Care Home: Ayresome Terrace

What the care home does well People and their families are encouraged to visit the home prior to admission. They are encouraged to stay for the day before making a choice. People are happy living at the home and were very positive about the care on offer. Comments included, "I`m very happy here", "the staff are good", " they are my friends". Staff have attended training which has provided them with information about how to make sure people are protected. Staff have good knowledge of the care and support needs of the people who use the service. They interact well and communicate well with people who use the service. They show warmth and a positive approach. They are also good at encouraging people who use the service to be more independent. What has improved since the last inspection? Staff flexibility enable people to go out in the evening and stay out for as late as they want. They are regular family contact maintained through one to one activity worker. They recognise each person`s capabilities and encourage them to participate in household chores. Health and safety checks are undertaken regularly, new bathroom suite and flooring fitted and a new washing machine provided. The home has been successful in recruiting and retaining staff ensuring stability for people living there. What the care home could do better: Information about the home should be produced in an easy read format. This would make it a lot easier for people using the service to understand more about the home and organisation. Care plans should show that all agreed actions are followed through. This would ensure people`s needs are not overlooked. Care plans should be written clearly and easy to read so staff are clear what care is to be given. The complaints procedure would benefit people who use the service more if it was produced in an easy read/using photos format. The complaints procedure needs to be updated to give current contact details for people to make complaints to organisations other than the home. The manager should make sure staff have regular supervision meetings to give them the support to carry out their jobs properly. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Ayresome Terrace 17 Ayresome Terrace Leeds West Yorkshire LS8 2BJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Frederick Rawlins     Date: 2 9 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. 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. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 25 Information about the care home Name of care home: Address: Ayresome Terrace 17 Ayresome Terrace Leeds West Yorkshire LS8 2BJ 01132888848 01132888848 ayresometerrace@c-i-c.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Community Integrated Care care home 4 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: Date of last inspection Brief description of the care home 4 Ayresome Terrace is a large detached house in a residential area made up of similar houses. There is nothing to show that it is a care home. Care is provided for four younger adults who have a learning disability. Accommodation is provided on two floors, each person having their own bedroom. There is a lounge, dining room and a quiet room for the use of the people that offer a comfortable and safe space for them. Bathing and showering facilities are available. The home is close to local amenities and is accessible by public transport. Information about the home can be found at the company head office Community Integrated Care and at the home. Care Homes for Adults (18-65 years) Page 4 of 25 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: The quality rating for this service is two star (2*). This means that people that use the service experience good quality outcomes. A visit was made on 29th April 2009 from 08:30 to 16:00. The home did not know that this was going to happen. The inspection was conducted in the company of the manager. Feedback was given to her at the end of the visit. The purpose of the visit was to assess what progress the home had made and the impact of any changes in the quality of life experienced by people living at the home. Before visiting the home we asked for information from the manager (the Annual Care Homes for Adults (18-65 years) Page 5 of 25 Quality Assurance Assessment - AQAA) which asks about what policies and procedures are in place and when they were last reviewed, when maintenance and safety checks were carried out and by who, menus used, staff details and training provided. The methods used during the inspection included talking to people who live in the home, staff, manager and relatives visiting at the time. Care records were looked at and a tour of the home was carried out. At the time of writing this report, the fees charged for care provided ranged from 498 pounds to 508 pounds per week. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the care home does well: What has improved since the last inspection? What they could do better: Information about the home should be produced in an easy read format. This would make it a lot easier for people using the service to understand more about the home and organisation. Care plans should show that all agreed actions are followed through. This would ensure peoples needs are not overlooked. Care plans should be written clearly and easy to read so staff are clear what care is to be given. The complaints procedure would benefit people who use the service more if it was produced in an easy read/using photos format. The complaints procedure needs to be updated to give current contact details for people to make complaints to organisations other than the home. The manager should make sure staff have regular supervision meetings to give them the support to carry out their jobs properly. Care Homes for Adults (18-65 years) Page 7 of 25 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.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 25 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 25 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 use the service can be sure that the home will meet their needs following assessment. Also written and verbal information provides enough information for them to decide whether the home will meet their needs. Evidence: The Statement of Purpose, which provides information on the services provided by the home, is available from the manager of the home. The information would benefit people who use the service and any people thinking of using the service if it was produced in an easy read format. People using the service said they were very happy with the home. One said, I like it here another said Its great here. The needs of people who use the service have been assessed before they moved in to the home. The assessment used covers all aspects of daily living. Care plans are then drawn up from any needs that are identified. People who use the service had also had Care Homes for Adults (18-65 years) Page 10 of 25 Evidence: a re-assessment carried out, if their needs had changed. In the AQAA (Annual Quality Assurance Assessment) the manager said meetings and visits are held at the home to enable new people to meet staff and to explore compatibility with other people to see if that person would want to live in the home. Care Homes for Adults (18-65 years) Page 11 of 25 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. Staff are aware of the individual needs of people who use the service. Evidence: Each person who uses the service has a pen picture, which gives some good information on the person as an individual. It includes some person centred information on peoples history, background and some of the things that are important to them. Care plans have been reviewed at regular intervals. However it ts not always clear who has carried out the review and what has been considered during the review. It was also not clear that things identified at the review are actioned. Example after a review the home wrote to a social worker about a persons contact with his father, there were no evidence of this been followed up. A lot of the information from reviews are hand written and are not always easy to read. A good support plan should give clear and detailed information on how and when care is given, taking particular notice of the Care Homes for Adults (18-65 years) Page 12 of 25 Evidence: peoples preferences and choices. Risks to people who use the service have been identified and assessed. Staff have good knowledge of most of the care and support needs of the people who use the service. They were able to accurately describe the care they give and talk about the detail of how people like to be supported in their daily routines. People who use the service were offered choices throughout the day, around what to do or what to eat. Staff interactions with people were very good. Staff showed warmth and a positive approach to people who use the service. Staff gave good examples of what they do to make sure people who use the service are encouraged with their independence. Care Homes for Adults (18-65 years) Page 13 of 25 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 home offers opportunities to people who use the service for personal development in addition to a range of leisure activities. People who use the service are able to make choices about their lifestyle. Evidence: Staff said that people who use the service have a variety of activities that they are involved in within their local community. This includes day centres, shopping, meals out, going out to the pub and going to shows. In the main, staff said they felt there were enough staff to make sure people who use the service get a good level of activity. People who use the service are supported to keep in touch with family and friends. Some people who use the service have regular visitors to the home. Others are Care Homes for Adults (18-65 years) Page 14 of 25 Evidence: supported to keep in touch by making by making phone calls. In a returned survey, a relative said Ayrsome Terrace is a good care home, we have regular contacts with our son and he comes home for visits Menus are developed based on the likes and dislikes of people who use the service. They are well balanced and nutritious. A good variety of good is available. People who use the service said they enjoyed the food. People also said they could always have something different if they didnt like what was on the menu. Care Homes for Adults (18-65 years) Page 15 of 25 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. Healthcare needs are met and practices regarding medication administration are safe. Evidence: Care plans have details of the personal and health care needs of the people who use the service. Staff have a good awareness of the personal care, and likes and dislikes of the people who use the service. They were able to talk about the way in which people liked to be supported. Staff were seen to offer support to people with their personal care needs in private and with dignity. The support plans have details of any health professionals that people who use the service see. These include the General Practitioner (GP) dentist, specialist nurse and optician. Good records are kept of any health appointments and their outcome. Medication records sheets were looked at. There were no errors in the recording of medicines that had been administered. Care Homes for Adults (18-65 years) Page 16 of 25 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 who use the service and their relatives have their views listened to, taken seriously and acted upon. Staff are aware of how to protect people from abuse. Evidence: The home has a complaints policy, which provides staff with the procedures they should follow if a complaint is made. The complaints procedure would benefit people who use the service more if it was produced in an easy read/using photos format. People who use the service, who were spoken to , said they would tell staff if they were unhappy. The complaints procedure also needs to be updated to give current contact details for people to make complaints to organisations other than the home. The home has not received any complaints since the last inspection. There is an adult protection policy and a whistle blowing policy in the home. The adult protection policy include information on what staff must do in the event of an incident or allegation of abuse being made. Care Homes for Adults (18-65 years) Page 17 of 25 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 home enables people to live in a safe, and comfortable environment, which encourages independence. Evidence: The home was clean and homely, providing sufficient space for people. Bedrooms have been decorated and furnished to suit individuals and their interests and personality. The last person admitted to the home said he chose the decor and furniture for his bedroom. The home is nicely decorated and has furniture and furnishing to a good standard. A maintenance officer makes sure any maintenance work is attended to promptly. Communal areas were clean and there were no odours noted. Staff said people are encouraged to help with the housework particularly in their own bedrooms. Clinical waste is properly managed and staff wear protective clothing when attending to the personal care needs of people who use the service. Care Homes for Adults (18-65 years) Page 18 of 25 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. Proper recruitment checks are made to make sure that people are safe and staff are suitable to work with people needing care. However staff are not always supervised to ensure they fully meet the needs of the people who use the service. Evidence: There are staff on duty throughout the day and night. In discussions with people they all confirmed that the staff are good. Comments from them were; my friends takes me out. There was a good up beat atmosphere with staff and people living in the home. Recruitment is properly managed; interviews are held, references and CRB (Criminal Record Bureau) checks are obtained before staff start work and checks are made to make sure staff are eligible for work. Staff said they felt they had a good team and the manager is very supportive. Some staff have had supervision from the manager in the form of one to one meetings. Records showed that this was fairly infrequently. The manager should make sure they have regular supervision meetings to give them the support to carry out their jobs properly. Care Homes for Adults (18-65 years) Page 19 of 25 Care Homes for Adults (18-65 years) Page 20 of 25 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 adequately managed. The interests of the people who use the service are seen as important by the manager and staff. Evidence: The homes manager is currently going through the registration process with the CQC (Care Quality Commission) and is also due undertake NVQ (National Vocational Qualification) level 4 registered managers award. Staff spoke highly of the support they receive from the manager. They said she is approachable. They also said she is a good leader and deal well with any matters in the home. The home holds money in safekeeping for a number of people. Only senior staff deal with peoples personal finances and receipts are obtained for any items purchased on their behalf. We checked a number of transaction sheets and no concerns were raised. This means that people can be confident that the system is safe and well managed. Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: Policies and procedures are in place to ensure the health and safety of people living at the home, visitors and staff, which are audited on regular basis to make sure that they comply with changes in legislation and good practice guideline. The home employs a maintenance officer who does regular health and safety checks around the home. This involves identifying any hazards and testing water temperatures to see they are safe. Care Homes for Adults (18-65 years) Page 22 of 25 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 23 of 25 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 1 1 Information about the home should be produced in an easy read format. This would make it a lot easier for people using the service to understand more about the home and organisation. Care plans should show that all agreed actions are followed through. This would ensure peoples needs are not overlooked. Care plans should be written clearly and easy to read so staff are clear what care is to be given. The complaints procedure would benefit people who use the service more if it was produced in an easy read/using photos format. The complaints procedure needs to be updated to give current contact details for people to make complaints to organisations other than the home. The manager should make sure staff have regular supervision meetings to give them the support to carry out their jobs properly. 2 6 3 4 6 22 5 23 6 36 Care Homes for Adults (18-65 years) Page 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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