be correct. Staff interviewed confirmed assessments were easy to understand and follow. Residents spoken to confirmed that they had been involved in the initial assessment. There was evidence of relatives contributions found within assessments. All records were signed by the resident or their representative and the member of staff who carried out the assessment. 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 identify all the areas of need and provide detailed care instructions to staff. This ensures appropriate care is provided and that resident’s health needs and care needs are met. The privacy and dignity of residents is respected by staff. Evidence: Care records were written in plain English and filed in a consistent manner. Care plans reflected the choices and wishes of each individual resident both for social and care needs. Dietary needs were well recorded. The likes and dislikes of each resident in respect of activity and diet were recorded in detail. Care staff stated that care plans will enable them to easily identify the needs of each individual. There was evidence of the reviews of care plans and risk assessments being held weekly. Care plans recorded visits by community health care services including any visits to see consultants when taking respite care. The travel requirements of each resident and any mobility problems were recorded in detail. Care records contained getting to know me documents completed by residents which informed staff about resident’s expectations and needs for assistance. Each file contained a photograph of the residents taken with their permission. Details of extended family and the life story of each resident were recorded. The individual goals of each resident were recorded. Detailed risk assessments are used to balance the choices of the residents against any perceived danger. Targets and goals were reviewed on a frequent basis. Details of the medication taken by residents were recorded on their individual files. At the end of each respite care period a summary was completed by staff to contribute information to be used at the next assessment. Evidence: Residents care plans instructed staff to ensure the dignity and privacy of each resident was protected. Each identified task included information of how told the task was to be carried out and if a potential risk was identified was to be managed. The number of staff required to complete the task was also recorded. 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 . Residents are offered a range of activities which meet the wishes and the choices of individual residents. The dietary needs are being met. Families are encouraged to maintain contact with residents. Evidence: The home offers a range of activities which are tailored to the individual needs of each resident. Care records provided evidence that those attending local day centres continue to do this during respite care periods. Residents had their goals and wishes recorded on their individual care plans. The company provides transport to make choice of activities available. The individual care plans for the three residents been case tracked all contained the choices and wishes of the resident in respect of activities. Care records and evidenced that these activities had taken place. Have your say documents confirm residents are happy with activities provided by the managers of the home. Care records contain all the details of extended family. Care plans and reviews demonstrated that families are involved in the long-term planning of their relatives. Discussions with staff and care records provided evidence that relatives are encouraged to keep in contact with their relations. The managers keep a record of the choice of menu for each resident. Their likes and dislikes were found recorded in their care plans. Residents stated in the “have your Evidence: say” document that they are happy that their dietary needs are being met. Staff stated that the quality of food is good and confirmed that in their opinions residents dietary needs are met. Any resident who has a special dietary need has an individual record kept within the homes kitchen. 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 care is provided in a manner which preserves the dignity and privacy of the residents. Health care needs are being met. The managers updated medication procedure ensures that prescribed medication is given safely. Evidence: Observation on the day of the site visit provided evidence that staff treat each resident as an individual. They respect their privacy and dignity and provide personal care in a sensitive manner. They were observed to offer choices to residents to speak softly and carefully to them ensure that they understood conversations. Health-care needs are identified at assessments and recorded on individual care plans. There are records of visits by GP and district nurses on individual care files. The managers have in place an updated medication policy which ensures the safe administration of medication. All staff are being trained in the administration and storage of medication and internal checks by managers confirm they are competent in this area. Have your say documents confirmed that residents feel their dignity and privacy is respected. 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 . Residents are able to raise concerns with the management of the care home. Staff are trained to ensure that residents are protected from any potential abuse. Evidence: There is an updated complaints procedure in place known to staff and residents. Residents stated in the have your say document that they can raise concerns with the homes managers. Complaints procedures are written in the format which can be understood by residents who have a learning disability. Staff said they had explained the complaints procedure to residents. There have been no complaints received by the home or the Commission for Social Care Inspection in the last year. No notifications have been received by the Commission for Social Care Inspection which have raised concerns. 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 . Residents live in a comfortable well maintained home. The health and safety policy of the care home is being followed. Evidence: The home is a modern detached property which is well maintained. Records show that there is an ongoing maintenance program for the home. Improvements have been made to bathrooms which include the installation of new shower. Some areas of the home have been decorated. The home was clean and smelt fresh. No health and safety issues were identified. Staff stating their satisfaction with the environment of the home. They said that it was a safe environment in which to work. “Have your say documents” completed by residents contained only positive comments in respect of the environment. 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 on duty, who have the appropriate skills to ensure the needs residents are met, who fall within the registration category of the home. Evidence: Staff, are provided with essential training and specialised training courses, 80 of staff hold an NVQ 2 or the equivalent. The evidence for this statement was found by the inspection of training records. Staff stated that feel confident and competent to be in able to meet the identified needs of the residents. They stated that there are always sufficient staff on duty to meet the needs of the residents. In the event of a problem additional staff are brought into the home. The homes manager stated that the recruitment procedure of the home is followed to ensure the safe recruitment of staff. The examination of records for recruitment provided evidence that the statement was correct. The homes AQAA states staff are provided with an induction on the commencement of employment. No staff member is employed until the information required by the Care Home Regulations has been obtained. Staff receive ongoing supervision and a yearly appraisal. All staff have an individual file which contains their training needs and how these needs are to be met in the future. The competency of individual staff members is checked regularly by the managers of the care home. The evidence for this statement was found within staff training records and discussions with the manager and staff members. Staff stated that the managers are very supportive and approachable. Residents raised no concerns or pasted any negative comments regarding staffing on the day of the site visit or in the have your say surveys. 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 managers of the home monitor and support staff to ensure the Care Home Regulations are met. Staff are provided with good leadership. No health and safety issues were identified. New staff are recruited safely. Evidence: There was evidence found of professional leadership and good team working which had not been found at previous inspections. The manager at regional and local level are working well together to ensure that the needs of residents are met. Roles are now clearly defined which benefits staff and residents Comments found recorded in quality assurance forms and have your say documents passed only positive comments about the management of the home. Staff stated the Acting Manager is very approachable and supportive. Pre inspection information contained in the AQAA shows that regular staff meetings are held and quality assurance surveys are carried out. QA Surveys seen at the site visit showed that Residents they are very happy with the services they receive. The acting manager said that she carried out staff supervisions in accordance with national guidelines. Staff confirmed that they receive formal supervision and stated that the acting manager supports them in their work and helps them to develop their own individual skills. There are financial procedures in place to ensure that resident’s financial interests are safeguarded and protected. No health and safety issue were identified at this key inspection. Evidence: 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: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web:www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) 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. - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!