Care Home: Berrishill Grove, 26

What the care home does well People living at the home can keep in touch with family and friends.Good information is collected about a new person coming to live at the home so staff can look after them well.There is good staff training to help staff look after people living at the home.There is a good choice of food.The home helps make information easy for people to understand. Everyone has a pictorial dictionary and care plan.The home supports people to have interesting lives. People who live at the home have a holiday every year.People living at the home enjoy a lot of activities and outings outside of the home. What has improved since the last inspection? There is some new kitchen equipment. Some parts of the house have been redecorated. What the care home could do better: A record should be kept every day of all meals provided from the kitchen to people living at the home.Two signatures should be obtained when dealing with residents` money.Training about medication should be updated for all staff who give out medication to people living at the home.A special bath should be provided for the people who need it in the home.The path to the home should be easier to walk on so people don`t fall and for people who use wheel chairs. Key inspection report Care homes for adults (18-65 years) Name: Address: Berrishill Grove, 26 26 Berrishill Grove Red House Farm Whitley Bay Tyne And Wear NE25 9XU two star good service The quality rating for this care home is: 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: Karena Reed Date: 2 3 0 6 2 0 0 9 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should:  Be safe  Have the right outcomes, including clinical outcomes  Be a good experience for the people that use it  Help prevent illness, and promote healthy, independent living  Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home:  3 stars – excellent  2 stars – good  1 star – adequate  0 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. They reflect the things that people have said are important to them: 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 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 Information about the care home Name of care home: Address: Berrishill Grove, 26 26 Berrishill Grove Red House Farm Whitley Bay Tyne And Wear NE25 9XU 01912537212 F/P01912537212 GM.E.NTAWNT.Berrishill@nhs.net 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) : Northumberland, Tyne & Wear NHS Trust care home 4 Number of places (if applicable): Under 65 Over 65 4 0 learning disability Additional conditions: The maximum number of service users who can be accommodated is 4 The registered person may provide the following category 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 category: Learning disability Code LD, maximum number of places 4 Date of last inspection 0 2 1 0 2 0 0 8 A bit about the care home This is a purpose built care home. This means that it is accessible to wheelchair users and other disabled people. Three people live at the home at the moment. There is metro station quite near to the home .There are also lots of different bus routes to the home. The home also has its own car. This means that the people who live at the home can get around easily. Everybody who lives at the home has their own bedroom. This means nobody has to share a room. 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 How we did our inspection: This is what the inspector did when they were at the care home The quality rating for this service is 2 stars. This means that the people who use the service experience good quality outcomes. An unannounced visit was made on June 23rd 2009. During the visit we talked to people who live at the home. We talked to staff who work at the home. We looked at some of the records kept in the office. What the care home does well People living at the home can keep in touch with family and friends. Good information is collected about a new person coming to live at the home so staff can look after them well. There is good staff training to help staff look after people living at the home. There is a good choice of food. The home helps make information easy for people to understand. Everyone has a pictorial dictionary and care plan. The home supports people to have interesting lives. People who live at the home have a holiday every year. People living at the home enjoy a lot of activities and outings outside of the home. What has got better from the last inspection What the care home could do better A record should be kept every day of all meals provided from the kitchen to people living at the home. Two signatures should be obtained when dealing with residents money. Training about medication should be updated for all staff who give out medication to people living at the home. A special bath should be provided for the people who need it in the home. The path to the home should be easier to walk on so people dont fall and for people who use wheel chairs. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Karena Reed St Nicholas Building St Nicholas Street Newcastle upon Tyne Tyne and Wear NE1 1NB 01912333300 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 http:/www.cqc.org.uk/. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535. 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 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. There are good arrangements in place to ensure that prospective residents can make an informed choice about the home and that the home can meet their needs. Evidence: Information was available about the service in their statement of purpose and service user guide. The statement of purpose was reviewed regularly and updated. The service user guide was available in a pictorial format for people who may not understand the written word. The home also plans to produce information about the service in CD and DVD format. Records for the three residents showed that when they were admitted to the home an assessment of their care needs had been carried out before their admission, all these relevant details were recorded and used to create care plans. The person moving into the home and relevant people who knew them were involved in the initial assessment. The assessment form encourages staff to explore issues relating to equality and diversity as it refers to gender ,culture ,religion ,spirituality ,education and social histories, preferred daily routine and preferences. It also looks at mood, speech, behaviour, mental health, risks, sexuality and living skills. This information and the care managers assessment of the residents care needs were used to ensure all the needs of the resident could be met by staff. The records contained a range of information. Residents have the opportunity to visit the home as often as they need in order to decide if they wish to live there. A prospective resident may come for meals, have overnight stays and be introduced to other people living at the home at a pace suitable to the individual. Residents living at the home have lived there for some time and are involved in deciding who may come to live with them when a vacancy occurs. 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. There are good arrangements in place to ensure that residents care and support needs are recorded and to ensure that residents are involved in decision making in their lives. Evidence: There are detailed assessments in the residents care plans. They were all created from the initial assessment. The home supports people living at the home to remain independent and take risks in order to live a more fulfilled lifestyle. Detailed risk assessments were also part of the plan and there was a clear link between plans and risk assessments. Staff are allocated responsibility for a small number of residents and are known as their key worker. The key worker together with the resident is responsible for updating the care plan at least monthly or sooner if a persons needs change. Care plans are person centred, they do show the amount of support that is required to assist the resident in certain areas. The tasks are broken down to give new staff clear instructions about the amount of care and support that is required to assist the resident to become more independent. Residents are asked individually and consulted about decisions involving themselves and the running of the home. Meetings are held with residents about the running of the home, choice of food,activities and outings. Each resident has an advocate from outside of the home to work with them and advise them about any issues. The manager stated in their self assessment, AQAA :Detailed care plans reflect individual needs and choices, staff support service users rights to make choices and are respected by the staff team. All service users have an advocate. All service users are encouraged to attend reviews and Evidence: house meetings. All staff endeavour to consult service users on as many aspects of their care as is possible involving themselves and the running of the home. Residents care records all contained statements of confidentiality to remind staff what information could or could not be disclosed about a resident. 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. Residents have access to a range of activities both inside and outside of the home which helps them to enjoy a more varied life. Residents are also supported to keep in touch with their families. Evidence: Residents records and residents meeting minutes provided evidence that all residents are consulted and asked their opinion and encouraged to make decisions. Information is made available in pictorial, audio and DVD format so people living at the home may be involved and helped to make choices e.g. pictorial menus, care plans and complaints procedure. Observation and conversation with residents and staff show that residents are provided with the necessary levels of support to help the resident maintain some level of independence and retain some skills to be more self sufficient in aspects of everyday living. Residents are encouraged to pursue their own interests and hobbies and are supported to do so, the AQAA stated: Taster sessions for activities are tried by service users to see if they enjoy them prior to enrolment. Activities for individual residents include; trampolining, swimming, cookery, art, music, aromatherapy, walking, shopping, discos. People living at the home also enjoy meals out at local pubs, shopping, barbecues, attending relaxation classes and whatever is of interest to the resident. The AQAA also stated: They enjoy being part of the community and regularly take walks, visit coffee shops, snoezellen, restaurants, shopping centres, museums, pubs and the cinema and Evidence: the theatre. Residents have enjoyed holidays to Yorkshire and Centre Parcs and chalet holidays. They also enjoy days out to the Yorkshire Dales, Whitley Bay, Tynemouth and North Shields. Within the home some residents bedrooms are equipped with their own televisions, radios, books, pictures and whatever is of interest to the resident. Residents care plans and case records detail any family involvement. Conversation with staff and care records also provided evidence that residents are encouraged to maintain contact with family and friends, if they wish to do so, with staff providing any support that may be required. The menu, produced in picture format, provided information about the variety of food available. There was no log held in the kitchen to record the daily food actually provided to residents in case alternatives to the menu were provided. 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. There are good arrangements in place to ensure that residents health and social care needs are met. Evidence: Three care plans and case records were inspected. Peoples health care needs were well documented. The daily records detailed the care and support required for different needs. They reflected the changing needs of residents as they become more independent, or the increased amount of care and support required if a resident is ill. Residents and their key workers up date the care plans every month. Residents do have some moving and handling needs. Specialist equipment is provided, however a specialist bath that is required is still waiting for further assessments to be carried out by external assessors. In the mean time the people do have use of a shower. Service users care records showed that they have access to external health care services. G.Ps also visit when necessary. Service users are referred for specialist health care if appropriate. The AQAA stated: All men attend the well mans clinic annually. Regular appointments are made with opticians, dentist, registered consultant and chiropodist. Referrals to other professionals e.g. physiotherapist and GP appointments are made when needed. Staff medication training is out of date and requires updating. Residents do not administer their own medication however a system could be put in place to oversee the medication of residents if they did retain and administer their own medication. Privacy and dignity issues are built into the homes policies and procedures and staff training. All personal care and medical examination or treatment is carried out in private. Evidence: 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 is a clear complaints procedure and systems are in place to protect residents from abuse. Evidence: There is a comprehensive complaints procedure that includes what complainants should do if they are not happy with the homes investigation and response. All service users have pictorial information in care plans as to how to make a complaint, this is also available in other formats if needed. The home keeps a record of complaints. No complaints have been received since the last inspection. The home has a Whistle Blowing policy and the Local Authorities Vulnerable Adults procedures. Staff have received training about Protection of Vulnerable Adults and Prevention of Abuse. Residents can deposit money for safe keeping in the homes safe and records are kept of accounts. Two signatures were not available in all the records when residents money was handled by staff. 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 provides a comfortable environment for those living there and areas are clean, tidy and free from offensive odours. Evidence: There is a programme of redecoration and improvement around the home. A tour of the home showed that the homely environment was maintained. The home was clean, well decorated and well maintained. Since the last inspection some bedrooms and the kitchen have been decorated, carpet has been replaced in the office. There are plans to decorate the hallway. A new tumble drier, fridge freezer, microwave and oven hob have been purchased. The home has a lounge and dining room and a separate conservatory. There is a well maintained garden at the back of the house with a small green house and garden furniture. Some residents are involved helping grow tomatoes and other garden produce. Residents can see visitors in private in their own rooms. Furnishings and fittings were domestic in design and in good condition. Residents’ bedrooms have opening windows. The rooms were centrally heated. All bedrooms were personalized according to individual taste. There was emergency lighting throughout the home. To the front of the house is a graveled drive which is difficult for people in wheel chairs to cross and also to maintain the independence and mobility of people with walking difficulties. As previously stated the home does not provide a specialist bath as required for the needs of some people who live at the home. The home was clean and free from offensive odours. Evidence: The washing machine has the specified programme to meet disinfection standards. 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. There are enough staff who are appropriately recruited and well trained to meet the needs of the residents. Evidence: The staff roster was checked and showed that staff work long shifts, normally joined morning and afternoon shifts. 7:45 am- 8:15pm 3 - 4 staff members 8:00pm -8:00am 2 waking night staff These numbers include the manager and an enabler who works from 9:00am until 5:00pm. A senior member of staff is on duty on all shifts. Staff members carry out cooking and cleaning duties. Staff stated that they enjoyed working in the home and were observed to be kind, caring and respectful to residents. Staff files were not available on the premises but two colleagues from CQC had recently visited the personnel department to look at staff files for the Trust. The findings have resulted in CQC writing to the Trust about some minor changes. There is a good level of staff training. All of the staff team have National Vocational Qualifications at level 2 or 3. The team leader and two assistant team leaders are registered learning disability nurses. Staff and their records showed that they also receive training or advice in other areas such as infection control, equality and diversity, person centred planning, first aid, fire training,food hygiene,moving and handling and epilepsy awareness. Staff receive regular Evidence: supervision. 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 health,safety and welfare of the residents are promoted and protected. Evidence: The manager has the appropriate qualifications, experience and management skills necessary to manage the service. The manager encourages an ethos of involvement amongst staff and residents within the home. The AQAA stated:The home is well managed and all the staff have very good relationships with the service users and respond well to their needs. The staff team have been in post for some time and there is a pleasant atmosphere within the home and service user needs are a priority. All documentation is well presented and there is a good standard of record keeping. Detailed care plans reflect individual needs and choices, staff support service users to make decisions. Residents living at the home appear to like living there. The health, safety and welfare of residents are promoted and protected. There is a health and safety policy and a range of associated procedures. The staff receive training in health and safety and safe working practices, fire safety, first aid, food hygiene, and infection control. Records as required by the Care Homes Regulations were well documented and completed. Evidence: Are there any outstanding requirements from the last inspection? Yes  No  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 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 Description 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 Description Timescale for action 1 20 18 Staff must receive updated 20/09/2009 safe handling of medication training to ensure the safety of people living at the home. This is required to ensure the health and safety of people living at the home. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 17 18 A record should be kept of all food provided to residents on a daily basis. A specialist bath should be provided to meet the personal and health care needs of people living at the home and to provide them with choice. Two signatures should be obtained where possible when dealing with service users money. The driveway should be made more accessible and not graveled for the use of people in wheel chairs and those 3 4 23 29 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 who walk independently, but who have mobility problems. Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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