Care Home: Burton Cottages

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Annual service review Name of Service: Burton Cottages The quality rating for this care home is: The rating was made on: two star good service 1 8 1 2 2 0 0 8 A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection We do an annual service review when there has been no key inspection of the service in the last 12 months. It does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection or annual service review.   Has this annual service review changed our opinion of the service?   No You should read the last key inspection report for this service to get a full picture of how well outcomes for the people using the service are being met. The date by which we will do a key inspection: Name of inspector: Jo Mohammed Date of this annual service review: 1 3 1 1 2 0 0 9 Annual Service Review Page 1 of 8 Information about the service Address of service: Bishop`s Lane Robertsbridge East Sussex TN32 5BA 01580881715 Telephone number: Fax number: Email address: Provider web address:   maggie,griggs@sact.org.uk Name of registered provider(s): Name of registered manager (if applicable) Mr Stephan Barton Conditions of registration: Category(ies) : learning disability Conditions of registration: Sussex Autistic Community Trust (Care Services) Ltd Number of places (if applicable): Under 65 Over 65 12 0 The maximum number of service users to be accommodated is 12. 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). Have there been any changes in the ownership, management or the Yes service’s registration details in the last 12 months? If yes, what have they been: Since the last inspection, the Manager has been registered by the CQC. 1 8 1 2 2 0 0 8 Date of last key inspection: Date of last annual service review (if applicable): Brief description of the service Burton Cottages is registered to provide accommodation for twelve adults with autistic spectrum disorders. The property is owned by Downland Housing Association and is run by the Sussex Autistic Community Trust. It is one of four homes in East Sussex run Annual Service Review Page 2 of 8 by the Trust. Burton Cottages is purpose built and is situated in a quiet residential area of Robertsbridge. The town centre with its shops and access to bus and rail services is a short walk away. The building is split into two units, each capable of accommodating six residents. Each of the units has their own communal facilities and a kitchen. Accommodation is on two floors and all bedroom accommodation is in single rooms. The home makes CQC reports and fee information available to prospective residents and their relatives/representatives upon request. Annual Service Review Page 3 of 8 Service update since the last key inspection or annual service review: What did we do for this annual service review? We looked at all the information that we have received, or asked for, since the last key inspection or annual service review. This included: -The Annual Quality Assurance Assessment [AQAA] that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. -Information we have about how the service has managed any complaints. -What the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. -The previous key inspection and the results of any other visits that we have made to the service in the last 12 months. -Relevant information from other organisations. -What other people have told us about the service. What has this told us about the service? The Annual Quality Assurance Assessment [AQAA] that we took our information from is dated 13th October 2009. This provided satisfactory information. The service is accredited with the Autism Services Accreditation programme by a specific set of standards in meeting the needs of people with Autism that is reviewed annually. Since May 2009, the Manager is now a registered Manager with the Care Quality Commission [CQC]. In the summary section of the Annual Quality Assurance Assessment [AQAA] the home identifies what the service does well as providing a person centred service to adults with Autistic Spectrum Disorders. They identify how the staff are highly trained in providing specialised support. The accommodation is described as homely and relaxed with an emphasis on reflecting the tastes and personalities of service users. Each service user has a structured programme of day activities and can attend the day resource centres run by the organisation. It says the development and wellbeing of service users is closely monitored. They identify staff undergoing detailed recruitment processes with the aim to select staff that are appropriate to work with vulnerable people. The Annual Quality Assurance Assessment [AQAA] identifies how the home has improved over the last twelve months by implementing and reviewing numerous policies and further developed the staff team to ensure more effective team working in all areas. They identify what they could do better and how they are going to do this by encouraging more service user involvement in reviews using pictures to enable service users to participate more. They plan to provide an environment more suitable to Annual Service Review Page 4 of 8 individuals and formalise service users input in respect of the recruitment process. The homes future plans over the next twelve months include compiling a video/picture review for a service user. Following extensive consultation, the service has decided to split the home up into smaller units which they say will give greater focus on meeting the needs and aspirations of service users. They describe how plans have been drawn up and are awaiting authorisation for the restructure of Burton Cottages in changing the current composition from two self contained cottages into two flats of three and a studio flat. The service identify this will improve the standard of accommodation by bringing it up to date, allowing greater personalisation of service users living space. They intend to ensure that Burton Cottages is fully staffed, maintain a high level of training and find more creative ways in which to involve service users in making as many decisions about their life as possible. The home must keep the Care Quality Commission[CQC] advised about the proposed changes to the environment. Examples of how the home has improved over last twelve months includes compilation of detailed kitchen risk assessments for each service user. The introduction of improved communication systems and tools to ensure all service users are provided with a fully structured day and are communicated with in a method they understand. They have supported a service user to undertake work experience in the organisations cafe. They have reviewed the Statement of Purpose, standardised keyworker meetings and reviewed medication policies. They have increased information to families and their representatives during the annual partnership days. They send out questionnaires to parents prior to a partnership day where they are invited to visit, spend the afternoon at the home and discuss the evaluation of questionnaires. They identify high levels of communication with the adult protection teams in clarifying procedures. They have introduced a staff performance monitoring scheme and non-absence bonus. They have reviewed health, safety and complaints policies, the Service User Guide and the format of Regulation 26 visits. In respect of equality and diversity the home identifies all staff have attended training on Equality and Diversity. They have an equal opportunity policy. Race, religious and cultural needs for service users are incorporated into support plans. They say they support service users with gender identity and self image according to personal preference, style and with opportunities to feel part of the community. They identify giving a service that provides value for money by setting fees that are reasonable and within the mainstream equivalent of other providers. That every month a Regulation 26 visit is conducted whereby staff and service users are met and after each visit the Manager ensures any identified points are addressed in a timely manner. They say the house is clean, well maintained and service users have a good level of staffing for them to enjoy a full and varied lifestyle. They report having good staff retention with staff being fully inducted and trained throughout employment. The home was last inspected in December 2008 when a key inspection was conducted; prior to this a random inspection was undertaken in October 2008. Three requirements were carried forward at the inspection in December 2008 as the dates to comply with the requirements set in October 2008 were still within the timescales. Two new requirements and four recommendations were made at the inspection in December 2008. Information obtained from the AQAA shows evidence as to how the home are progressing towards meeting these requirements. Annual Service Review Page 5 of 8 The Manager is now registered with the Care Quality Commission [CQC]. Two bedrooms have been updated and personalised with plans over the next twelve months to refit the kitchens. In respect of requirements about risk management strategies, restraint protocols and eliminating unnecessary risks to the health and safety of service users; the information contained in the AQAA identifies the service buys in training and support for challenging behaviour, physical intervention and risk assessments. That behaviour support plans describe any potentially challenging behaviour and detailed descriptions of support strategies with an emphasis on preventative measures. That a new risk assessment policy has been adapted for all the service users and since the last inspection all the risk assessments have been fully reviewed. The home identifies the risk assessment policy ensures people are enabled to take responsible risks in adequately promoting independence and there are specific risk assessments for each individual and their activities. Further examination of the requirements made at the inspection in December 2008 will be undertaken when the next inspection of the home is conducted. The AQAA identifies seven staff have obtained their National Vocational Qualification [NVQ] in care at level 2 or above and thirteen staff have completed the Skills For Care induction training. The AQAA indicates maintenance of equipment, health, safety checks, policies, procedures and recruitment matters are in order. The data section of the AQAA indicates a number of the homes policies and procedures were last reviewed in 2006 with some gaps in identifying a review date. It is recommended this be addressed as information obtained from the AQAA reports the homes policies and procedures have been reviewed. The home has identified in the AQAA that over the last twelve months they have not received any complaints and made two safeguarding referrals. They identify neither of these being referred for investigation. However from the information held by the Care Quality Commission [CQC] there have been three safeguarding investigations; two of which were referred back to the service to investigate and another safeguarding investigation that was led by the police. The Care Quality Commission [CQC] has not directly received any concerns or complaints from other parties; however during a safeguarding investigation anonymous concerns about the home were raised and this information was shared under multi agency working. The home appropriately reports notifications about significant occurrences to the Care Quality Commission [CQC]. What are we going to do as a result of this annual service review? We consider the quality rating of the home remains the same since the last key inspection. We will do a key inspection by December 2010 to review our assessment of the home. However, we reserve the right to re-visit this decision if additional information is brought to our attention. 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