Care Home: Agricola House

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What the care home does well People are provided with information and involved in an assessment of their needs to help them decide if the service is suitable. People have all of their needs, goals and wishes recorded, and they are involved, along with family and friends, in planning and reviewing their care. People are supported to make decisions in their day to day lives, to take responsible risks, and to develop themselves in order to promote their confidence and self esteem. People living at the home are listened to and their safety is promoted. They feel that they are supported in the way they prefer and their choices are respected. Staff members are trained so that they can understand peoples` needs and meet them well, and the service is managed with competence and enthusiasm. The home is clean, homely, and furnished and decorated to a high standard so that people living there are comfortable and have the private and communal space they need. What has improved since the last inspection? Not applicable as this was the first key inspection. Agricola House DS0000072991.V374928.R01.S.doc Version 5.2 What the care home could do better: The AQAA self assessment shows that the provider knows where improvements can be made and plans to develop the service are in place. Key inspection report CARE HOME ADULTS 18-65 Agricola House 17 Kirklees Street Tottington Bury BL8 3NE Lead Inspector Rukhsana Yates Unannounced Inspection 19th May 2009 09:30 Agricola House DS0000072991.V374928.R01.S.doc Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. 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 home adults 18-65 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. Agricola House DS0000072991.V374928.R01.S.doc Version 5.2 Page 2 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 Agricola House DS0000072991.V374928.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Agricola House Address 17 Kirklees Street Tottington Bury BL8 3NE TBC TBC Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Voyagecare.com Voyage Limited Care Home 8 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (8), Physical disability (8), Sensory of places impairment (8) Agricola House DS0000072991.V374928.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care home only - Code PC To people 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- Code MD Physical disability- Code PD Sensory Impairment- Code SI The maximum number of people who can be accommodated is: 8 Date of last inspection Not applicable First key inspection Brief Description of the Service: Agricola House provides support to eight adults with a head or acquired brain injury. The service aims to support individuals who would benefit from increasing their independence in a community setting, enabling them to regain their social and cognitive skills, and to develop their confidence. Support is based on rehabilitation techniques which strive to increase independence. The service is located in Bury, with access to a wide range of community resources, from leisure and recreational activities to educational facilities. Agricola House has eight bedrooms with level access en-suite facilities, suitable for the needs of people with physical disabilities. Communal facilities include a training kitchen, a spacious living room and an assisted bathroom. There is an extra training kitchen where people can be supported by staff to develop their menu planning and food preparation skills. The service is fully wheelchair accessible, and ceiling tracking is available as required. Externally there is a garden with a level access patio area. The fees range from £1400 to £1633 per week, and may vary depending on the needs of the individual. Agricola House DS0000072991.V374928.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that people who use this service experience good outcomes. This is a new service. We carried out a site visit over one day as part of the unannounced key inspection. Three people were living at the home at this time. We spoke with the manager, people living at the home, and staff. A range of records were looked at, relating to training and to health and safety, and the care records of people receiving support. Before the inspection the manager completed an Annual Quality Assurance Assessment (AQAA). The AQAA is a self assessment document that is filled in once a year by all providers. It is one of the ways we get information from providers about how they are meeting outcomes for people, and what they are planning to improve. The assessment was well completed. What the service does well: What has improved since the last inspection? Not applicable as this was the first key inspection. Agricola House DS0000072991.V374928.R01.S.doc Version 5.2 Page 6 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. Agricola House DS0000072991.V374928.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Agricola House DS0000072991.V374928.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2: People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with information and involved in an assessment of their needs to help them decide if the service is suitable. EVIDENCE: The service has a statement of purpose and service user guide describing the support and facilities available. People living at the home, and their advocates, are given a copy of the service user guide in a suitable format, and the manager ensures that people understand the residency/service agreement before they move in. Prior to any decision being made, the manager obtains available assessments from social and health care professionals involved, and the prospective service user is fully involved in discussions and decisions about whether the service will be able to meet their needs. The service facilitates introductory visits at a pace to suit the individual to ensure that the move is a positive choice, and that there is compatibility with others already living at the home. Agricola House DS0000072991.V374928.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9: People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individual needs are known and understood, and people are enabled to make decisions and develop independence. EVIDENCE: The care records showed that people have all of their needs, goals and wishes documented, and that they have been involved, along with family and friends, in planning and reviewing their care. There was evidence of people being enabled and supported to make decisions in their day to day lives, to take responsible risks, and to develop themselves in order to promote their confidence and self esteem. Examples included the use of photographs to help one person with their memory, one person who had become much more active and independent having lost skills in a previous placement, and another had developed independent daily living skills with a view to returning home. Agricola House DS0000072991.V374928.R01.S.doc Version 5.2 Page 10 The needs assessments were very detailed, including, for example, information relating to the person’s health, social skills, mobility, finances, relationships, cultural and spiritual needs, communication and behaviour. Support plans had been signed by the service user, and included details about the person’s routines, family, friends, networks and hobbies. Short and long term goals were identified and plans clearly described the support needed to enable people to work towards their goals. Risks were assessed, reviewed and managed well in all relevant areas. Agricola House DS0000072991.V374928.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): This is what people staying in this care home experience: 12, 13, 15, 16 & 17: People using the 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 experience a lifestyle that promotes their individual preferences and opportunities to participate in leisure and community based activities. EVIDENCE: People have a wide range of leisure activities to choose from, and have been involved in developing weekly plans to suit their preferences and chosen routines. Evidence of these was available in support plans and in files containing photographs, records of activities undertaken, and individuals’ reflections on their experiences. Staff support is provided to ensure that people can attend activities of their choice, at the time they choose. People are encouraged to maintain relationships, and friends and relatives are able to visit at any reasonable time, and with the consent of the service user. Agricola House DS0000072991.V374928.R01.S.doc Version 5.2 Page 12 Staff support people living at the home to carry out the weekly shopping, and to create menus that reflect their choices, preferences and dietary needs. There are assisted kitchen facilities where people are supported to develop their food preparation skills, and people have a choice as to where to have their meals. Agricola House DS0000072991.V374928.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20: People using the 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 receive personal support in the way they prefer and require. EVIDENCE: It was evident form the care and support plans, daily records, reviews, ongoing assessments and observations made during the visit, that individual needs and preferences are known and responded to. Staff are knowledgeable about each person living at the home, and the ways in which to best support them. Support strategies are recorded and evaluated by staff so that they can learn from each other and positively enable each service user to reach their potential. As a result people living at the home feel that they are supported in the way they prefer and their choices are respected. There are policies and procedures in place for storage, administration and management of medication. Medication was seen to be well organised and managed. People are supported to self-administer medication if their individual risk assessment indicates that it is safe for them to do so. Agricola House DS0000072991.V374928.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23: People using the 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 at the home are listened to and their safety is promoted. EVIDENCE: The complaints procedure is included in the service user guide. It is clear and easy to follow and available in a range of formats and languages as needed. The service also provides families of service users with a “letting us know what you think” document which gives them a way of communicating their views. The people living at the home have their own meetings which are documented, and individual records also show that their views on all aspects of their home and experiences are listened to, taken seriously and responded to. Staff have received training relating to safeguarding and whistle-blowing, and are aware of their responsibilities in promoting the safety of people they support at all times. Agricola House DS0000072991.V374928.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30: People using the 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 benefit from living in a clean, homely and well maintained environment. EVIDENCE: The home has been purpose built, and as such provides a high standard of accommodation, furnishings and facilities that ensures people have very pleasant private and communal space, including an attractive garden. The environment has been designed to meet the needs of people with physical disabilities. The environment was clean, homely, comfortable and well decorated, and people living at the home are encouraged to personalise their own rooms. Records showed that all relevant health and safety checks, including fire precautions, are carried out as required, ensuring that the environment is safe. Agricola House DS0000072991.V374928.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35: People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing arrangements promote the health and well being of people who live at the home. EVIDENCE: The service adheres to robust recruitment procedures. Staff are only appointed once full and satisfactory information has been received, including references and a Criminal Records Bureau check. Once in post staffs undergo a comprehensive induction and receive training relevant to their roles and responsibilities. The first six months of employment is a probationary period, and the manager clearly uses this period to ensure that the service only retains staff members who are able to work positively to the ethos of the organisation, and for the full benefit of people living at the home. Most staff members have the NVQ qualification at level 2 or 3. There are regular staff meetings and regular individual supervision meetings. Staff were seen to interact in a friendly and respectful way with the people they support. Agricola House DS0000072991.V374928.R01.S.doc Version 5.2 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42: People using the 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 service promotes the best interests of the people it supports. EVIDENCE: The person managing the home at the time of the visit was not registered, but demonstrated the skills, ability and enthusiasm to ensure that the service operates in the best interests of people living at the home. All care records, reviews and safety checks were in order, and individuals receiving a service were being encouraged to develop their skills and independence, and to exercise choice in their daily lives. Regular visits are made to the service by a Quality Assurance Manager, in addition to regulation 26 (provider) visits, to monitor all aspects of quality and service user experience. Regular staff meetings take place, with minutes showing that staff views are listened to. Agricola House DS0000072991.V374928.R01.S.doc Version 5.2 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Version 5.2 Page 19 Agricola House DS0000072991.V374928.R01.S.doc N/A Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Agricola House DS0000072991.V374928.R01.S.doc Version 5.2 Page 20 Care Quality Commission North West Region Citygate Gallowgate Newcastle upon Tyne NE1 4PA National Enquiry Line: 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. 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