Care Home: Douglas Close (19)

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What the care home does well The home continues to provide a gentle, relaxed and stable environment which meets the range of residents needs residing at the home. Central to the aims of the home is the promotion of community access with services and practises designed to enable residents to positively access as many aspects of the local community as possible. Resident`s lives are enriched by excellent practises in the promotion of meaningful occupation, leisure pursuits, choices and being enabled to live chosen lifestyles. Good person centred care plans helps to ensures that residents support needs are thoroughly assessed enabling the staff to provide individual support with residents actively engaged in the development and review of their plans. Staff make a positive contribution in residents lives as residents benefit from a supervised, well trained and enthusiastic staff team that know them and who are robustly recruited and employed in sufficient numbers as is necessary to meet their needs. Resident`s benefit from a well motivated and knowledgeably manager who promotes good practises and has a strong leadership and runs the home in the best interest of residents. What the care home could do better: There are no areas of shortfalls in practises which have resulted in requirements beingmade. Random inspection report Care homes for adults (18-65 years) Name: Address: Douglas Close (19) 19 Douglas Close Jacobswell Guildford Surrey GU4 7RB three star excellent service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Jane Jewell Date: 3 0 0 4 2 0 1 0 Information about the care home Name of care home: Address: Douglas Close (19) 19 Douglas Close Jacobswell Guildford Surrey GU4 7RB 01483537181 F/P01483537181 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Adrianne Gallagher Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Pamela Mary Eales care home 3 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 3 The maximum number of service users who can be accommodated is: 3 The registered person may provide the following category/ies of service only: Care home only - PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - LD Date of last inspection Brief description of the care home 19 Douglas Close is a care home providing personal care for up to three adults both male and female who have a learning disabilities and who are over the age of 45 years. The home is owned and managed by Just Homes who also own a further five Care Homes for Adults (18-65 years) Page 2 of 11 Brief description of the care home residential care homes in the south east. The building is a converted domestic detached bungalow situated in a quiet residential close in Jacobs Well village. Guildford and Woking town centre is a short distance away and has a large range of public services and amenities. The village has a thriving community spirit and the residents of 19 Douglas Close are actively involved in the local community. The premises are presented across a ground floor with level access throughout the internal areas. Residents accommodation is for single occupancy with communal washing and bathrooms available. Communal space consists of a large combined lounge/ dining room, fitted kitchen, utility room, bathroom, separate shower room, and an activity. There is a terraced area in the garden which provides seating and additional occasional dinning out areas. The manager reported that the fees for residential care currently range from £47,129 to £71,822 per annum, depending on the services and facilities provided. Extras such as: newspapers, hairdressing, chiropody, transport , toiletries are additional costs. Care Homes for Adults (18-65 years) Page 3 of 11 What we found: At the last Key inspection the home was assessed as providing excellent outcomes for residents, there has been no evidence to indicate that this has changed and therefore instead a random inspection was undertaken to just focus on some key outcome areas for residents. The random inspection was undertaken across three hours and was facilitated by the registered manager Adrianne Gallaghen. The inspection involved a brief tour to the premises, discussion with two residents, two staff and two residents and examination of some of the homes key documentation. Feedback surveys were sent to the home for distribution and nine were return, six were completed by staff, and three from residents and their comments are included in this report. Residents continue to live in a clean and homely environment with their personal space individualised to reflect their lifestyle and preferences. A resident fedback the room is clean and tidy my room is decorated nicely we have lots to do and go on nice holidays. A relative commented Always clean and tidy and he has everything in his bedroom he needs. There are three residents residing at the home who are assessed as having a range of needs including learning disabilities and some complex physical needs. Residents ages range from 58 to 91 years. Residents present as a close cohesive group who have lived together several years. There has been no admissions to the home since 2007. Through observation, looking at records and speaking to residents, staff and relatives it was clear that the home is able to meet the range of residents needs. Residents spoke positively about their experiences at the home, a sample of their comments included I love living her. I feel like part of a family I do not think they could do anything better it is a lovely place and I am very happy living here the staff are all so kind and helpful. I like watching TV the staff bring me cups of tea. A sample of relatives feedback included I can visit anytime and I could not look after him as well as they do they really know what they are doing. Consistent feedback from staff was received regarding what the home does best was putting residents needs first and providing high standards of community access. Three individual plans of care were viewed which contained comprehensive, detailed and up to date information on residents needs and the appropriate guidance for staff on how to support residents to meet these needs. Person centre planning is an established and embedded practises at the home with residents actively participating in the development and review of their plans. Staff consulted with were very knowledgeable about the individual support needs of each resident. Any changes in residents needs and preferences are identified promptly through the regular review of care plans. Daily notes are recorded on each resident, which recorded the actions and events that have occurred. One example was noted whereby details were not written in a respectful tone and the manager agreed to address this immediately. The manager subsequently confirmed that they had also reviewed all other documentation at the home to ensure that this was a one off incident. The home follows (John O Brien Philosophy ) to underpin the care planning process which concentrates on five main areas of person centred planning (Community Presence, Care Homes for Adults (18-65 years) Page 4 of 11 Community Participation, Choice, Respect, and Competence). This ensures that central to the ethos of the home is the promotion of individuality and community presence, with residents positively engaged in the local community, through use of local facilities, attendance of two local churches and participation in local community groups. Residents spoke of undertaking a wide Variety of activities and occupations including day centres, cinemas, shopping, friendship groups. One resident spoke enthusiastically about their interest in all things royal and frequently visit Buckingham Palace to view the changing of the guards. A relative fedback He does lots of things including the day centre always going out, it is the perfect location. Staff spoke about residents being able to be spontaneous in their choice of activities as this is made possible by adequate staffing levels and the home having its own vehicle. Much positive feedback was received by residents on the importance and the fun they have on their annual holidays. Recent holidays have included overseas holidays with families or UK based holidays with other residents and staff. The manager confirmed that there is a subsidies budget to ensure that all residents have equal leisure opportunities. Respecting residents rights to make decisions about their lives is integral to the ethos of the home. Much feedback was received from residents on how they make decisions about what to eat, how to decorate their bedrooms, how to spend their day and what leisure activities to undertake. Any potential restrictions on a residents freedom of choice have been dealt with appropriately through new legislation (Mental Capacity Act) which effects residents rights to make decisions in their lives. The home has a developed system in place for enabling residents to take responsible risks as part of an independent lifestyle. For example core risks faced and posed by residents are assessed and any measures to reduce or mange the risk is recorded for staff to follow. A range of ways was seen of how well residents are actively involved in the running of the home with regular meetings and consultations, all of which was confirmed in records and discussions with residents. Residents are supported to access a wide range of health care services, to meet their individual needs and their health action plans. This includes input from GPs, specialist nurses teams, Occupational Health, speech and language therapists, dentists, and opticians. A relative spoke of how the staff have managed to stabilise their relatives complex health care needs. It was clear that where there are concerns regarding the health or welfare of residents prompt medical advice or intervention is sought on their behalf by staff with a resident commenting If I do not feel very well they get the doctor for me. There is an accessible complaints procedure for residents, their representative and staff to follow should they be unhappy with any aspect of the home. No formal complaints has been received or recorded by the home since the previous inspection. All residents consulted with felt confident to approach any member of staff with any concerns and felt that it would be dealt with promptly. A relative fedback Complaints can talk about anything if you have a slight query they would do anything to help. The home has written policies covering adult protection and whistle blowing. These make Care Homes for Adults (18-65 years) Page 5 of 11 clear the vulnerability of people in residential care, and the duty of staff to report any concerns they may have to a responsible authority for investigation. Staff have received formal training in safeguarding adults and prevention of abuse and the staff consulted with showed a good understanding of their roles and responsibilities under safeguarding adults guidelines. Residents felt that there was always sufficient staff around for them to get the support or advice they needed when they wanted it. Staff confirmed that there is some flexibility in the staffing hours should they need additional cover. There is a small stable staff team who have worked at the home for some time and who knew the residents well and were observed providing dignified sensitive support, which also used appropriate humour to help aid communication. Residents feedback about staff included staff are very nice always someone around to help me and the staff re kind and helpful. A relative fedback The staff are excellent. Consistent feedback was received by staff of the positive working environment, their comments included I have worked for just homes for 10 years and received a lot of job satisfaction. I have also found it a constant learning process and I myself have worked at the home for 9 years . The home has been an inspiration to me. I have had the opportunity to build my career with the support of my home. There is currently an all female staff team with a staff member confirming that they were not aware of any residents expressing a gender preference for staff. The manager confirmed that all but a part time staff member have obtained a National Vocation Qualifications (NVQ). The manager reported that there is little staff turnover and therefore limited recruitment. The personal files of a staff were inspected and this showed that a good recruitment process is followed which includes the use of an application form, interviews, Criminal Records Bureau (CRB) checks and written references prior to employment commencing to help ensure that only staff who are suitable to work with vulnerable people are employed There is a commitment to improving staff skills through an ongoing training programme both in practical matters and the broader aspects of working with people who have learning disabilities. Staff confirmed that there is a formal programme of monthly supervision and direct supervision with the manager working along side support staff each shift. All staff consulted with felt well supported by the manager to undertake their roles. The registered manager has considerable experience in working and managing services for people who have a learning disability. They confirmed that they hold the recommended management qualifications and have undertaken ongoing training to keep updated in best care practise issues and changes in legislation. They demonstrated much commitment and understanding of the promotion of independence and in the daily running of a care home. They provide a strong sense of leadership and direction which enables staff to then provide good individual support. A sample of comments about the manager very nice manager fantastic very personable support easy going Manager excellent can always get hold off very accessible so is the owner Douglas close is a very well organised home and the home manager has set a very high standard and the staff team follow by example. Care Homes for Adults (18-65 years) Page 6 of 11 There are several mechanisms in place for the manager to obtain feedback on the services of the home and whether it is achieving its aims and objectives. These include, annual placement reviews, residents and staff meetings, internal quality audits, written feedback from relatives and health care professionals. Examples were noted whereby improvements to the homes working practises and the environment have been made based on this feedback. Written guidance is available on issues related to health and safety. Records submitted by the manager prior to the inspection stated that all of the necessary servicing and testing of health and safety equipment has been undertaken. There are regular health and safety checks around the building. Systems are in place to support fire safety, which include, regular fire alarms and emergency lighting checks, staff training and maintenance of fire equipment and fire drills were reported to have been undertaken. The manager reported that a fire risk assessment has been undertaken by themselves. This records significant findings and the actions taken to ensure adequate fire safety precautions in the home. The area manager undertakes the required monthly audit of services and facilities on behalf of the provider to monitor the quality of the homes services and facilities. They had completed a comprehensive written report on their visit highlighting areas of good practises and of any areas for future service development. What the care home does well: What they could do better: There are no areas of shortfalls in practises which have resulted in requirements being Care Homes for Adults (18-65 years) Page 7 of 11 made. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Adults (18-65 years) Page 8 of 11 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 9 of 11 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 10 of 11 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. 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