Care Home: Champions Place

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What the care home does well Staff are valued by service users and feedback in surveys was largely very positive about the service offered at Champions Place. Some easy read documents were available for service users for example, the home`s complaints procedure. The home continues to provide a relaxed and stable environment which currently meets the full range of service user`s needs. The home is set in beautiful surroundings that service users can access and enjoy. The Responsible Individual and appointed manager are open to constructive feedback and have a good awareness of how the service needs to develop and further improve to maintain their current excellent quality rating. What the care home could do better: The home`s Statement of Purpose and Service User Guide require review to show how the service meets the needs of individuals who come into the category of older adults and should reflect the specialist training available to staff to ensure they can care and support people with a learning disability who may also suffer from dementia or other types of mental illness associated with an ageing client group. Staffing levels must also be based on the Statement of Purpose. This will ensure that prospective service users or their representatives have all the information they need when making a decision about moving in. The appointed manager had a raised awareness that some care plan and risk assessment documentation requires further development and personalisation and spoke of her firm intention to remedy shortfalls in this outcome area to ensure the home can better evidence their good practice. The complaints procedure requires review to ensure people have all the information and guidance they need. Specific shortfalls in staff training were discussed with the appointed manager, including some courses that will inform her practice and ensure service users are adequatelysafeguarded from any potential for harm. Robust and effective staff recruitment procedures must be in place to ensure service users are fully protected. Staff should receive formal supervision and identification of training needs at least six times a year. Advice should be sought in relation to infection control concerns to ensure service users and staff are protected and good practice is not compromised. The service has a risk assessment in place for uncovered radiators installed throughout the home. This should be reviewed regularly in light of the ageing service user group accommodated. Random inspection report Care homes for adults (18-65 years) Name: Address: Champions Place Kent Hatch Road Limpsfield Chart Surrey RH8 0TA three star excellent service The quality rating for this care home is: The rating was made on: 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. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Marion Weller Date: 1 4 0 6 2 0 1 0 Information about the care home Name of care home: Address: Champions Place Kent Hatch Road Limpsfield Chart Surrey RH8 0TA 01883722006 01883730268 sandrahayworth@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) R & G Sparkes Limited Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 14 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 14 The maximum number of service users to be accommodated is 14 The registered person may provide the following category of saervice 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 : Learning disability (LD) Date of last inspection Brief description of the care home Champions Place is a care home registered to provide accommodation and care for up to fourteen people with a learning disability in the age range of 18 - 65 years. The home currently provides a service to a predominantly older client group who have lived there for a number of years. The care home is a large detached property that has been listed as a Grade 2 protected building; it stands in extensive and secluded grounds that Care Homes for Adults (18-65 years) Page 2 of 11 Brief description of the care home have far reaching views of the surrounding countryside. Although the service is in a rural location it is close to community facilities that can be reached by car or public services. There is some car parking space available to the front of the building for visitors. The communal accommodation internally is spacious and includes a large entrance hall, a dining room and two sitting rooms. There is dedicated office accommodation on the ground floor. The majority of service user bedrooms are for single occupation. There remain two shared bedrooms that are currently occupied by people who have made a positive choice to do so. Bedroom accommodation is arranged over three floors of the house. There is no passenger or stair lift installed. Access to the first and second floors is reached by stairs. Service users accommodated at Champions Place need to be fully mobile to access all areas of the building. The current level of fees range from £520 to £580 per week. Please contact the manager for more information. Care Homes for Adults (18-65 years) Page 3 of 11 What we found: CQC currently caries out its regulatory responsibilities under the Care Standards Act 2000. On the 1st October 2010, the CSA (2000) will be revoked and we will head into a new regulatory and registration regime under the Health and Social Care Act 2008. Our current revised methodology under the CSA (2000) for inspections due to take place up to and until the end of September 2010 allows for services previously judged as providing Good and Excellent outcomes for service users to receive a random inspection instead of a Key inspection, where our risk based approach allows. As a consequence of the revised arrangements, Champions Place received a random Inspection on the 14th June 2010. Champions Place was first awarded the quality rating of Excellent following their last Key Inspection of the 22nd June 2007. The home has had two annual service reviews since that date. The first on the 20th June 2008 and the second on 16th June 2009. It was not necessary to change our inspection plans for Champions Place as a result of the two reviews. This random inspection was undertaken to focus on some key outcome areas for service users and to look at some specific issues in relation to the homes infection control measures. The random inspection was facilitated by the Responsible Individual for the service, Mr Roger Sparkes and the appointed manager. The inspection involved a tour of the premises internally and some informal discussions with a number of service users, three staff and the examination of some of the homes key documentation, including individual plans of care, staff recruitment, and staff supervision and training files. Feedback surveys were sent to the home for distribution and ten were returned to the inspector prior to the site visit taking place. Six were completed by service users with the support of staff. Four were completed by staff employed at the home. Some comments received have been included in this report. The inspection report also takes into account all the information obtained about the service. This includes any formal notifications, reports, phone calls and letters received and any information concerning complaints or allegations. The manager was asked to complete the homes Annual Quality Assurance Assessment (AQAA) prior to the inspection. The AQAA is a self assessment that focuses on how well outcomes are being met for people using the service. It also gives some numerical information about the service. The completed document gave us information that provided a reasonable picture of what was happening in the service, and their plans for further development. Since the last inspection the home has reduced registered occupancy figures from 17 to 14 places. Our records show staffing levels have been reduced in line with falling occupancy. There are currently thirteen service users who live at Champions Place. The home is registered to provide care and accommodation for people of both genders, who have a primary need of learning disability. The homes Annual Quality Assurance Assessment (AQAA) records that service user ages range from 53 to 93 years. Service users present as a close cohesive group who have lived together for many years. The appointed manager said there have been no new admissions to the home for the last 18 years. The home is currently able to meet the full range of service users needs. There is no Care Homes for Adults (18-65 years) Page 4 of 11 passenger or chair lift available at Champions Place however and this may impact on their ongoing ability to meet older services users changing needs. Bedroom accommodation is arranged over three floors of the home so service users must be mobile to access all areas. The home has a Statement of Purpose and Service User Guide. It was discussed that such documents should clearly show how the service meets the needs of individuals who come into the category of older adults and the specialist staff training provided to people accommodated who may suffer from dementia or other types of mental illness, associated with an ageing client group. Staffing levels must also be based on the Statement of Purpose. It was recommended that the homes information documents should be comprehensively reviewed to include this information and to accurately reflect that the home predominantly cares for people from an older service user group with a learning disability. This will ensure that prospective service users or their representatives have all the information they need when making a decision about moving in. Service users spoke positively about their experiences at the home, a sample of their comments included They make me happy, Good friendly place. and They give me wonderful holidays and look after me. When asked what the home could do better, feedback included, More activities and More time for staff to listen to us Feedback from staff was also received regarding what the home does well. A staff respondent records, Look after residents extremely well, enabling them to live a happy, healthy and long life. Another states, Respects the needs of clients. They have lived here for many years and are very happy, so I think that says it all. An entry in a service users formal review report, written by a commissioning care manager records. Beautiful surroundings and setting, the home is lovely. A warm, comfortable environment. Gorgeous home. Each person accommodated has an individual plan of care, health action plan and hospital passport information. Two plans of care were inspected in detail. Content in both was seen to be current, regularly reviewed and designed to enable the individuals health, personal and social care needs to be identified and addressed. Risk assessments had been completed as part of the individual plans of care. The risk assessments seen could be further developed to ensure they provide clear direction for staff to ensure people are safe, while aiming for improved outcomes. Where there were limitations placed on an individuals freedom, decisions had been made either with the agreement of the person or their representatives and had been recorded and an appropriate risk assessment developed. The service operates with key workers identified for all the people who use the service. Staff spoken with were knowledgeable about the needs of the people living at the home and were clear about their role in the promotion of peoples choices as part of an independent lifestyle. Service users daily records were being maintained. Content seen was variable however and dependent on the skill of the person completing them. Content did not consistently reflect the demands of the individual plan of care in place. One of the individual plans of care inspected was not signed by the service user. It was discussed with the appointed manager that plans of care should be signed by the service user to evidence their involvement in its compilation and their agreement to it. If a service user is unable to sign, the reasons why should be recorded. The appointed manager had a raised awareness that some care plan documentation requires further development and personalisation and spoke of her firm intention to remedy shortfalls in this outcome area to ensure the home can better evidence good practice outcomes. The homes complaints procedure is made available to service users, their Care Homes for Adults (18-65 years) Page 5 of 11 representatives and other people visiting the home. It is also produced in a picture and symbols format to meet individual service user need. The homes AQAA records that the service has received no formal complaints in the last 12 months. Some minor review of wording should be undertaken to the homes complaints procedure to reflect that the Care Quality Commission can be involved at any stage of a complaint, but the Commission is not a complaints reconciliation service. The quality of the service provided is the responsibility of the provider and concerns and complaints should be raised with the home in the first instance. The complaints procedure would also benefit from the inclusion of the contact details for the local Social Services Department. Social Services hold statutory powers to investigate complaints and safeguarding issues raised with them about registered homes. Survey respondents raised no concerns about the how the home deals with complaints or concerns raised with them. There are procedures in place for responding to the suspicion or evidence of abuse or neglect to ensure the safety and protection of people living in the home. The staff induction and staff NVQ training have elements of adult protection. Records confirm that vulnerable adults safeguarding training for all staff is planned for August 2010. It is imperative that the appointed manager in particular receives Adult Protection, Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DOLS) training to ensure she has a sound understanding of procedures designed to protect and safeguard the people she is responsible for. The AQAA records that there have been no safeguarding alerts or investigations involving service users accommodated at Champions Place in the last twelve months. The homes AQAA clearly indicates robust recruitment procedures are in place for the protection of service users. Two out of the three staff files inspected on this site visit evidenced no CRB or POVA documentation in place for new staff. The Responsible Individual was given 24 hours to provide the relevant documentation to the CQC as there appeared to be some confusion as to its availability. No additional evidence was received by the inspector to consider within that 24 hour time frame. The responsible individual took swift action and removed the individuals without the correct documentation from the staff rosters. He also confirmed that future recruitment practice would clearly evidence that all pre employment checks were in place before staff were confirmed in post and given access to vulnerable adults. A requirement was issued in this respect. The Responsible Individual for Champions Place states that he plans a rolling maintenance programme every year together with the homes handyman and gardener. For instance, the driveway leading to the home had undergone repair and refurbishment this year. Such programmes ensure the home is suitably maintained and service users enjoy a safe, homely and attractive place to live. A tour of the home showed that some areas internally such as communal toilets and bathrooms could be made more homely and domestic in nature. Some service users bedrooms evidenced aged decoration, furniture and fittings that would benefit from refurbishment or renewal. Some radiators were uncovered both in bedrooms and communal areas. Some potential environmental infection control issues seen in bathrooms, toilets and the laundry were discussed with the appointed manager and the Responsible Individual. These clearly had the potential to compromise the homes infection control policy and place staff and service users at risk. The Responsible Individual was advised to contact the local NHS Infection Control Unit who would offer them advise and direction to resolve shortfalls. The appointed manager contacted the Care Homes for Adults (18-65 years) Page 6 of 11 inspector prior to completion of this report to say that an appointment had been made and an adviser would be visiting Champions Place. The registered manager in post at the last inspection retired in October 2009. As mentioned throughout this report a new manager has been appointed by the provider. Application for the appointed managers registration with CQC was made in a timely manner. The application was assessed. It was agreed with the CQC South East Regional Registration Team that the applicant did not meet the requirements for registration and could withdraw. The appointed manager has since evidenced work toward gaining a recognised qualification at Carshalton College in Leadership and Management in Care at Level 4. Completion of the qualification course is reported to be due in September 2010. The appointed manager stated her firm intention to apply for registration with CQC at that time to both confirm fitness in the post and to evidence responsibility for service outcomes. What the care home does well: What they could do better: The homes Statement of Purpose and Service User Guide require review to show how the service meets the needs of individuals who come into the category of older adults and should reflect the specialist training available to staff to ensure they can care and support people with a learning disability who may also suffer from dementia or other types of mental illness associated with an ageing client group. Staffing levels must also be based on the Statement of Purpose. This will ensure that prospective service users or their representatives have all the information they need when making a decision about moving in. The appointed manager had a raised awareness that some care plan and risk assessment documentation requires further development and personalisation and spoke of her firm intention to remedy shortfalls in this outcome area to ensure the home can better evidence their good practice. The complaints procedure requires review to ensure people have all the information and guidance they need. Specific shortfalls in staff training were discussed with the appointed manager, including some courses that will inform her practice and ensure service users are adequately Care Homes for Adults (18-65 years) Page 7 of 11 safeguarded from any potential for harm. Robust and effective staff recruitment procedures must be in place to ensure service users are fully protected. Staff should receive formal supervision and identification of training needs at least six times a year. Advice should be sought in relation to infection control concerns to ensure service users and staff are protected and good practice is not compromised. The service has a risk assessment in place for uncovered radiators installed throughout the home. This should be reviewed regularly in light of the ageing service user group accommodated. 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 2. Care Homes for Adults (18-65 years) Page 8 of 11 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 9 of 11 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 1 34 19 New staff are confirmed in post only following completion of a satisfactory police check, and a satisfsactory check of the POVA registers. Recruitment must be robust to ensure that service users are protected from any potential for harm. 16/06/2010 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, 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 10 of 11 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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