Care Home: Claremont Road Care Home

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What the care home does well The home is set within easy reach of community facilities. The staff team have been working there a long time and know how to look after people safely. People living there have a say in how the home is run and they make their own decisions about their life. People like living at the home and feel safe. Staff help people find lots of activities that people can be involved in. The home is clean and people have their own room. What has improved since the last inspection? There have been lots of improvements in the home, a new bath, carpets and decoration. There have been improvements in the management of health and safety to make sure people are safe from harm. What the care home could do better: Make staff recruitment records available for inspection so that we can be sure that people only start work there if they are suitable. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Claremont Road Care Home 4 Claremont Road Sherwood Rise Nottingham NG5 1BH     The quality rating for this care home is:   two star good service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Mary OLoughlin     Date: 2 7 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Claremont Road Care Home 4 Claremont Road Sherwood Rise Nottingham NG5 1BH 01158443584 01159857579 helen.street@ncha.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Nottingham Community Housing Association care home 12 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Claremont Road Care Home is registered to provide accommodation and personal care for a maximum of 12 people whose primary care need falls within the category learning disability (LD). Date of last inspection Brief description of the care home Claremont Road provides 12 places for adults with learning disabilities. It is a large detached property that is located close to the centre of Nottingham. The home is also conveniently situated for public transport, local shops and community facilities. The property has a private rear garden. The home is accessible to people who are wheelchair users. There is a minibus provided for service users use. The fees range from £738.00 to £974.00 this does not include toiletries, newspapers and clothing. Information about the service is available to people and their representatives upon 12 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 27 Brief description of the care home request. Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The last inspection of this service was completed on 4th June 2007. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI)is upon outcomes for people and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice and focuses on aspects of service provision that need further development. One inspector conducted the unannounced visit. The main method of inspection used was called case tracking which involved selecting three people and looking at the quality of the care they receive by speaking to them, Care Homes for Adults (18-65 years) Page 6 of 27 observation, reading their records and asking staff about their needs. As most people who live at the home were out undertaking activities during our inspection we did a follow up visit on Saturday 14th March to obtain their views, speaking to a total of 6 people. The acting manager, members of staff and visitors to the home were spoken with as part of this visit. Documents were read as part of this visit and medication management was inspected to form an opinion about the health and safety of residents at the home. A review of all the information we have received about the home since the last inspection was considered in planning this visit and this helped decide what areas were looked at. A range of additional information was used to determine the outcome of this visit, including information provided by the registered provider within an Annual Quality Assurance Assessment (AQAA). What the care home does well: What has improved since the last inspection? What they could do better: 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are properly assessed and provided with suitable information about the home before they are admitted. Evidence: The service has made significant improvements for people who are considering moving into the home. We looked at the records of 2 recently admitted people and saw that staff recognised the importance of obtaining sufficient information about them from external professionals involved in their care and the persons advocates to make sure that people where properly represented about how they wished to live and be supported in the home. The AQAA tells us that staff have accessed an independent advocate for one person so they can assess the persons views on the home and ensure he is listened to. The manager has made information available to prospective people more suitable for Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: their needs, all information is now provided in a picture or symbol format including the tenancy agreement, this helps people understand what is available at the home before they move in. Individuality is seen as a priority within the records seen and the information we received in the AQAA, it shows that the staff team are trained to recognise and support each persons needs in a person centred way, ensuring that gender, sexual orientation, race, religion or belief are considered and planned for. Care Homes for Adults (18-65 years) Page 11 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have an individually appropriate lifestyle determined by assessment, suitable support and consultation with them. Evidence: We looked at the records of 3 people and saw how each person had a key worker who had prepared an essential lifestyle plan with them, supporting them to be fully involved in deciding how their individual aspirations would be considered and met. People had signed their own plan to show they were involved with them and agreed to them. People living at the home told us they knew about their care plans and were able to see them. Key workers complete daily records that inform changes to plans and risk assessments to make sure people have any changes in their needs identified and addressed safely. Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: The plans were produced in a format that helped people understand and be involved in them. We saw that people were able to make decisions about their lives, what they did each day, what activities they participated in and what social events they attended, key workers recognised that people could take risks as part of their independent lifestyle and assess risks to peoples safety to support them in achieving their goals safely. People told us they had different levels of support that had been developed over time with their key workers, some people were able to access the community independently whilst others had the support they wanted and needed to manage any risks to their safety when shopping or taking part in community events. There were some shortfalls in completing 1 of the 3 plans we saw, however the manager recognises this and tells us within the AQAA that they plan to address this over the next year as part of the continuous improvements. Care Homes for Adults (18-65 years) Page 13 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to live ordinary and meaningful lives appropriate to their age and individual needs and wishes. Evidence: The service has continually shown us that they are committed to helping people develop and maintain their skills through support with peoples communication, social and emotional wellbeing and independent living skills. The people we case tracked on this occasion all had suitable opportunities and support with their lives. People we spoke with said they were very happy with the way they were supported, some could attend independent living training, some had paid employment and all said they felt the staff were really helpful. The AQAA tells us that staff obtain information on community events and use the Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: information to help people plan what they want to take part in. People have good guidance on healthy eating options from staff and everyone is involved in planning the menu. The care plans we looked at tell us that each person is able to continue with their previous interests and develop new ones as they wish. The AQAA tells us that the manager recognises the importance of enabling people to develop personal and family relationships, developing policies and support plans for supporting people with their sexuality and relationships. People we spoke with could develop friendships outside of the home and have visitors as they choose, there is a payphone in the home which is presently out of order but people could use the office telephone if they wished or use their personal mobile to contact friends and family. We spoke to relatives of one person who told us they have regular contact by planned home visits. They did feel that further improvements could be made to provide another daytime activity for their relative. The acting manager was in the process of reviewing this persons care file and intends to arrange a full review of the care they receive to make sure that the persons expectations and aspirations are fully taken into account. Care Homes for Adults (18-65 years) Page 15 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their health and personal care delivered according to their needs and wishes and they receive their medicines safely as prescribed. Evidence: We saw how staff complete a health screen for each person that shows how they are supported with health care needs. Records indicated that people have good access to health services including dentistry. People told us that they are supported to see their doctor if they need to and daily records show that staff monitor changes in peoples conditions and refer them to the external professionals as required. Each person also has a basic personal care record that shows how and when people would like their personal care supported in accordance with their wishes and needs. There is an efficient medication policy in place and staff take time to audit the medication practices on a daily basis to ensure that people receive their medicines as prescribed. We saw that staff are trained to administer medicines, that medicines are Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: stored, administered and recorded safely. People told us they receive their medicines on time. More potent medicines are stored in line with controlled medicine laws and a suitable register is held. Care Homes for Adults (18-65 years) Page 17 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are robust systems in place to make sure people are listened to, taken seriously and protected from abuse. Evidence: Since our last inspection there have been no complaints received by the home or the commission showing that the way the service is consulting with people through 1-1 consultation, regular meetings for people to voice their opinions on the service and quality assurance mechanisms. We were notified by the service of 1 safeguarding adult investigation which was investigated under the local multi agency agreements through social services. We identified that following the investigation more safeguards have been put in place to prevent any recurrence of the issues. Staff told us that they were aware of the local safeguarding adults procedures and have attended training in the issues to make sure they deal effectively with any suspicion of abuse within the home. We spoke to 5 people who live at the home and they all said that the home was a nice, safe place to live and were listened to and valued. Care Homes for Adults (18-65 years) Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean and well maintained home that is accessible to community facilities. Evidence: The AQAA tells us that lots of improvements have been made to the home over the last 12 months. They have considered the needs of people using the service, involved them in plans for any decoration in their living space and acted on their opinion of new bathing systems. A new Hydro bathing unit is now in place which assists people to be more independent. The building is in a good state of repair and was found to be clean and warm on the day of inspection. The staff recognise the importance of good infection control practices, they have attended training and have access to the Department of Health Essential Steps auditing tool to make sure that people are safe from infection. There have been no reported outbreaks of infection in the last 12 months. People living at the home told us they help with the housework at weekends if they Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: are able, some people do their own laundry and staff help others who need it. Everyone spoken with liked the home and felt it was a clean and comfortable place to live. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are in safe hands from a well trained staff team but the lack of access to recruitment files did not enable inspection of the homes procedures. Evidence: We looked at the staff rota which identified that suitable numbers of staff were on duty and people requiring extra support where receiving this. We recognise that the service has a suitable recruitment procedure in place which identifies that appropriate pre- employment checks are completed before people start work to make sure they are safe to work with vulnerable people, however on this occasion we could not access the recruitment files to inspect them as the acting manager was on leave and staff did not have a key to the storage cabinet. The records of induction training that staff receive show that new staff are not placed in situations they cannot manage. There was evidence that the manager views training as a high priority, planning staff training on an annual basis and ensuring that the workforce has the required skills and competencies needed to keep people safe at all times. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: There is a high proportion over 75 of the staff who are trained to National Vocational Level 2 in care which ensures they know how to care for people safely. We spoke to the key workers of those people we case tracked and they were fully aware of the needs of people and how they wished to be supported. 5 People living at the home told us that they knew their key worker and got on well with them. They spoke of how helpful staff were and how they were always supported to make their own decisions. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from a well managed home that involves and protects the people who live there. Evidence: The manager of the home is registered with the commission. The acting manager is presently managing the home in the appropriately reported absence of the manager. The acting manager was not on duty during this inspection but was later contacted for information regarding this inspection. The information that was provided in the AQAA was very comprehensive and clear, it told us how the service has improved and how the manager continues to improve the home through auditing and monitoring of the quality of the services provided. The systems in place to assess peoples satisfaction include regular meetings and surveys for people living at the home, and questionnaires for their families to complete. People living at the home confirmed that they are involved in regular Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: meetings and have a say in how the home is run. The manager has made all the required improvements in response to our last inspection and the requirements that we set ensuring that the health and safety of the premises is a priority to protect people from harm. Regular external managers assess the safety of the home and produce a report on the quality of the services to ensure that there is continuous improvement. There have been no avoidable accidents reported to us and the manager ensures that through person centred planning and risk assessments that people are safely supported both inside and outside of the home. There are effective systems in place for staff to have specific roles and responsibilities ensuring good outcomes for people who use the service. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 34 17 Basic details of the staff employed at the home must be available for inspection if centralisation of records is the homes policy. To make sure that we can check your recruitment procedures are followed. 29/05/2009 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 1 20 Any controlled medicines that are received into or out of the home should be recorded within the controlled medicine register to provide a suitable audit trail. Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. 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