Care Home: Astbury View

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What the care home does well Astbury View is a purpose built service registered to offer personal care and support to nine adults with a learning disability and physical disability. Astbury View provided a warm and homely domestic setting for people to live. The service has a Statement of Purpose and the Service Users Guide in place, both documents were detailed in their content and format of pictorial details, thus enabling each person at the service to understand the facilities available to them. Each of the people were provided with a copy of the documents, maintained in their bedrooms. The service has a robust assessment process, this would include agencies and other professionals. People wishing to come to the service have a full assessment of their needs carried out prior to admission to ensure their needs can be met by the service. People using the service were well cared for they were well presented their independence was encouraged during the inspection. Individuals routines continued within the framework of any risk assessments. Arrangements were in place for the continued health, social and personal care needs of the people using the service. People live in a clean, homely and comfortable environment which is maintained to a high standard. The staff spoken with demonstrated their understanding of the needs of the people they care and support at the service. The company and manager have systems in place that ensure that the service is managed safely to a high standard and in the best interests of the people who use it. What has improved since the last inspection? This is a new registration and the first key inspection following the registration. What the care home could do better: This report makes no requirements or recommendations Key inspection report Care homes for adults (18-65 years) Name: Address: Astbury View 81 Turnberry Road Bloxwich Walsall WS3 3UB     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: Wendy Grainger     Date: 0 3 0 8 2 0 0 9 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) 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 Care Homes for Adults (18-65 years) Page 3 of 24 Information about the care home Name of care home: Address: Astbury View 81 Turnberry Road Bloxwich Walsall WS3 3UB 01922496213 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Voyage Limited Name of registered manager (if applicable) Mrs Hayley Whitehouse Type of registration: Number of places registered: care home 9 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: 2. The maximum number of service users who can be accommodated is: 9 The registered person may provide the following category/ies of service only: Care Home Only - Code PC To service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning Disabilities - Code LD (9) Physical Disabilities - Code PD (9) Date of last inspection Brief description of the care home Located on a large estate near to the main A34 into Bloxwich and Walsall. The service is registered to provide care and support to nine adults with a learning disability or physical disability The property has been purpose built and is situated near to local amenities. Car parking space is at the front of the service. The rear garden is screened off from the Care Homes for Adults (18-65 years) Page 4 of 24 Over 65 0 0 9 9 Brief description of the care home shops and provides a grassed and patio area. The internal part of the service premises is modern, homely, tastefully furnished and decorated. Bedrooms were on two levels and offer en-suite facilties in each room. A well maintained kitchen/dining room plus communal space are provided. The Statement of Purpose and Service Users Guide contained the current fees of £1,645/£1,748 per week. Readers of the report may wish to contact the service for any current changes to the fees that may have occurred since the inspection. 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: This key inspection was the first inspection following the registration of the service in February 2009. The inspection was carried out by one inspector on the 3rd August 2009 who used the National Minimum Standards for Care Homes for Younger Adults,(18-65) and the outcomes for people as a basis for the inspection. On arrival we were asked to sign the visitors record, this is maintained for records in the event of a fire and evacuation purposes. Prior to the inspection we had sent to the service the Annual Quality Assurance Assessment (AQAA) this is a self-assessment tool, the completion of the document had been returned to us within the required timescale. The contents were detailed and informative providing an overview of the service, aims and objectives for the future provision of care. The document (AQAA) is a legal requirement and it enables the service to focus on how well outcomes are being met for people who use the service. It Care Homes for Adults (18-65 years) Page 6 of 24 also gives us some numerical information about the service. We spoke and observed the staff on duty and the interaction between the people who use the service. We discussed the food and menus. The care manager provided written information regarding staffing, staff training, and the complaints procedure. Care Homes for Adults (18-65 years) Page 7 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 8 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 9 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. People who wish to move into the service receive all the information they require, they are assessed so that they can be sure the service can meet their needs. Evidence: People who wish to move into the service can access the Statement of Purpose and Service Users Guide located in the front entrance to the service. These documents were combined and in a pictorial format, this enables the people using the service to understand the provision of care and facilities. We saw the assessment for two of the people using the service. Following this assessment the people would be invited to move into the service. Care plans for individuals would commence to add to the already collected information from the assessment. We saw four of the people on this inspection they appeared relaxed and comfortable with the staff who responded to their needs. The admissions processes mean that no person would be admitted to the service without a pre assessment ensuring their needs can be met. 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. Individuals can be assured that their needs can be met, involvement in their daily support was evident when planning the care and support required. Evidence: The services AQAA told us that each person from a combination of assessments will have a tailor made support plan. The service had impressive detailed and structued support plans for individuals. The plans we saw identified there had been consultation with the family, other professionals and agencies. The plans included likes and dislikes, personal needs, health requirements and contact with health agencies including the general practitioner. One person likes shopping, library, animals, and family visits. We saw pictorial evidence for some of the external activities including the Races. The second support plan identified that this person continued their lifestyle as before their move to Astbury View with attendance at a day centre maintaining contact with friends. Each activity and lifestyle has an individual risk assessment, which highlights any Care Homes for Adults (18-65 years) Page 11 of 24 Evidence: needs or risks they may have. Each person has an allocated key worker we observed the positive interaction and the knowledge the carers had of the people holistically and individually. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people using the service are given opportunities to enjoy a fulfilling lifestyle, while maintaining contact with the community, families and friends. Evidence: The services completed AQAA told us that the development and support plans reflect the lifestyle and choice for each individual We evidenced from the daily diaries a well documented social plan including pictorial evidence of activities in the community. Personal preference for care and food monitoring information was contained in the diaries. This information enables staff to have an overview of the persons daily routine at a glance. Each person will be encouraged to eat a healthy diet and will be supported where applicable. The new menus were varied and in a pictorial format, easily displayed in the dining room. We were aware that two people attend a day centre continuing their contact with Care Homes for Adults (18-65 years) Page 13 of 24 Evidence: friends and the community. One person is being considered for a course at a local college enabling his social circle and skills can be extended. 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. The service meets the health and personal care needs of the people using the service. Evidence: The services AQAA we received tells us that staff are encouraged from the onset to provided personal care in a manner, which is acceptable to the individual. This was evidenced in a number of documents including the medication records. All the people are registered with the local Health Centre, the centre caters for all aspects of care including a dentist, district nurse and chiropody. People using the service will be encouraged where necessary to attend the clinic. The service has extensive policies and protocols on the administration of medication, no medication would be administered unless training had been provided. We observed the breakfast medication round, we had no concerns in respect of the staffs knowledge and training for medication. Staff when spoken and from the returned surveys confirmed that training had been provided, this included an in depth exam linked training package provided by the Company. A recent inspection by the Primary Care Trust (PCT) gave the service a 100 review of the systems, storage procedures and administration. Care Homes for Adults (18-65 years) Page 15 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. People can be assured they will be listened to ans safeguarded by the services procedures. Evidence: The services completed AQAA told us that the service has several effective policies and procedures that are designed to protect the people and support them in the event a concern is raised. We received two completed surveys from the people using the service, they told us that while they were not aware how to raise a formal complaint they would communicate concerns to the staff. Staff training records confirmed the comments in the returned staff surveys that they were aware of the process to make a complaint. Staff told us during the insection that they were aware of the whistle blowing policy and would not hesitate to use it if necessary. All the staff had received adult protection training, we saw staff training records that confirmed this. Criminal Records Bureau and Protection of Vulnerable Adults checks were carried out prior to employment. This was confirmed by the staff on duty and within the returned surveys. This ensures that the people using the service are protected. The services AQAA told us that the service had received one compliant since opening. We evidenced numerous correspondence between the parties and company. The issue was dealt with satisfactorily and to the satisfaction of all parties. Care Homes for Adults (18-65 years) Page 16 of 24 Evidence: Finances are audited on a regular basis, we checked the funds held on behalf of two people. Records we looked at were satisfactory. Arrangements were in place for the protection of finances with families, and by the Walsall Council who acts as an appointee for two people. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The design of the service enables people to live in a safe and comfortable environment that is well maintained. Evidence: The services completed AQAA told us that the service Astbury View was purpose built and furnished to a high standard. This was confirmed when we looked around the premises. Bedrooms were of a good size all had en-suite facilities. Fixtures and fittings were of a good quality and high standard. Bedrooms were personalised identifying interests and hobbies displayed on the walls. Located in a busy road, a public house and shops were on the much larger complex and away from the service, which stands in its own grounds. Car parking is at the front of the service, the rear of the service has a small well maintained garden with a patio area for people to enjoy the outside. 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. People using the service can be assured they are safe and supported by a well trained and experienced staff tea. Evidence: The Services completed AQAA told us that they recruit from a variety of backgrounds and experience with a view of developing a team rich in diversity skill and experience. The service was able via records, staff files and documents to evidence the robust recruitment procedure to ensure peoples needs can be met. We observed the rota openly displayed on the notice board, there were sufficient staff on duty during the day to meet the needs of the present group of people. At this time night staffing was one waking and one sleeping. This will change when more people are admitted, further supporting individuals ensuring that their needs can be met. We observed from the staff files that staff when recruited had individual files, which contained Criminal Records Bureau and Protection of Vulnerable Adults checks, applications, references, training records. This robust recruitment process means that the people using the service are protected and safeguarded. The staff spoken with and records seen confirmed that the manager had a system in place for the regular supervision and appraisals completed and planned of the year. Care Homes for Adults (18-65 years) Page 19 of 24 Evidence: We sent out three surveys for the staff to provide us with feed back about the service comments included: The home does everything to a high standard we work as a team, Everyone gives 100 in their work, We have full support, We are like a family. Care Homes for Adults (18-65 years) Page 20 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. People using the service are supported and safeguarded by competent management systems and the staff team Evidence: The manager continues to take training relevant to her role enabling her to support the staff team, she ensures that the policies, audits and supervision of the staff are being operated appropriately. Questionnaires for feedback on the first six months for the service and care provided have been sent to professionals and families. Records and certificates we looked at all told us that safe working practices were in place, records told us that the manager has developed a detailed fire emergency assessment and plan in the event of a fire or emergency. 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. 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. Care Homes for Adults (18-65 years) Page 24 of 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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