Care Home: Amberwood

What the care home does well Young people who use the service have detailed assessments of their needs completed before they move into the service. Plans are in place detailing how the young person needs to be supported in their daily life and how they need to be supported to make decisions in their life. Young people who use the service are supported to take risks as part of an independent lifestyle. Young people who use the service are supported to participate in activities sin the community and take part in activities they are interested in. Young people receive personal support in the way they prefer and have their physical and emotional needs met. The homes policies and procedures for dealing with medicines ensure that young people using the service are protected. There is a system in place to ensure that people can say when they are unhappy. Staff receive the training they need to ensure they understand how to protect the young people using the service from harm. The home is comfortable, clean and reflects the needs of the young people using it. Staff receive the training they need to understand the needs of the young people using the service. The home is well managed. What has improved since the last inspection? This was the first key inspection of the service since it was registered. We inspect new services within six months of registration. What the care home could do better: At the end of this inspection there are no requirements and no recommendations. Key inspection report Care homes for adults (18-65 years) Name: Address: Amberwood 6 St. Osmunds Road Poole Dorset BH14 9JN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Tracey Cockburn     Date: 0 4 0 3 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 24 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 24 Information about the care home Name of care home: Address: Amberwood 6 St. Osmunds Road Poole Dorset BH14 9JN Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Donna Courtis Type of registration: Number of places registered: care home 10 Cambian Education Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability old age, not falling within any other category sensory impairment Additional conditions: The maximum number of service users who can be accommodated is 10. The registered person may provide the following category of service only Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category Learning disability - Code LD Date of last inspection Brief description of the care home Amberwood is registered to provider care and support to young people aged between 16 and 25. The registered provider Cambian Education has a number of other registered services in the area. There are ten bedrooms all en suite. There are two kitchens and two lounges. There is Care Homes for Adults (18-65 years) Page 4 of 24 Over 65 0 0 0 10 0 0 Brief description of the care home an art room an ICT room with interactive white board and another study room. There is public transport nearby with easy access to both the centre of Poole and Bournemouth. There is a small secure garden and patio area. Care Homes for Adults (18-65 years) Page 5 of 24 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: We visited the service without telling them we were coming. We spent five hours at the service looking at information such as care plans, training, health and safety. we spoke to staff who work in the service, the manager and we observed people being supported. In planning the inspection we looked at information sent to us about the service such as notifications about incidents as well as any safeguarding concerns. We looked at information about the service gathered during the registration process. Care Homes for Adults (18-65 years) Page 6 of 24 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 24 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 8 of 24 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. Young people who are considering the service have their needs fully assessed before a decision is made. Evidence: The manager told us that they are proceeding carefully when admitting people to the service to ensure that the transition process is completed properly and that the young people they are considering for the service are compatible with each other. The manager was clear she is in no rush to fill the service quickly and is under no pressure to do so. Services which provide care and support to people aged 17 are required to meet supplementary standards, there are two in this outcome area, the statement of purpose has information in it about arrangements for leaving care and transition into adulthood. The other supplementary standard states each young person has a placement plan. Care Homes for Adults (18-65 years) Page 9 of 24 Evidence: We looked at the care file for one person and could clearly see their placement plan. Care Homes for Adults (18-65 years) Page 10 of 24 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. Young people who use the service have their individual needs clearly recorded. Evidence: We looked at information in one persons care file which detailed how they are supported, the plan was clearly based on their assessments and covered how they will be supported with personal and social support as well as detailing their healthcare needs. The plan also detailed how they need to be supported at times when they are unsettled. We could see that reviews have taken place and people have the choice about their level of involvement in the review, one person did not attend their review but did see a power point presentation of the activities they were involved in. the person was given a copy of the review in a format they could understand. We could see that people are involved in setting goals and they are targeted, focused and time limited. There are communication plans in place for each person using the service that show Care Homes for Adults (18-65 years) Page 11 of 24 Evidence: each persons communication both ability and preferences and a variety of tools are involved to engage the young person in making decisions in their daily life. We looked at the risk assessments for one person, we found them to be detailed and they formed part of an overall strategy to ensure people are able to live a active life in the service. Supplementary standard:Reviews with placing authorities take place and the manager maintains contact with the placing authority. High risk activities are arranged by people qualified to supervise the activity. Care Homes for Adults (18-65 years) Page 12 of 24 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Young people who use the service are supported to participate in activities they might be interested in. Evidence: We looked at evidence of activities taking place in the home and those planned for half term. The manager has made it very clear that staff plan structured activities which are clearly timetables for people using the service. A short term activity planner is used and this is linked to individual goals and interests, the activity planner also considers other factors such as risk, backup plan, resources needed, who will be going on the activity as well as communication aids, medication and equipment. Supplementary standard: young people are supported to develop self esteem, relationships, daily life skills and prepare for the world of work. Individual plans contain details of educational history and progress. Young people are supported to Care Homes for Adults (18-65 years) Page 13 of 24 Evidence: participate in planning events as well as ensuring there is a balance between free and controlled time. During our visit to the service one person had gone out for the morning and two people were in the service participating in activities. During our visit staff were very calm, responded to situations with skill and we observed them being very aware of individuals needs and how the particular behaviour may impact on someone else. We observed staff following guidance in care plans to support people with activities. In one survey form returned by someone who uses the service, the parent had completed the form and stated that X is bored at the weekends several of the survey forms returned by staff made the following comments about activities: more links with local activity more in house activities and things to do on site We looked at photographs of activities which have taken place, each person has a life book which is a record of their participation in activities they are interested in and started when they moved into Amberwood. We looked at the photo record of the activities one person took part in. We could see that activities do take place at the weekend. We spoke to the cook about how meals are planned and how people who use the service are involved. Care Homes for Adults (18-65 years) Page 14 of 24 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. Young people who use the service are supported to meet their health needs. Evidence: We found that information in care plans was very specific in how to support people both when they are calm and when they are unsettled. There was clear information on how to communicate with someone and how to support and communicate effectively when they were unwell. We could see in one care file that the person had clear instructions on how they wanted their morning routine to be including how they like to get up. there was also guidance on their after school and evening routine, structured to meet their needs. We could see evidence of how people are supported to maintain their health and how health professionals are involved in supporting them. We looked at how the home manage medication. All medication requires two signatures, there is a clear audit trail and plans are in place for PRN medication. The manager audits weekly. There is a controlled drugs cabinet. One person takes their medication in some food, this is covert medication, however this is clearly documented Care Homes for Adults (18-65 years) Page 15 of 24 Evidence: in the care plan and a multi disciplinary approach has been taken including identifying the risks to the individual if the medication is not taken. We looked at one care file and could see an Individual behaviour plan in place updated when changes occur, covers general proactive strategies such as simple key words, good eye contract, also details reactive strategies when unsettled, use symbols, give time and space to calm. Also details of behaviours which require a specific intervention plan, such as stripping, self injurious behaviour and physically harmful behaviour, there are proactive and reactive strategies for all three. Supplementary standards: advice about alcohol and illegal substances is available and staff do not smoke in the presence of children. Care Homes for Adults (18-65 years) Page 16 of 24 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. There are systems in place to ensure that concerns are listened to and acted upon. Evidence: Since the service registered there has been one safeguarding alert and investigation which the manager dealt with according to local procedures and their own internal disciplinary procedures. Management have taken appropriate action liaised with the appropriate authorities and ensured the safety of the young person. There is a complaint procedure which is in an accessible format. All staff receive safeguarding training and have demonstrated they understand how to put the training into practice. Supplementary standards: the service has a copy of the local child protection policy and staff are trained in the procedures. There is a policy on bullying and there are written procedures on the action to take if a child is absent from the home. Care Homes for Adults (18-65 years) Page 17 of 24 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 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 been created and designed to meet the needs of young people. Evidence: Tour of the building, extremely well decorated to a very high standard and specifically for young people with a high level of support needs. Rooms are light and airy and the lighting changes colour. There is lots of space for people to calm when they need to and a variety of communal rooms for activities, ICT and studying. One of the registered bedrooms is currently being used as a staff room and there is a suggestion that this will continue. Home very clean, no odours, liquid hand gel used and paper towels available however the paper towel dispensers have not arrived. Home can be split into two units if necessary but when 10 people are using the service they will have access to all the communal spaces. Supplementary standards; there is space for study. Care Homes for Adults (18-65 years) Page 18 of 24 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. Staff are competent and skilled to meet the needs of young people with complex needs. Evidence: All staff complete a two week induction in which all mandatory training is covered as well as communication, nutritional awareness, signalong, ICT and sensory room training, Positive behaviour support is a two day course as well as diversity, mental capacity act. We randomly selected two staff files, recruitment information is kept off site but all supervision, professional development evidence and disciplinary action is kept on site. A record is kept of all application documentation including CRB POVA 1st, references. All staff receive supervision and during their probation they meet with management every two weeks. We spoke to one person who said they were very proud of the staff team and someone else said staff work exceptionally well together Supplementary standards: staff are working towards NVQ level 3 caring for children and young people. Staff left in charge must be at least 21 and induction must include guidance on child protection. Care Homes for Adults (18-65 years) Page 19 of 24 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 well managed. Evidence: Regulation 26 visits are completed my a senior person in the organisation. The manager completes spot checks and these are done in the evenings, during the night, early mornings. The manager is registered with the commission, is experienced and understands her role and responsibility well. We looked at the fire records, they were up to date. There was a clear record of routine maintenance and when it is completed. There is a quality assurance process in place. Staff are up to date with all mandatory training. Windows are restricted on the first floor. Care Homes for Adults (18-65 years) Page 20 of 24 Evidence: Supplementary standard: home must keep additional information required by childrens homes regulations schedule 3. Care Homes for Adults (18-65 years) Page 21 of 24 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 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 23 of 24 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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