Care Home: Community Care Solutions (Husbands Bosworth)

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What the care home does well The home provides a good standard of care within a bright, modern and homely environment. The home maintains a good standard of cleanliness throughout. Meal times are flexible to suit individual lifestyles and choices. Visitors are made welcome. Levels of staffing ensure that the peoples` health, social and emotional needs needs are met. What has improved since the last inspection? x What the care home could do better: The manager was advised to complete her personal development plan and re-apply for registration with CQC as soon as possible. The Statement of Purpose and Service Users` Guide should be revised to clarify that the home`s manager is not yet registered with CQC as the Registered Manager for the service and The Statement of Purpose and Service Users` Guide should also include and clarify the role of Social Services in managing complaints. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Community Care Solutions (Husbands Bosworth) 29 High Street Husbands Bosworth Lutterworth LE17 6LJ     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: Carole Burgess     Date: 1 8 0 6 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 26 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.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Community Care Solutions (Husbands Bosworth) 29 High Street Husbands Bosworth Lutterworth LE17 6LJ 01858881200 F/P01858881200 husbands.manager@communitycaresolutions.co m Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Community Care Solutions Limited care home 8 Number of places (if applicable): Under 65 Over 65 0 0 learning disability mental disorder, excluding learning disability or dementia Additional conditions: 8 8 No one falling within category LD may be admitted into Community Care Solutions (Husbands Bosworth) where there are 8 persons of category LD already accommodated within this home. No person under 16 years of age and over 25 years of age who falls within category LD may be admitted into Community Care Solutions (Husbands Bosworth). The service users admitted into Community Care Solutions (Husbands Bosworth) who fall within service user category LD may only be accommodated in number 29 High Street. To accommodate the existing 4 named service users over the age of 25 at Community Care Solutions (Husbands Bosworth) until 31st December 2006 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 26 Brief description of the care home Community Care Solutions (Husbands Bosworth) is registered to provide care for up to eight people aged between sixteen and twenty-five years of age who have a learning disability or mental disorder. The home is on the main street in Husbands Bosworth, close to local shops, churches and pubs. There are bus routes nearby to Leicester and Market Harborough. People are accommodated in single bedrooms with hand washbasin, with additinal toilets and bathrooms. They have access to two lounges, a dining room and a kitchen. There is a small patio and garden area to the rear of the house. At the time of the inspection the manager stated that fees ranged from £1530 to £6898 per week. Information about the service provided at Husbands Bosworth is available. Care Homes for Adults (18-65 years) Page 5 of 26 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 quality rating for this service is 2 Stars. This means the people who use the service experience good quality outcomes. We as it appears throughout the Inspection Report refers to the Care Quality Commission. The focus of the inspections undertaken by the Care Quality Commission(CQC) is upon outcomes for people who use the service and their views of the service provided. The previous key inspection was undertaken on 18th June 2007 Care Homes for Adults (18-65 years) Page 6 of 26 The site visit was unannounced and took place over 6 hours. We selected 2 people and tracked the care they received through a review of their records, discussions with them (where possible), other people who use the service, visitors, the care staff, and observation of care practices. We spoke with staff members regarding the training and support they received. Planning for the inspection included assessing notifications of significant events, a review of the Annual Quality Assurance Assessment (AQAA) sent to CQC by the service. Surveys were sent to the service to people who live in the home, to staff and health professionals, to provide feedback to the CQC. Two residents and two care staff returned the surveys. People who live in the home said that the home was kept clean and that staff were supportive, cooked nice meals and took them out. One person said that they would like more time to themselves, but another person said that they would like more activities. One person spoken with told us that staff were supportive which enabled them to pursue their individual educational and social interests, and that there were sufficient staff do do this where one to one support was needed. Staff said that that the home provided good support for both staff and people who live in the home and that the service ran smoothly. Both staff and service users commented that they would like more permanent staff to eliminate the use of agency staff. The Manager and other staff spoken with were positive and helpful during the inspection. The fees at the time of inspection were between £1,530 - £6,898, but cost was dependent on the care and support required. Extras included travel when using the homes vehicle. 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.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 8 of 26 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 26 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. Prospective residents have sufficient information and have their care needs fully assessed so that they can be met once they move into the home. Evidence: The home has a comprehensive Statement of Purpose and Service Users Guide, also provided in a pictorial format, to ensure that people have sufficient and clear information to enable them, or their advocate, to decide if the home is the right one for them. The Statement of Purpose states that the manager is a Registed Manager e.g. someone who is registered with CQC as fit to manage a care home. This is incorrect and should be amended until such time as the manager becomes registered with CQC. Both of the plans of care reviewed contained detailed and comprehensive assessments to ensure that the home could meet individual general health, mental health and social care needs. Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: Care Homes for Adults (18-65 years) Page 11 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples plans of care were comprehensive and reflective of their changing personal, health and social care needs. Evidence: The person centred care plans were detailed and covered all aspects of care. They showed that people who live in the home were involved in planning their care. They contained pictorial and written information by them about how they wished to be supported in their daily lives and there hopes and aspitations for the future. Care plans and risk assessments demonstrated that the home worked with the people who live there, their relatives (where possible) and health professional to support people to make choices and take risks appropriate to their abilities and progress. One person spoken with told us that staff were supportive which enabled them to pursue their individual educational and social interests, and that there were sufficient Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: staff do do this where one to one support was needed. During the inspection it was evident that support was provided on on a number of personal issues and that staff had time to sit and talk and provide constructive advice where this was required. Care Homes for Adults (18-65 years) Page 13 of 26 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. Peoples personal development, social and educational needs are encouraged and well supported by staff. Evidence: It was evident from the care plans that each persons educational and social needs and aspirations were enabled and supported by staff. There were some planned activities such as college days, sports activities and holidays, and other activities such as shopping and going to the park and to church were arranged to fit in as people chose. Peoples personal achievements were celebrated and in some cases recorded in the companys magazine. Certificates and cups for sporting achievements were displayed Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: in one persons room and it was evident that both the resident and staff were proud of these. Although the home has a menu planner this is very flexible. People were able to choose what they would like to eat and the meals were cooked by the staff, and people are able to assist with supervision. Care Homes for Adults (18-65 years) Page 15 of 26 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. Peoples physical and emotional healthcare needs are met Evidence: Both residents files were seen. They provided detailed information regarding the specific health and emotional healthcare needs of the people who lived in the home. Visits with GPs, Community Nurses (CPNs) and other health professionals such as opticians, chiropodists, dentists etc were well documented. The medicines were checked. Neither person was self medicating at the time of inspection. Prescription sheets were completed correctly. Staff had received medication training through Boots the Chemist, and Boots provided and disposed of all their prescribed medication. Homely remedies, such as paracetamol, had been discussed with the GP and added to the prescription sheet to be given as required. The home does not have a medicines fridge but the manager said that she could order Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: one at short notice should this be necessary. One person spoken with said that the staff were caring and supportive. Care Homes for Adults (18-65 years) Page 17 of 26 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. Arrangements for receiving and responding to complaints ensure that peoples right are protected. Evidence: We reviewed the Complaints file. Two complaints had been received in the last twelve months and had been dealt with appropriately. CQC had received on complaint, linked to a complaint made to the home. This has since been resolved. The home had the necessary safeguarding policies and procedures which were reflective of local guidance. Staff received appropriate training in safeguarding vulnerable adults and were able to show that they new what procedures to follow and were of whistleblowing procedures, if this was required. There was accessible information regarding advocacy should people or their relatives require independent help or advice. Care Homes for Adults (18-65 years) Page 18 of 26 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. A comfortable, clean and modern environment reflects the younger age of the people who live in the home. Evidence: The home was clean and well maintained. The modern decor was reflective of the younger people who live there. The were two communal rooms - a games room and a sitting room with TV & DVD player - and a bright, modern kitchen leading to an enclosed, safe garden. Peoples rooms were bright and well personalised. Each one had a sink and there were sufficient, additional bathrooms and toilets. The home was comfortable and safe with both specific and generic risk assessments to ensure that the people who lived in the home and staff who work there did so within a safe environment. Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff at the home are trained and sufficient in number to meet the needs of the people who live there. Evidence: At the time of the inspection there were two people resident in the home. The number of staff were sufficient to provide either one to one or two to one care as was required. One fairly new staff member showed us her induction programme which had been completed over a ten day period providing the basic knowledge required to care for the people who lived there. Staff receive mandatory training in specific areas such as Health & Safety which are updated on an annually basis. All staff had an National Vocational Qualification in care (NVQ) Level 2 or 3 to ensure that they had the skills to care for the people who lived in the home. Staff received regular, recorded supervision to ensure that they are well supported by Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: the manager. All staff files were reviewed. All staff had received an enhanced Criminal Records Bureaus (CRB) check. Other details such as application forms etc were stored at head office but could be provided as required. In addition, a recruitment check sheet had been ticked and signed to say that all the necessary documentation had been received and was satisfactory. The manager said that she vetted all references and was involved in the recruitment of staff to ensure that staff employed were suitable to work with vulnerable people. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager provides support and leadership to ensure that people who live in the home receive a good standard of care. Evidence: The manager is a Registered Mental Nurse (RMN) with a level 4 NVQ and many years experience in care. She has a personal development plan that includes improving her skills in the care of people with mental health and learning disabilities. She intends to re-apply in September to CQC to become the Registered Manager for the service. The home has a quality assurance (QA) programme and is visited regularly by the QA manager, who was there on the day of the inspection. People who live in the home, relatives, staff and health professionals are provided with satisfaction surveys to give them an opportunity to comment on the care provided. These were then analised and a written report with bar charts provided. It was disappointing to note that having Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: been given the opportunity in 2008 relatives and heath professional had failed to respond. This years surveys were yet to be analised. Additional QA recorded checks were made such as regular medication audits to ensure that standards of good care were maintained. Care Homes for Adults (18-65 years) Page 23 of 26 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 24 of 26 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 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 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) 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 26 of 26 - 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. You have been warned!