Care Home: Bishops Way

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What the care home does well There is a detailed and informative Statement of Purpose and Service Users Guide that gives prospective residents and their representatives the information required to enable them to make an informed choice about where they live. This is also available in an specially formatted style if required. Residents have access to a very varied programme of interesting and stimulating activities making full use of their local community and attending the home`s day service activities. There are robust admission processes to the home. A full needs assessment and transition document by a competent person is undertaken and they are assured in writing that their needs will be met before they move in. Some residents were able to confirm that they visited the home prior to moving in. The menus evidence a well thought out balanced diet with a varied choice of food in line with residents` preferences. A comment received was ` The food is good and I enjoy it`. Quality assurance systems are in place which enables the service to monitor and improve their service and ensure that the home is run in the best interests of residents. Comments received included: `The staff are great`. There is an open-house policy which welcomes visitors at all reasonable times. Satisfactory arrangements are in place to safeguard residents finances. Staff provision is well maintained with a robust recruitment practice being followed and appropriate numbers of suitably qualified staff working in the home. The atmosphere of the home is pleasant with good interaction seen between residents and staff. What has improved since the last inspection? Five requirements were made at the last key inspection which were reviewed and found to have been met. Medication practices were safe and competent ensuring that the residents health needs are protected and promoted. Recruitment practices were robust and thorough and safe guard the residents. Care plans and risk assessments included personal goals and were upto date and current. What the care home could do better: There were no requirements made at this inspection. The monthly reviews of residents needs were discussed and it was acknowledged that some do not contain all the information necessary. Key inspection report Care homes for adults (18-65 years) Name: Address: Bishops Way 36 St Peters Road St Leonards-on-Sea East Sussex TN37 6JQ     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: Deborah Calveley     Date: 1 7 1 2 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 27 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 27 Information about the care home Name of care home: Address: Bishops Way 36 St Peters Road St Leonards-on-Sea East Sussex TN37 6JQ 01424720320 01424421684 admin@newdirections.gb.com www.newdirections.gb.com New Directions (St Leonards on Sea) Ltd care home 4 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) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 4. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Brief description of the care home Bishops Way is a care home providing social and residential care for four young adults with learning disabilities, in particular those with Prader-Willi syndrome and some behaviours that can be challenging. The home is owned by New Directions (St Leonards on Sea) Limited. It is situated in a quiet residential part of St. Leonards-onSea and is close to shops and a bus route into Hastings town centre. The house is a two storey- property. There is a garden to the rear of the property with a workshop for day service activities. There is a communal lounge and a separate dining room. In addition there is a small conservatory, which could be used as a smoking area. Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 4 1 3 0 2 2 0 0 9 Brief description of the care home Inspection reports can be read at the home and reference to how to obtain a copy is also made in the homes statement of purpose. Care Homes for Adults (18-65 years) Page 5 of 27 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 reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term service user to describe those living in care home settings. For the purpose of this report those living at Bishops Way will be referred to as residents. This was a key inspection that included an unannounced visit to the home and follow up contact with residents representatives and visiting health and social care professionals. This unannounced inspection was carried out over two days totally 6 hours on the 15 and 17 December 2009. There were 4 residents living in the home on those days. The purpose of the inspection was to check that the requirements of previous inspections had been met and inspect all other key standards. During the inspection visit, a range of documentation was viewed. These included the Service Users Guide, Statement of Purpose, care plans, medication records and recruitment files. Four members of the care team were spoken with in addition to discussion with the registererd manager, Miss Walling. Care Homes for Adults (18-65 years) Page 6 of 27 An Annual Quality Assurance Assessment was received completed in full prior to this key inspection. Care Homes for Adults (18-65 years) Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: There were no requirements made at this inspection. The monthly reviews of residents needs were discussed and it was acknowledged that some do not contain all the information necessary. Care Homes for Adults (18-65 years) Page 8 of 27 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 9 of 27 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 10 of 27 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. Prospective residents and their representatives receive the information they need in respect of the homes facilities in a format that is easily understood. Evidence: The home has a detailed Statement of Purpose and Service User Guide in place that gives prospective service users the information they require to make an informed choice of where to live. These documents are updated and reviewed regularly. All of the people who use the service have a copy of their terms and conditions of residence in their personal care file. These evidenced that the room allocation and the fees charged are discussed and confirmed before admission to the home. These documents are signed by the individual confirming acceptance. There are four people using the service at this time of both sexes and varying ages from 18 years to 60 years of age. All the people who choose to live in the home have a detailed transition document in Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: place before admission. This document contains detailed information in respect of the persons individual needs to ensure a smooth transition in to the home and provides staff with pertinent information. Care Homes for Adults (18-65 years) Page 12 of 27 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. Residents are involved in all aspects of life in the home. They are offered opportunities to participate in the day to day running of the home. The residents each have a support plan with risk assessments in place that ensures that their changing needs and personal goals are monitored are updated. Evidence: The homes care documentation ensures that the needs and goals of the residents are identified clearly and reviewed on a regular basis in individual files. There was evidence that the plans of care and their risk assessments for daily living are drawn up with input from each resident. From talking with the residents and staff and from the documentation viewed it was evidenced that the residents are supported and enabled to make decisions and choices in their everyday lives within a risk assessment framework. This enables them to maintain their independence. Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: When the home employ new staff all the residents are involved in the selection process and help to choose the member of staff that they relate to. There is a daily handover which is used to pass on information between shifts and staff and concentrates on any changes or behavioral changes that may have occurred. The key workers write a report on each resident on a regular basis and these are then used towards the monthly review. Discussion took place about the content of the monthly review. Some were seen to be only mentioning a particular problem without mentioning the whole person and this is something that is in need of expanding. This was acknowledged and will be undertaken during staff supervision and training. Residents meetings are held regularly and records showed that each of the residents had either suggested changes that they would like or asked for new food choices or new opportunities such as going to a club. There is now written evidence that the issues raised had been addressed. There is a keypad lock on the front door to the home. This is clearly stated in the Service User Guide and residents and their families are advised of this prior to admission. One resident has been assessed as being able to go out independently for short periods and this is clearly documented within his care plan. There is also documentation that evidences that the use of a key pad for the front door has been discussed with his family and does not impinge on his rights. The homes policy on confidentiality is included in the Service User Guide. There is also a detailed policy for staff in the homes policy and procedure manual. Care Homes for Adults (18-65 years) Page 14 of 27 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 are enabled to participate in a wide range of varied and stimulating activities to meet their individual needs. Evidence: The home staff ensure that each resident is treated as an individual and are responsive to their culture, religion, age, disability, gender and sexual orientation. All the residents have a busy and fulfilling lifestyle and attend a variety of activities inside and outside the home. There is an activity room in the garden of the home which the residents use for a variety of craft and activity sessions. Residents talked of the cards and presents they were making for Christmas and birthdays. The care plans evidence daily activities and these included exercise sessions, swimming and gym work. Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: Residents are supported and encouraged to develop friendships with the residents from other services within the organisation and there are regular opportunities for them to meet socially. On the day of the first site visit the residents were all going to a Christmas party of which they were all looking forward to. Some of the residents attend a gateway club on a regular basis. There is a pub night once a week and also visits to the cinema. The residents had also recently attended a pantomine at a local theatre. The home has a people carrier that is used for transporting residents to and from activities in the community. Residents are enabled to keep in touch with family, friends and representatives and the home supports them to join family for holidays and visits. All the residents were going away to stay with family over the Christmas hoilday. The home ensures that residents dignity and rights are respected in their daily life and this was demonstrated by the interaction observed during the visit to the home. The home has developed a structured plan that ensures that all of the residents have a house day when they spend some time doing cleaning tasks around the home and helping with meal preparation. In addition they also do any personal shopping which is needed. The home have a menu that rotates on a four weekly cycle and includes a choice of main meals which offers a vegetarian option. The meals are monitored for their calorific content and this is something that is audited regularly. Residents are offered a cooked breakfast once a week. The menus viewed demonstrated that the residents have healthy, well presented meals and snacks at a time and place to suit them individually. Care Homes for Adults (18-65 years) Page 16 of 27 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. Residents are protected by the systems in place to manage their healthcare needs. Evidence: The care plans are comprehensive and ensures that the residents receive personal support from staff in the way that is individual. There is clear guidance for staff to follow in ensuring that residents needs are met in a consistent manner. The organisation have provided procedures that staff have easy access to ensure they can competently and safely meet residents physical and emotional health needs. Residents weights are monitored and recorded regularly and are also displayed in a graph form so it can be discussed and reviewed with the individual resident regularly. The care plans evidenced that the home staff support the residents to access health professionals as necessary. The medication practices in the home have been reviewed and improved since the last key inspection and there are clear records kept of changes to the residents medication. The home have risk assessed residents as to their capabilities of administrating their own medications. There are clear procedures in place for dealing Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: with medication that is provided when residents are away from the home. This inspection demonstrated that the management of medication is safe and competent. Care Homes for Adults (18-65 years) Page 18 of 27 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. The home has a formal complaints system with evidence that residents feel that their views are listened to and acted upon. Staff receive training to protect residents from abuse. Evidence: There is a detailed procedure in place in relation to complaints. There is also a simplified version in place, a copy of which is included in the service user guide. Records showed that the complaints received have been dealt with appropriately clearly recorded along with any action taken as a result. There is a detailed procedure in place in relation to the protection of vulnerable adults. All of the staff team receive training in safeguarding vulnerable adults. The staff members spoken with were clear about what types of issues would need to be reported and were fully aware of whom they should be reported to. Care Homes for Adults (18-65 years) Page 19 of 27 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. Bishops Way provides a comfortable, well maintained, clean and safe environment for those living in the home and visiting. Evidence: The home meets its stated purpose and provides a comfortable clean and homely environment for those who live there. It is decorated to a good standard and is well maintained. Residents are able to choose colour schemes and personalize their rooms with their own belongings and furniture. The home has sufficient communal areas to meet the needs of the people who live there. They have a good sized lounge with a separate dining room. Leading from the dining room there is a small conservatory which has been designated as a smoking area if required. The residents are encouraged and supported to do their own laundry within a risk assessment framework. The Statement of Purpose states that the kitchen is kept locked. Residents can use the kitchen facilities with staff supervision and on their house days they assist with meal. Care Homes for Adults (18-65 years) Page 20 of 27 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 sufficient trained and competent staff on duty at all times to meet the assessed needs of the residents. Robust recruitment procedures and appropriate staff training ensure the safety and protection of residents. Evidence: From direct observation and from viewing the staffing rota, it evidenced that there were appropriate numbers of suitably trained and competent staff on duty over a 24 hour period to care for the people who live in the home. The fire safety risk assessments and resident dependency levels are taken into consideration when reviewing staffing levels at night. It was confirmed by Miss Walling that there is flexibility of the staffing levels and they are adjusted according to the changing needs of the residents. A selection of staff recruitment files were viewed and demonstrated that there is a thorough and robust recruitment process in place to protect their residents. The documentation in the files supported the information supplied in the Annual Quality Assurance Assessment (AQAA) that all staff receive a thorough induction to the home. All new staff complete a trial period to ensure that the job is suitable for them. Staff spoken with said that training opportunities are good and interesting. Miss Walling follows a training matrix which enables the management team to track the training needs. This ensures that all staff receive the training required to perform their job competently and therefore promoting the health and well Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: being of the residents living in the home. There is an induction programme in place and has been introduced for all staff. Files seen confirmed this. The induction and foundation training is in line with the Skills for Care guidance. As previously stated all new staff are required to complete an initial induction programme and undertake mandatory training including fire and health and safety. This leads into foundation training in preparation of National Vocational Qualification (NVQ) training. Staff working in the home have received training in prader-willi syndrome and other health related illnesses. All staff receive supervision on a monthly to two monthly basis and a staff member spoken with stated that they are well supported. It was acknowledged that supervision is slightly behind at present, but this is being dealt with. Care Homes for Adults (18-65 years) Page 22 of 27 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 overall management of this home is good with effective systems in place to protect residents. Evidence: Miss Walling, the registered manager has been in post since the home opened in 2008. She has the necessary qualifications and experiance to run the home effectively and has completed the NVQ level 4 and the Registered Managers Award. There are systems in place to monitor the quality in the home and include the use of questionnaires. It was confirmed that these are audited, reported on and responded to. There are resident/relative meetings and staff meetings which are minuted and form part of the quality assurance system. The complaints received are also audited and responded to. The home receives an unannounced visit each month from a member of the senior management team who then reports to the director on the running of the home. Record keeping was thorough and showed that a wide range of areas had been assessed and reported on. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: The arrangements in place for the management of residents finances were discussed and records were seen in relation to residents monies. All records seen were in order and receipts kept. All policies and procedures are updated regularly. The home provided an annual quality assurance assessment in advance of the inspection and within the assessment there was evidence that the home is ensuring that all equipment is tested and serviced regularly. Care Homes for Adults (18-65 years) Page 24 of 27 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 25 of 27 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 26 of 27 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 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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