Care Home: Addington Close (12)

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What the care home does well A person was admitted to the home in December 2009. There was good evidence of the way their admission was planned. They had visited the home a number of times for increasing duration, before deciding to accept a place. Each of these visits had beenrecorded in detail. This information in turn had contributed to the assessment of the person`s needs and of the ability of the home to meet the needs identified. Consideration was given to the needs of the two people already residing at the home. The person concerned and the home also had the benefit of a full external professional assessment. The person told us they were happy with the move to the home and how it was handled. They were already familiar with their room when they moved in. They were pleased that the staff shared their own aspiration that staying in the home will be a stage in achieving longer-term goals. They described ways in which staff supported them to rebuild strong links in the community where they intend to return. Care planning records for the person confirmed this focus. The home presented as homely and clean. Our observations showed people felt completely at home. There had been significant investment in the environment, for example there was a newly constructed garden room, many new furnishings, and the home had been redecorated. The people in the home confirmed they had been fully involved in choices. The garden had been landscaped and one person pointed out various parts of the garden they had helped with designing, planting and maintaining, which they found very satisfying. People expressed high satisfaction with their individual rooms. A comment in the staff survey was: `In the past the home maintenance and general upkeep left a lot to be desired, but recently the home has been upgraded throughout which has made a huge difference to the environment, more space and communal areas. Still very homely feel. Also external upgrades and new windows.` The same person hoped there would be a rolling maintenance programme to ensure the newly achieved standards were sustained. What the care home could do better: Many references to the Care Quality Commission in the home`s documentation showed our regional office address. This needs to be replaced in all instances by our contact address in Newcastle Upon Tyne. There were no negative comments in survey returns from people living in the home. However, we noted people had been assisted by staff of the home. It is preferable in seeking people`s views, to arrange for support from external trusted people, such as college tutors or independent advocates, in order to demonstrate independence from the service. The home had changed its supplying pharmacy and was provided by them with a new lockable medicines cabinet. However, this was not compliant with current legislation about the level of security necessary for storage of medicines in general, or controlled drugs in particular, and must be replaced. Any cupboard installed must be metal and should have a certificate or similar that states that it meets the British Standard 2281 so long as it is correctly fitted. It must be fixed to a solid wall by rag or rawl bolts. Random inspection report Care homes for adults (18-65 years) Name: Address: Addington Close (12) 12 Addington Close Devizes Wiltshire SN10 5BE one star adequate service 07/05/2009 The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Roy Gregory Date: 2 6 0 5 2 0 1 0 Information about the care home Name of care home: Address: Addington Close (12) 12 Addington Close Devizes Wiltshire SN10 5BE 01380720001 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ordinary Life Project Association Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 3 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 3 No more than 3 service users with learning disabilities at any one time. Date of last inspection Brief description of the care home 12 Addington Close is one of a number of care homes in Wiltshire that are run by the Ordinary Life Project Association (OLPA). The property is a detached bungalow in a residential area of Devizes. Each person has a single room. A large shared space gives a choice of sitting room, dining room and garden room. Patio doors lead out to an attractive and accessible enclosed garden. There is a domestic style kitchen. A driveway at the front has space for parking, and there is on-street parking close by. It is possible to walk to the town centre. 0 7 0 5 2 0 0 9 Care Homes for Adults (18-65 years) Page 2 of 9 Brief description of the care home The people who live at the home receive support from a manager and a permanent staff team. In 2009 the fees ranged from £860 to £986 per week. Information about the service is available in a Statement of Purpose. Care Homes for Adults (18-65 years) Page 3 of 9 What we found: We visited the home on Wednesday 26th May 2010 between 4:55 p.m. and 6:20 p.m. This random inspection replaced a previously planned key inspection, following changes in our inspection priorities during the period of transition between our obligations under the Care Standards Act 2000 and the Health and Social Care Act 2008. The focus of this random inspection was on key areas of safety, and the services response to requirements and recommendations we made at our previous key inspection on 17th May 2009. Prior to the visit we received their Annual Quality Assurance Assessment [AQAA], which demonstrated how they plan to develop the service and also gave some numerical information. We received survey questionnaires by post from the people who live at 12 Addington Close, and from five members of staff. During the visit we met the three people who were living at the home and had a longer talk with one of them. There were two staff on duty, both of whom shared views and made documentation available. We looked around all the shared areas of the home, including the garden, and were able to see two bedrooms. We looked at some care and health planning records, and how the home recorded accidents and incidents affecting the people that live there. We saw the arrangements for handling peoples medicines. We looked at staff training records. We made a requirement at the key inspection that staff must be deployed in a way that would provide greater flexibility at particular times of day. This was so that people could receive more support to their individual needs. The provider wrote to us in December 2009 to inform us staffing levels had been improved by 33 hours per week, in order to provide more availability at evenings and weekends. This was giving more one-to-one support to people to realise their care planning aims by enabling participation in desired activities. In the survey responses from members of staff, received in February 2010, three considered there were usually enough staff to meet the individual needs of all the people who use the service, and two that there sometimes were. One person wrote that Some staff could be more flexible to meet individual needs and not their own. Both the members of staff that we met said staffing provision was definitely better than that seen at the previous inspection. They said there was much more one-to-one engagement, more fitting with what people in the home wanted, and more community access. This was borne out by what we observed during our visit, and by records of support given. In each persons care record there was specific recording of a wide variety of activities and community access they were supported to achieve individually, which demonstrated a flexible and responsive staffing arrangement. Three staff in survey responses made additional comments about staff meeting peoples individual needs, rights and choices among things the home does well. We recommended in 2009 that the homes plan for staff training should be expanded to include more specialist and skills related areas of training. The staff had recently received external training about epilepsy and rescue medication, which particularly referred to one of the people they support. One member of staff that we met described OLPA as Care Homes for Adults (18-65 years) Page 4 of 9 fantastic for provision of training and support to attain NVQ [National Vocational Qualification] beyond level 2. We saw that OLPA have improved the planning, recording and delivery of training, to include more external training provision and wider variety, tied in with identification of specific needs and staff interests through supervision. All five staff who responded to our postal survey indicated they received relevant, up to date training that helped them understand and work with peoples needs. The AQAA told us that staff training had included bereavement and loss, dementia awareness and equality and diversity. We made a requirement in 2009 that people must receive the support that they require as detailed in their individual plans, to include the monitoring of a persons weight. We found at this inspection visit that all people were being weighed regularly. Care plans were person-centred and included goals and preferences. There was good provision for intermediate monitoring of progress towards achieving care plan aims. Care and support records were sufficient to show delivery of planned aims. For a person with epilepsy there was a new risk assessment to inform care planning, which was awaiting agreement with an occupational therapist. We saw work in progress on health action plans. The AQAA said staff had received some training to help with this task, which we identified as an area for development at our last inspection. There was a low level of use of medicines in the home. One person was being supported towards achievement of self-administration. The medicines administration records were in good order. Each chart was accompanied by a photograph of the person it related to, and relevant supplementary information. The home had a very low rate of accidents. There was an incident-reporting system between the home and OLPA head office, which appeared to work well. In line with a requirement we had made, there was a full record in the home of the providers monthly unannounced monitoring visits. This showed among other things that the complaints log was checked each time, albeit none had been received since our previous inspection. As a result of the alterations to the home, fire precautions had been upgraded and there had been liaison with the Fire and Rescue Service. The fire risk assessment had been reviewed as we had required. We were informed at the home, and by OLPA, that the recently registered manager [who had been appointed since our previous inspection] had given notice that they would leave at the end of June 2010. Some of the staff who responded to our survey commented they saw the manager as poorly supported in her role, feeling this affected the quality of information and supervision that staff received. Apart from the manager, no new staff had been recruited since the previous inspection. We saw on a check of recruitment practice at OLPA head office that staff were appointed only after completion of checks on their history, to ensure they were not unsafe to work with vulnerable people. They were subject of scored interviews. The required confirmation of peoples identity and integrity was undertaken. What the care home does well: A person was admitted to the home in December 2009. There was good evidence of the way their admission was planned. They had visited the home a number of times for increasing duration, before deciding to accept a place. Each of these visits had been Care Homes for Adults (18-65 years) Page 5 of 9 recorded in detail. This information in turn had contributed to the assessment of the persons needs and of the ability of the home to meet the needs identified. Consideration was given to the needs of the two people already residing at the home. The person concerned and the home also had the benefit of a full external professional assessment. The person told us they were happy with the move to the home and how it was handled. They were already familiar with their room when they moved in. They were pleased that the staff shared their own aspiration that staying in the home will be a stage in achieving longer-term goals. They described ways in which staff supported them to rebuild strong links in the community where they intend to return. Care planning records for the person confirmed this focus. The home presented as homely and clean. Our observations showed people felt completely at home. There had been significant investment in the environment, for example there was a newly constructed garden room, many new furnishings, and the home had been redecorated. The people in the home confirmed they had been fully involved in choices. The garden had been landscaped and one person pointed out various parts of the garden they had helped with designing, planting and maintaining, which they found very satisfying. People expressed high satisfaction with their individual rooms. A comment in the staff survey was: In the past the home maintenance and general upkeep left a lot to be desired, but recently the home has been upgraded throughout which has made a huge difference to the environment, more space and communal areas. Still very homely feel. Also external upgrades and new windows. The same person hoped there would be a rolling maintenance programme to ensure the newly achieved standards were sustained. 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 2. Care Homes for Adults (18-65 years) Page 6 of 9 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 7 of 9 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, 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 You are required to ensure 30/09/2010 that medicines are stored in a cupboard that complies with The Misuse of Drugs and Misuse of Drugs [Safe Custody] [Amendment] Regulations 2007. 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 1 2 1 39 Ensure all references in documentation about how to contact the Care Quality Commission are accurate. Try to identify people outside the service who can support individuals living in the home to give feedback to the company, and to the inspection process, by way of questionnaires or other means. Care Homes for Adults (18-65 years) Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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