Care Home: Conroy Close (2)

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What the care home does well There have been no new admissions to the home since our last visit. The manager is aware that people need to have their needs assessed before they move into the home and that records of this assessment should be available. New people would still be introduced gradually to the service, to help make sure it is the right place for them to live and to help them get to know the other people who live and work at Conroy Close. In our surveys we asked people if they had been asked if they wanted to move into the home and all six people answered `yes`. During our visit we looked at one person`s care records. Since our last visit the home`s manager and staff have done a lot of work to improve people`s care records. The records have been re-organised and include information about people`s health needs, their person centred plans and reviews, their risk assessments, their financial situation and the social activities and education they like to take part in. People had been involved in reorganising their files. In our surveys we asked people if the staff treated them well. All six people said `always`. During our visit we saw staff interacting nicely with the people who live in the home and staff were able to tell us how they did things in ways that maintained people`s privacy and dignity. We also asked if people could do what they wanted during the day, in the evening and at weekends. All six people said they could do what they wanted during the day and in the evening. People`s weekly planners and records showed us that they are very active during the week, with placements and social activities. People`s comments about the home and the staff included `they try to take me out as much as they can` and `they always try to help me`. We ate lunch at the home and found that the food was very nice. Staff usually eat their meals with the people who live at the home, making meals a sociable experience. People told us that the food at the home was good, saying things like `they are good at cooking` and `the food is good`. People are involved in deciding what meals they have and the manager is looking into possible alterations to the kitchen, which would make it easier for people to help with cooking and food preparation. The care records we looked at showed us that nutritional screening and monitoring has been introduced. The manager also toldus about a new community committee that has been set up to provide nutritional advice, discussions and regular access to weigh scales that can be used by people in wheelchairs. Some of the people who live at the home are involved in this committee. During our visit we looked at the way medication is being stored and administered at the home. Since our last visit the home has reviewed the way medication is managed and changed their pharmacy provider. They now use the monitored dosage system that is supplied by Boots. Records showed us that a pharmacist from Boots had recently completed a medication audit and found no problems. We checked a random sample of medications and medication administration records and found that these were accurate and correct. Staff told us that they have completed medication training and a weekly check of medication stock and the medication administration records is being completed, to make sure that people are getting the correct medication. We were also shown the new `medication pen pictures` that are being developed for each person who lives at the home. These provide information about the medication people take, how they like to take it and any possible side effects. Protocols were also being developed for the people who have medication that is prescribed on an `as required` basis, to help staff decide when it is appropriate to give it. All six people who returned our surveys told us that there was someone they could speak to if they were unhappy and that they knew how to complain if they needed to. Staff also told us that they knew what to do if someone raised concerns about the service. There have been no recent complaints made to the home and no complaints made to us since our last visit. Staff we spoke to confirmed that they had been trained on recognising and reporting abuse. Some staff were updating their training on this during the next week. The manager is currently liaising with the local authority, because of the behaviour of one of the people who lives at the home. There have been some incidents between this person and the staff and other people who live at the home. The manager has kept the local authority informed of these incidents, but formal safeguarding procedures haven`t yet been considered necessary. The manager has agreed to contact the local safeguarding team about this again, to make sure that people are being adequately protected. In our surveys we asked people if the home was kept fresh and clean. Five people said `always` and one said `usually`. During our visit we saw that the home was clean and tidy. It is decorated and furnished in a homely way and people have made their bedrooms individual, with their own furnishings and decorating decisions. Some changes have been made to help one person find their way around more easily and there are plans to install a shower so that people have more choice. The manager has made changes to the home`s rotas, so that staffing can be more flexible and based on people`s needs. Some people living at the home get one-to-one and two-toone staff hours and the rotas showed how these were being provided. New staff have been recruited to help cover the increased staff hours that are now needed. We looked at the recruitment records for a new member of staff. These records confirmed that the new staff member had been recruited carefully and that the required checks had been completed before they started to work in the home. People we spoke to felt that staffing levels at the home were generally good. Comments made to us included `staffing is a lot better than it was before, much better, time for activities and in the house daily bits and bobs` and `we`re all flexible with the rota and things like that`.Staff we spoke to told us that they were provided with regular training. The home`s training records also showed us that staff are provided with appropriate training. Comments made to us included `brilliant training` and `we`re forever on courses and I`m at the moment going on renewals, you know, where you go to jog your memory`. All five staff who returned our surveys were also pos What the care home could do better: In our surveys only four people said that they could do what they wanted at weekends. People also said things like `I wish I could go out more at weekends` and `I wish they could take me out more`. People`s weekly planners showed us that they are very active during the week, but that things are quieter during the weekend. We discussed this with the manager, who agreed that it was an area they intended to look at and try to improve. Some of the communal parts of the home would benefit from being re-decorated, so that they look nice and well maintained. The manager still needs to apply for registration with us. We discussed the delay with her during our visit and expect to receive an application very soon. Random inspection report Care homes for adults (18-65 years) Name: Address: Conroy Close (2) 2 Conroy Close Easingwold North Yorkshire YO61 3NS one star adequate service 27/08/2009 The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Rachel Martin Date: 2 9 0 4 2 0 1 0 Information about the care home Name of care home: Address: Conroy Close (2) 2 Conroy Close Easingwold North Yorkshire YO61 3NS 01347821488 Telephone number: Fax number: Email address: Provider web address: h1002@mencap.org.uk www.mencap.org.uk Name of registered provider(s): Name of registered manager (if applicable) Royal Mencap Society Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 6 Number of places (if applicable): Under 65 Over 65 6 learning disability Conditions of registration: 6 Service Users to include up to 6 (LD) and up to 6(LD(E)) up to a maximum of 6 Service Users. Date of last inspection Brief description of the care home Number 2 Conroy Close is registered to provide residential care for up to six people. It is registered to provide care for younger adults with learning disabilities, although the home is also registered to provide care for older people providing their needs are primarily those of someone with a learning disability. The registered provider is Mencap, who leases the building from a landlord and provides the care. The home is a single storey bungalow, providing single bedroom accommodation and suitable communal space. There are pleasant patio and garden areas. Conroy Close is Care Homes for Adults (18-65 years) Page 2 of 9 2 7 0 8 2 0 0 9 Brief description of the care home situated in a residential area, close to the local services and amenities of Easingwold. At the time of this inspection the homes fees were £911.85 per week. Up to date information about the homes fees and terms and conditions should be sought directly from the homes manager. Care Homes for Adults (18-65 years) Page 3 of 9 What we found: This was an unannounced inspection of the care home at 2 Conroy Close. The visit was completed on 29th April 2010 by one inspector. The homes staff and the people living there did not know that we were going to visit on this day. During our visit we looked at a selection of records, looked round some parts of the building and talked to some of the people who live at the home and the staff who work there. Before our visit we looked at all of the information we had about the service and asked the home to complete an annual quality assurance assessment. This is a self-assessment that tells us about the home. We also sent out surveys to people who live and work at the home. Six people who live at the home and five staff completed and returned surveys to us. We used all of this information to plan our inspection visit and have included it in this report where appropriate. What the care home does well: There have been no new admissions to the home since our last visit. The manager is aware that people need to have their needs assessed before they move into the home and that records of this assessment should be available. New people would still be introduced gradually to the service, to help make sure it is the right place for them to live and to help them get to know the other people who live and work at Conroy Close. In our surveys we asked people if they had been asked if they wanted to move into the home and all six people answered yes. During our visit we looked at one persons care records. Since our last visit the homes manager and staff have done a lot of work to improve peoples care records. The records have been re-organised and include information about peoples health needs, their person centred plans and reviews, their risk assessments, their financial situation and the social activities and education they like to take part in. People had been involved in reorganising their files. In our surveys we asked people if the staff treated them well. All six people said always. During our visit we saw staff interacting nicely with the people who live in the home and staff were able to tell us how they did things in ways that maintained peoples privacy and dignity. We also asked if people could do what they wanted during the day, in the evening and at weekends. All six people said they could do what they wanted during the day and in the evening. Peoples weekly planners and records showed us that they are very active during the week, with placements and social activities. Peoples comments about the home and the staff included they try to take me out as much as they can and they always try to help me. We ate lunch at the home and found that the food was very nice. Staff usually eat their meals with the people who live at the home, making meals a sociable experience. People told us that the food at the home was good, saying things like they are good at cooking and the food is good. People are involved in deciding what meals they have and the manager is looking into possible alterations to the kitchen, which would make it easier for people to help with cooking and food preparation. The care records we looked at showed us that nutritional screening and monitoring has been introduced. The manager also told Care Homes for Adults (18-65 years) Page 4 of 9 us about a new community committee that has been set up to provide nutritional advice, discussions and regular access to weigh scales that can be used by people in wheelchairs. Some of the people who live at the home are involved in this committee. During our visit we looked at the way medication is being stored and administered at the home. Since our last visit the home has reviewed the way medication is managed and changed their pharmacy provider. They now use the monitored dosage system that is supplied by Boots. Records showed us that a pharmacist from Boots had recently completed a medication audit and found no problems. We checked a random sample of medications and medication administration records and found that these were accurate and correct. Staff told us that they have completed medication training and a weekly check of medication stock and the medication administration records is being completed, to make sure that people are getting the correct medication. We were also shown the new medication pen pictures that are being developed for each person who lives at the home. These provide information about the medication people take, how they like to take it and any possible side effects. Protocols were also being developed for the people who have medication that is prescribed on an as required basis, to help staff decide when it is appropriate to give it. All six people who returned our surveys told us that there was someone they could speak to if they were unhappy and that they knew how to complain if they needed to. Staff also told us that they knew what to do if someone raised concerns about the service. There have been no recent complaints made to the home and no complaints made to us since our last visit. Staff we spoke to confirmed that they had been trained on recognising and reporting abuse. Some staff were updating their training on this during the next week. The manager is currently liaising with the local authority, because of the behaviour of one of the people who lives at the home. There have been some incidents between this person and the staff and other people who live at the home. The manager has kept the local authority informed of these incidents, but formal safeguarding procedures havent yet been considered necessary. The manager has agreed to contact the local safeguarding team about this again, to make sure that people are being adequately protected. In our surveys we asked people if the home was kept fresh and clean. Five people said always and one said usually. During our visit we saw that the home was clean and tidy. It is decorated and furnished in a homely way and people have made their bedrooms individual, with their own furnishings and decorating decisions. Some changes have been made to help one person find their way around more easily and there are plans to install a shower so that people have more choice. The manager has made changes to the homes rotas, so that staffing can be more flexible and based on peoples needs. Some people living at the home get one-to-one and two-toone staff hours and the rotas showed how these were being provided. New staff have been recruited to help cover the increased staff hours that are now needed. We looked at the recruitment records for a new member of staff. These records confirmed that the new staff member had been recruited carefully and that the required checks had been completed before they started to work in the home. People we spoke to felt that staffing levels at the home were generally good. Comments made to us included staffing is a lot better than it was before, much better, time for activities and in the house daily bits and bobs and were all flexible with the rota and things like that. Care Homes for Adults (18-65 years) Page 5 of 9 Staff we spoke to told us that they were provided with regular training. The homes training records also showed us that staff are provided with appropriate training. Comments made to us included brilliant training and were forever on courses and Im at the moment going on renewals, you know, where you go to jog your memory. All five staff who returned our surveys were also positive about the training they had been given. The homes manager has made a lot of changes and improvements since our last visit. She was able to demonstrate a good understanding of the needs of the service and how things could be continuously made better. Comments made to us about the homes management included she is good, she praises us, we have our meetings, if I had a problem Id go to her and shed sort it out and things are good, we are going in the right direction. Although staff are not receiving a formal, recorded supervision session six times a year, they are receiving support and having their work supervised. For example, there are regular staff meetings, observations and competency checks are carried out and an annual appraisal is completed. Staff we spoke to felt that they were well supported and can raise any difficulties with their manager whenever they need to. The manager told us they get a lot of supervision, but Im not good at formalising it. We have a good open door policy and staff will come if there is anything and well sort it out. 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 2. Care Homes for Adults (18-65 years) Page 6 of 9 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 7 of 9 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, 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 1 2 13 24 The service should look at how choices about activities and outings can be improved at the weekends. Some of the communal parts of the home would benefit from being re-decorated, so that they look nice and well maintained. The manager should apply for registration with us as soon as possible. 3 37 Care Homes for Adults (18-65 years) Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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