Care Home: Christie Development Centre

What the care home does well Each person has their own care plan that they have agreed to, this tells the staff about your likes and dislikes and helps them keep you safe. People living there get to decide what they want to do each day and staff help support them with activities.There are lots of different things to do and people said they have lots of nice meals. One person living there told us, "I get to do lots of things every day and I like it here". What has improved since the last inspection? This is the first inspection at the home as it did not open until September 2009. What the care home could do better: They need to appoint a permanent registered manager. Key inspection report Care homes for adults (18-65 years) Name: Address: Christie Development Centre Christie Development Centre Mansfield Road Blidworth Nottinghamshire NG21 0LR 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: Mary O’Loughlin Date: 1 9 0 1 2 0 1 0 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 © (2010) 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: Christie Development Centre Christie Development Centre Mansfield Road Blidworth Nottinghamshire NG21 0LR Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Vacant Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 8 0 care home 8 Blue Sky Care Ltd learning disability Additional conditions: The maximum number of service users who can be accommodated is 8 The registered person may provide the following category of service only Care Home only PC To service users of the following gender Both Whose primary care needs on admission to the home are within the following category Learning Disability Code LD Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 31 A bit about the care home Christie Development Centre is a newly built detached home. The home is in Blidworth Nottinghamshire and is surrounded by countryside. The home has a bus stop close by which connects to both Nottingham and Mansfield. It has 8 single bedrooms. 6 Bedrooms are on the first floor and each has a shower and toilet. Care Homes for Adults (18-65 years) Page 5 of 31 The ground floor has 2 bedrooms that are spacious and suitable for people with poor mobility or wheelchair users as the two bathrooms and toilets opposite these rooms provide disabled bathing facilities. There are two lounges and a dining room. There is a private garden area. Care Homes for Adults (18-65 years) Page 6 of 31 It costs £1,710.00 a week to live in the home. Care Homes for Adults (18-65 years) Page 7 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 8 of 31 How we did our inspection: This is what the inspector did when they were at the care home The acting manager and both directors were at the home when we visited and they were helpful and friendly. We had asked the manager to fill out a form for us. We call this an Annual Quality Assurance Assessment (AQAA). We sent out surveys to people who live at the home and staff who work there. 7 people returned these to us. All this helped us plan what we needed to look at when we inspected the home. Care Homes for Adults (18-65 years) Page 9 of 31 We spoke with one person living there and observed the facilities and services available to another person. We looked at the care plan of one person living there. What the care home does well Each person has their own care plan that they have agreed to, this tells the staff about your likes and dislikes and helps them keep you safe. People living there get to decide what they want to do each day and staff help support them with activities. Care Homes for Adults (18-65 years) Page 10 of 31 There are lots of different things to do and people said they have lots of nice meals. One person living there told us, I get to do lots of things every day and I like it here. What has got better from the last inspection What the care home could do better They need to appoint a permanent registered manager. Care Homes for Adults (18-65 years) Page 11 of 31 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Mary O’Loughlin East Midlands CQC Citygate Gallowgate Newcastle Upon Tyne NE1 4PA 03000 616161 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 12 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 13 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. People are only admitted after an assessment which ensures the home has the facilities and services to meet their needs. Evidence: We looked at the homes statement of purpose which was specific to the home and the resident group they care for. This was supported by a service user guide that gave clear information, including pictures, of the specialist services available at the home. The three residents living at the home told us in our surveys that they had enough information provided to them to help them decide whether the home was right for them. We saw how staff who are trained to undertake care assessments had visited a prospective resident and consulted with health and social care professionals about their needs. They had used this information to determine if the home was the right place for them before offering a short visit and then a three month trial period where both the resident and the home management could decide if permanent residence was satisfactory. Page 14 of 31 Care Homes for Adults (18-65 years) Evidence: The acting manager told us in the AQAA that before moving in all the residents are given the opportunity to choose which room they would like to have and how they would like it decorated and furnished. They aim to help residents to feel at home and safe and to do that they encourage them to have choices through person centered approaches. Residents can choose who they would like to be their key worker. Care Homes for Adults (18-65 years) Page 15 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. The service ensures that residents are fully involved in planning the care and support they need and the management of risk is positive in addressing issues of safety. Evidence: The three residents in the home told us that they always or usually made decisions about what they did each day and all said they could do what they wanted both during the day and evening. We looked at a care plan for one resident which showed that the staff had fully involved the person in planning the care they were receiving. The plans set out the development of the person and enabled responsible risk taking. The resident told us there were no restrictions placed on them and they were able to be part of the local community. The acting manager told us in the AQAA that residents have key worker sessions on a monthly basis to ensure they are given dedicated time to raise any issues or request improvements. This is documented in each individuals care plan and actions are initiated by the key worker. Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: They have also bought in communication training for staff e.g. Makaton which is delivered by a speech and language therapist which is good practice. 4 staff responding to our surveys told us that they felt they had enough skill and experience to meet peoples different needs, and they always had enough information about them. Care Homes for Adults (18-65 years) Page 17 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. Staff support people to be part of the local community and promote independence through person centered care planning. Evidence: We found that the service provides a varied range of activities both inside the home and within the community. The acting manager told us in the AQAA that all activities are researched by staff, families and other professionals. They are visited to assess suitability before the activity is put in an activity planner. They have started a resource pack which includes in house and community based activities. One resident has shown a great enjoyment in Karaoke. They have since purchased a play station 3 console which has a karaoke system called singstar. It also has wireless microphones. This has proven to be a fun activity for all and has encouraged the interaction of residents and staff. We saw that the care plans set out individual strengths and focus on developing skills for Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: residents. All activities that people take part in are risk assessed to ensure their safety. We spoke to one resident who told us that staff had helped them access an allotment locally where they grew vegetables and kept chickens. Residents told us that they can choose different foods but liked the menu offered; staff told us that they do encourage healthy eating. Care Homes for Adults (18-65 years) Page 19 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. Personal support is planned in accordance with the resident’s wishes. Health care and medication are safely managed. Evidence: The care plan we looked at was person centred and recorded the wishes of the person about how they wished to be supported. We spoke to them about health care and found they had regular access to the local primary health care team including opticians. The staff had completed health care plans and were able to demonstrate that they knew about the health needs of the person and monitored any changes in health. There was an efficient medication system in place that recorded all medicines coming into the home, the administration and the disposal to ensure there was no misuse. We saw that staff had received accredited training in the administration of medicines and the acting manager completed regular checks on staff competency which is good practice. The acting manager told us in the AQAA that if residents are from the local area they ask if they would like to stay with their current Doctor, optician and dentist. If the resident chooses not to then a local one will be sought. This is to keep familiarity and consistency for the resident. Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: Residents tell us that staff always listen to them and they confirm that their healthcare is properly monitored. Care Homes for Adults (18-65 years) Page 21 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. Residents have access to a complaint procedure and staff are trained to recognise and safeguard them from abuse. Evidence: The information provided to residents within the homes guide explains what they can to do if they have concerns or complaints. The 3 survey responses received from residents tell us they know who to speak to if they have concerns and that they feel listened to by staff. The staff tell us that they understand what to do if people have any concerns and we saw from their training records that they have received training in how to safeguard people from abuse. They have also been trained to manage difficult behaviours such as aggression to ensure people are safe from harm. The service has not received any complaints since its registration and the commission has not been notified of any concerns or complaints. Care Homes for Adults (18-65 years) Page 22 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 suitable for its stated purpose. Evidence: A site visit of the premises carried out on 25 August 2009 as part of the registration process found that that the premises were safe and fit for purpose. The accommodation is modern and spacious and has been decorated and furnished to a good standard to meet younger people’s needs and preferences. The facilities are on three floors which are accessed by stairs and a passenger lift. Communal areas include two lounges a kitchen dining room activity room and sensory room. Two bedrooms are located on the ground floor the remaining six bedrooms on the first floor provide ensuite shower and toilet facilities. The ground floor bedrooms are spacious and suitable for people with poor mobility or wheelchair users as the two bathrooms and toilets opposite these rooms provide disabled bathing facilities. Although these bedrooms do not have ensuite facilities they are considered fit for purpose in view of the two bathrooms located directly opposite these rooms. Page 23 of 31 Care Homes for Adults (18-65 years) Evidence: The second floor provides a staff sleep in room a dedicated visitor sleepover room for family and friends and a training kitchen for residents. In view of the size of the home and the level of need of people who are likely to be admitted a staff call system is not provided. We asked residents if they have found the home clean and fresh and all 3 told us it was. At this inspection the home was warm and clean throughout and staff training files recorded how they had received training in the control of infection. The staff also complete regular cleaning schedules to ensure all areas are kept clean and tidy. Suitable aids and equipment to support resident’s disabilities were seen in place. 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. There are sufficient numbers of staff who are appropriately recruited and trained in their role. Evidence: The staff told us in our surveys that they were receiving training in their role and they were regularly supervised. They also confirmed that they had the appropriate checks undertaken before they commenced work to ensure they were suitable to work with vulnerable people. We looked at the recruitment and training files of 3 staff; they were in good order and reflected that the acting manager always ensures a safe and thorough recruitment procedure is carried out in practice. New staff have an induction to their role and are shadowed by other senior staff to ensure they are not left in situations they cannot handle. The acting manager also keeps a record of each persons induction which we verified. Following induction staff commence on a National training module for care, 5 of the staff have completed level 2 NVQ and the remainder are in the process of completion. The staff training records showed that they receive regular training to ensure their Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: practice is up to date. The home was clean and well maintained and the care files were up to date, clear and organised appropriately. 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 home is managed in the best interests of the people living there. Evidence: The home is presently being managed by an acting manager who has many years of experience including her registered managers award. The director of care and director of operations were present at the home during this inspection and said they are there on a regular basis to oversee the management of the home until a person is recruited to the position of manager. The home was found to be properly organised, records were in good order and regular audits were being completed to measure the quality of the services provided. The staff team were receiving appropriate supervision and training. The staff files showed that they had received training in the management of health and safety. Care Homes for Adults (18-65 years) Page 27 of 31 Evidence: Records of Fire drills and evacuation were seen. As this is a new service all appropriate maintenance and servicing of equipment is in place and up to date. 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 © (2010) 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 31 of 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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