Care Home: Bon Secours

What the care home does well Each person has an assessment and there is good information forming the basis of the individual support plan.People said they have a good lifestyle.The people living in the home and their families are supported very well to keep in touch with each other. Their families said that they they think the staff look after the people living in the home well.The home is well organized and the people living there said it is comfortable. People can arrange their bedrooms the way they like. There is a good range of training for the staff so that they can support the people living in the home well. What has improved since the last inspection? The home now has a registered manager who is talking to the people living in the home and looking at developing it. The times the staff work has changed. This is so that they can support the people living in the home better.The staff have had some training from the manager about keeping records. What the care home could do better: People need to do more for themselves with help rather than have things done for them.Individual goals need to be set as part of the continuing person centred planning.Risk assessments and guidelines need to be developed to include social situations and relationships with people with regard to known behaviours.The manager talked about his plans to develop the home and these were the same as the things we have written in this report. He is writing a new development plan so that everyone can see what is planned and when it will happen. Key inspection report Care homes for adults (18-65 years) Name: Address: Bon Secours 250 Middle Deal Road Deal Kent CT14 9SW 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: Julie Sumner Date: 1 1 0 9 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 Care Homes for Adults (18-65 years) Page 2 of 31 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 31 Information about the care home Name of care home: Address: Bon Secours 250 Middle Deal Road Deal Kent CT14 9SW . Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Family Care Homes Ltd Name of registered manager (if applicable) Mr Michael Britton Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 3 0 care home 3 learning disability Additional conditions: The maximum number of service users who can be accommodated is: Three (3) The registered provider 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 category/ies: Learning Disability - LD Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 31 A bit about the care home Bon Secours is a small three bedroomed house in the town of Deal. It is registered for people with learning disabilities. Three people can live there. The house is near the town. There is a space for a car to park in the front of the house. There is other parking along the street. Care Homes for Adults (18-65 years) Page 5 of 31 There is a garden at the back of the house that is arranged so that people can sit out and also do some gardening. It costs around £700 to £800 a week to live there. Care Homes for Adults (18-65 years) Page 6 of 31 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 Care Homes for Adults (18-65 years) Page 7 of 31 How we did our inspection: This is what the inspector did when they were at the care home The manager sent us an annual quality assurance assessment (AQAA) which tells us about the service provided, what improvements have been made and how they plan to develop it further. The AQAA was clearly written giving us a good range of information. We talked to the manager about including more detail in the AQAA next time. We sent 2 surveys out to the people living in the home and 6 to the different people who are involved with them. We received 5 surveys back which was a good response. We visited the home without telling anyone we were coming so that we could see what they do on a usual day. We were in the home from 10.30 in the morning to around 2 oclock. Care Homes for Adults (18-65 years) Page 8 of 31 We talked to all the people living in the home. We talked to the manager and the staff who were working that day. We had a look around in the house and outside. We looked at some of the policies and procedures. We looked at plans and records for supporting the people living in the home. Care Homes for Adults (18-65 years) Page 9 of 31 What the care home does well Each person has an assessment and there is good information forming the basis of the individual support plan. People said they have a good lifestyle. The people living in the home and their families are supported very well to keep in touch with each other. Their families said that they they think the staff look after the people living in the home well. Care Homes for Adults (18-65 years) Page 10 of 31 The home is well organized and the people living there said it is comfortable. People can arrange their bedrooms the way they like. There is a good range of training for the staff so that they can support the people living in the home well. What has got better from the last inspection The home now has a registered manager who is talking to the people living in the home and looking at developing it. The times the staff work has changed. This is so that they can support the people living in the home better. Care Homes for Adults (18-65 years) Page 11 of 31 The staff have had some training from the manager about keeping records. What the care home could do better People need to do more for themselves with help rather than have things done for them. Individual goals need to be set as part of the continuing person centred planning. Care Homes for Adults (18-65 years) Page 12 of 31 Risk assessments and guidelines need to be developed to include social situations and relationships with people with regard to known behaviours. The manager talked about his plans to develop the home and these were the same as the things we have written in this report. He is writing a new development plan so that everyone can see what is planned and when it will happen. If you want to read the full report of our inspection please ask the person in charge of the care home Care Homes for Adults (18-65 years) Page 13 of 31 If you want to speak to the inspector please contact Julie Sumner CQC South East, Citygate, Gallowgate Newcastle upon Tyne, NE1 4PA or Telephone the National Contact Centre: 03000 616161. Fax - 03000 61 61 71 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 14 of 31 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 15 of 31 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. Admissions are not made to the home until a full needs assessment has been carried out. Evidence: The statement of purpose and service user guide has been redesigned and updated. The design is simplified with clear sections. The service user guide also includes pictures and photos. Both documents can be modified and different versions can be created to meet different peoples needs if they are considering moving to the service. We talked to the people living in the home about their experiences of moving into the home. They were both happy with how they were supported to make the choice of moving in. We looked at one of the assessments. They are designed so that the person can be involved in their own assessment. The language is straight forward and there are pictures and spaces to insert photos to assist with their understanding. The people living in the home are given the opportunity to meet and get to know prospective people before they move in. Care managers and learning disability nurses Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: have been involved in the assessments of the people living in the home. Care Homes for Adults (18-65 years) Page 17 of 31 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. Each person has a person centred plan with some good information to support their personal care. People are helped to stay safe carrying out their day to day activities and would benefit from further support to develop their independence. Evidence: We talked to the people living in the home about their care plans. One person showed us theirs and we looked at it together. The plans are set out in a way that the people living in the home can understand. The assessment part of the person centred plan has been completed. The assessment says whether an individual can carry out a task independently or whether they need support. At the time of the visit the guidelines of how each person needs to be supported by the staff have not been written. Also there are no goals written in the plan. We talked to the manager who explained that the plans have recently been reviewed and they are in the process of talking to each person to find out what is important to them. From this they will decide on the goals that each person wants to achieve first and write the guidelines for staff support. The people living in the home said they are supported Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: well by the staff and their care managers to decide what they want to do. Risk assessments have been carried out for the activities that are currently participated in and there are guidelines for staff to minimise the risks identified. A simplified risk assessment format called My understanding of health and safety is also included in the new person centred plan. This is set out in a way that can be more easily understood by people living in the home. We talked to the manager about the areas that the current risk assessments cover because these need to be expanded. The manager agreed that the risk assessments need to be expanded to include developing skills and social situations for the protection of the people living and working in the home. The manager has plans to do this and complete the next stage of the care plan. Care Homes for Adults (18-65 years) Page 19 of 31 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people in the home are supported to lead active lifestyles and helped to keep in touch with their families. Good quality meals are served. Evidence: The people living in the home talked about their lifestyle. One person can go out independently at times along with the other planned activities. One person explained some of the things they do at the company day centre at Eastry during the week. These were a mixture of activities developing daily living skills and some educational skills like numeracy and literacy as well as creative activities. They said they like going out into the town shopping and meeting with some of their friends. During the afternoon both the people living in the home went out. People talked about their families and said they are supported to keep in touch with them as much as they want. People who are important to them are written in their care and support plan with the contact details. Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: The meals are home cooked and times vary depending on what everyone is doing. A new menu had recently been completed. One of the people living in the home explained that they were developing an understanding of health eating and this had been taken into consideration when planning the menu. The manager explained that he plans to develop the philosophy of the home so that people are encouraged to be more independent. This will include cooking their own meals with support. He is currently writing the new development plan to reflect this. Care Homes for Adults (18-65 years) Page 21 of 31 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. People who live in the home are supported and helped to be more independent with their personal care. They benefit from good health care support and are able to access community health care services. Evidence: The people in the home talked about the support they have with their personal care and health care. One person spoke about healthy eating and about plans they have to improve their health. We looked at both health action plans. They contain clear information about the health needs of each person with lists of appointments attended and any plans for treatment or further check ups. Information about medication that people are prescribed is in their health action plan. There is general information and the medication administration procedure in a folder in the office. The home uses a monitored dosage system and all the staff have received medication training. The people living in the home are aware of the medication they are on and what it is for. At this time they do not administer it themselves. Care Homes for Adults (18-65 years) Page 22 of 31 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 feel that the staff listen to them and their views are taken into consideration. Evidence: The company has produced a complaints policy in various formats to assist people with learning disabilities to understand. The people living in the home said they felt well supported by the staff. They also said if they need to they can talk to their care manager and they talk to their families. In the surveys we received from the people involved with the service including families, they said the staff listened and they are happy with the service the home provides. We dd not receive any surveys from health or social care professionals this time. There have been no complaints since the last key inspection. Staff have attended safeguarding training and the senior staff have completed NVQ 3 or are studying it. The staff demonstrated an understanding and knowledge of safeguarding issues in conversation. The company have produced a flow chart to assist staff with what to do if they suspect abuse and who to report to and this goes up the line through the organisation to the directors. Care Homes for Adults (18-65 years) Page 23 of 31 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 is well maintained and provides a clean, comfortable living environment for the people living here. Evidence: We looked round parts of the home. The home looked clean and well organized. One of the people said they like to keep it tidy and clean and they do this with the staff. The people living in the home have their own bedroom and one person has chosen his colours and there are plans for it to be redecorated. There is a cycle of redecoration and refurbishment and several areas have been redecorated recently and new furniture has been purchased. The garden has been landscaped. It looks well maintained and has various shrubs and plants with paved areas. One person has a pet rabbit that they look after. Care Homes for Adults (18-65 years) Page 24 of 31 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. The people living in the home have confidence in the staff who care for them. Evidence: The company have a recruitment procedure which includes all safety and identity checks required by law for care homes. New staff have induction training that includes the Skills for Care common induction standards. Staff do not work alone and unsupervised until their criminal records bureau check has been processed and they have had essential training for health and safety. Recently the manager has introduced some changes to the staffing. Now the staff team work both in Beach House and Bon Secours. Beach House is a larger home in Kingsdown, Deal and the manager is registered for both homes. There is a rota in both homes so that staff know when they are working and which times they are in Bon Secours. Staff work different shifts and they can be for a shorter time which means that they are fresher and able to support people better. We talked to the people living in the home about this and they say they like seeing the different faces. They are getting to know the staff well. With this arrangement they also have the opportunity to be supported by male staff some of the time which they say is good. Bon Secours provides a service for both men and women with learning disabilities. Only the female staff do the sleep over shift at this time. Staff talked about their role. They said they like to work in both the homes. There is a Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: good range of training provided by the company of both essential training for health and safety and training for peoples specialist needs. The staff we spoke to had completed NVQ level 3 and had attended training and had previous experience of mental health awareness. The manager has organized a staff meeting for the whole team to be held in October and meets with the staff individually for supervision to develop ideas and communication within the team. Care Homes for Adults (18-65 years) Page 26 of 31 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 manager has good people skills, understands the importance of person centred support and has a clear understanding of what needs to improve in the home. Evidence: The manager has been working in Bon Secours since September 2008. He has several years of experience supporting people with learning disabilities and has also worked as a manager in another company. He has NVQ 4 and RMA. He became the registered manager for both Beach House and Bon Secours in August 2009. There is an operations manager who has been in post since the last key inspection. She carries out unannounced visits to the home under regulation 26 to monitor and also provides a link between the senior staff, manager and directors of the company. We have seen that good practice within the company is passed from home to home via the operations manager. The company has developed a quality assurance system and questionnaires are sent out to families and people who are involved in the service. The people living in the home said that the staff talk to them and their families to see what they think of the home. The Care Homes for Adults (18-65 years) Page 27 of 31 Evidence: manager talked about his plans for developing the service to enable the people living in the home to increase their independence skills. He is currently updating the development plan to reflect this. All health and safety checks are carried out to maintain the building safely. The staff have all attended essential health and safety training. The maintenance person carries out the regular fire safety equipment and emergency lighting checks. Environmental risk assessments have been completed and the staff check the hot water temperatures routinely. Care Homes for Adults (18-65 years) Page 28 of 31 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 Care Homes for Adults (18-65 years) Page 29 of 31 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 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 30 of 31 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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