Care Home: Drayton Road (14)

What the care home does well There is information available for service users in a format which they can understand and their needs would be assessed before they move to the home to ensure that they could be met. Service users choose how they would like to spend their day and are given support to make as many decisions as they are able. Their support plans are comprehensive and up to date. Risk assessments are undertaken to enable service users to undertake a variety of interests whilst minimising the risk of them coming to any harm. Menus are varied and service users have a choice of meals. Meals are well balanced nutritionally and are well cooked and appetising. Service users are registered with the local health services and staff are very aware of their health needs. They know the residents well and respond quickly if residents are unwell. Medication is managed well. Complaints and safeguarding issues are managed well and service users concerns are acted upon promptly. They are protected from harm. The complaints procedures are available in an easy read and large print format to make them more accessible for service users who may have difficulty understanding complex ideas. The home is homely and welcoming. It is well maintained and part of the local community. There is a good access for people with disabilities. Service users are encouraged to personalise their rooms, which were comfortable and clearly reflected their tastes and interests. There is a consistent staff team who have training to meet service users` diverse and complex needs. Recruitment procedures are thorough and should protect service users from unsuitable staff. There is an experienced manager overseeing the home in the absence of the registered manager. She is supported by the organisation`s senior management team. The organisation has a quality assurance procedure in place and regularly consults with service users and their families on the standards of care and support offered. What has improved since the last inspection? Medication management has been improved and medication is recorded accurately. Staff are now reporting potential safeguarding concerns to the local authority which is the lead agency in these matters and taking their advice as to how they should be handled. Recruitment procedures have been improved to ensure that staff working on an occasional basis are recruited to the same high standards as permanent staff. All staff now have an induction programme. All staff have had moving and handling training to ensure that service users and staff do not come to harm arising from their care. Fire safety training has been implemented. Staff do not now use latex gloves which may cause allergic reactions to both staff and service users. What the care home could do better: There have been no requirements or recommendations made as a result of this inspection. Key inspection report Care homes for adults (18-65 years) Name: Address: Drayton Road (14) Drayton Road (14) Newton Longville Bucks MK17 0BJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Chris Sidwell     Date: 1 2 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. 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. Care Homes for Adults (18-65 years) Page 2 of 24 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 24 Information about the care home Name of care home: Address: Drayton Road (14) Drayton Road (14) Newton Longville Bucks MK17 0BJ 01908649592 01908649592 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Turnstone Support Ltd Name of registered manager (if applicable) Emma Louise Kilarski Type of registration: Number of places registered: care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: 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 Physical disability - PD Date of last inspection Brief description of the care home 14 Drayton Road is a care home providing personal care and accommodation for three younger people with learning and physical disabilities. The home is run by Turnstone Support Ltd and is situated in Newton Longville, which is a small village on the edge of the market town of Bletchley in Buckinghamshire. The home is centrally located within the village. Although village amenities are limited, the home is close to them and makes full use of the facilities. Bletchley and the new town of Milton Keynes provide Care Homes for Adults (18-65 years) Page 4 of 24 Over 65 0 0 3 3 0 7 0 5 2 0 0 9 Brief description of the care home the home with a wider range of amenities. Both towns are within a short journey of the home. 14 Drayton Road is a large, detached bungalow, which has been well designed and refurbished to meet the needs of the three service users who reside there. All bedrooms provide single room accommodation but do not have adjoining en-suite facilities. As the home is a bungalow, there is no passenger lift but aids and adaptations are fitted at key assessed points. The home has a drive that is able to accommodate three vehicles and there is a small garden to the rear and side of the building. Care Homes for Adults (18-65 years) Page 5 of 24 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: This inspection was conducted over three days and included a review of the information we hold about the service and an unannounced visit to the home of six hours. Information received about the home since the last inspection was taken into account in the planning of the visit. Questionnaires were sent to the home for distribution to service users, families, staff and other stakeholders. Service users were spoken to on the day of the unannounced visit. Discussions took place with the manager and care staff and some records were checked. Care practice was observed and the care of one service user was followed through in detail. The homes approach to equality and diversity was considered throughout. Care Homes for Adults (18-65 years) Page 6 of 24 What the care home does well: What has improved since the last inspection? Medication management has been improved and medication is recorded accurately. Staff are now reporting potential safeguarding concerns to the local authority which is the lead agency in these matters and taking their advice as to how they should be handled. Recruitment procedures have been improved to ensure that staff working on an occasional basis are recruited to the same high standards as permanent staff. All staff now have an induction programme. All staff have had moving and handling training to ensure that service users and staff do not come to harm arising from their care. Fire safety training has been implemented. Staff do not now use latex gloves which Care Homes for Adults (18-65 years) Page 7 of 24 may cause allergic reactions to both staff and service users. 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 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 24 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 24 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. There is information about the service for service users in a format which they can understand and their needs are comprehensively assessed before they move to the home. Evidence: The home has a statement of purpose and service users guide which is in pictorial format to help them understand the information. Records showed that these had been explained to service users. There have been no admissions to the home since the last inspection which has a stable group of service users. The organisation has policies and procedures in place to guide staff should a vacancy arise. All prospective service users would be fully assessed and would be introduced to the existing service users to ensure that their needs could be met and that they would settle in with the established group. Care Homes for Adults (18-65 years) Page 10 of 24 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. Service users needs and wishes are identified with them and their care plans hold detailed information to guide carers and to support service users to engage in everyday activity in a safe way. Evidence: The care records of one service user was examined in detail. They held a comprehensive care plan which described the care which has been agreed. There was information to show that the service user and her family had been involved in developing the care plan. Aspects of the care plan were available to the service user in a pictorial format and there was information to show that the key worker had talked to her about her care. The care plan had been updated regularly and a regular review had been held with the service user, her family and care manager. A communication dictionary and a personalised symbols chart was used to engage the service user in making decisions about care and what she wanted to do. Carers were observed to offer service users a choice of meal, clothes to go out in and to give them time to indicate their wishes in everyday activities. An independent advocate visits the home Care Homes for Adults (18-65 years) Page 11 of 24 Evidence: regularly to help service users communicate their wishes. Comprehensive risk assessments were in place to support service users in their activities and to reduce the risk to them arising for their disabilities. Care Homes for Adults (18-65 years) Page 12 of 24 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. Service users enjoy a varied lifestyle of their own choosing. Meals are good meeting service users nutritional and social needs. Evidence: None of the service users have a work placement at the moment but all have full and active lives. There is daily programme of activities and excursions which are undertaken as a group or individually. These are documented in care plans. Service users are a part of the local community and have access to college courses and links with other homes and specialist clubs. On the day of the unannounced visit, service users were going out together to local college cookery classes, then on to a party at another home and out to gateway club in the evening. There was evidence in the service users files that they remain in contact with their families who are welcomed at any time. Care Homes for Adults (18-65 years) Page 13 of 24 Evidence: There is a varied menu, with three meals a day, breakfast, lunch and supper. Picture cards are used to help people choose what they would like to eat. Records are kept of the meals provided. These show that the meals are well balanced nutritionally and varied. The meal on the day of the unannounced inspection was well cooked, appetising and presented well. Mealtimes were observed to be a sociable occasion. Nutritional advice had been sought from the dietician for one service user who was overweight and for another who had swallowing difficulties. Care Homes for Adults (18-65 years) Page 14 of 24 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. Service users personal, healthcare and medication needs are met safely. Evidence: Service users health care needs are met. There is good liaison with local healthcare teams and clear evidence in the service users records that they see the general practitioner and other members of the healthcare team on a regular basis. They visit the dentist regularly. There are medication policies and procedures in place. The management of medication has improved since the last inspection. All medication was recorded, included prescribed creams. It was clear whether medication had been discontinued and the medication administration charts had been completed in full. The manager audits medication management on a monthly basis. Staff said that medication was never administered covertly. None of the service users are able to manage their own medication. This is kept in a locked cupboard in their own rooms. The key is stored in a key safe in the room. All care staff have had training in medication administration. Care Homes for Adults (18-65 years) Page 15 of 24 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. The home has systems in place which should protect service users from harm. Evidence: The organisation has complaints and safeguarding policies in place. There is an easy read version available for service users. Everyone had a copy of the complaints policy in their personal file. Information about how to make a complaint is posted on the notice board as are details of local advocacy services. Complaints are monitored as part of the organisations quality assurance programme. The manager said that there have been no complaints since the last inspection. She said that any concerns are usually raised verbally and are dealt with immediately. The atmosphere in the home was relaxed and happy, supporting this approach. There are safeguarding policies and procedures in place. The home has a copy of the local multi agency procedures. A requirement was made at the last inspection that the manager should ensure that staff were clear as to their responsibilities to report potential safeguarding concerns. This has been addressed. Staff have had refresher training and appropriate reports are now made to the local authority which is the lead agency in these matters. There are systems in place to safeguard service users personal allowance and valuables. Each resident has a cash tin, which is stored safely. Records of transactions and receipts are kept. One was checked at random and found to be correct. Care Homes for Adults (18-65 years) Page 16 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is maintained well and has good access for people with disabilities. It is a comfortable and homely place for people to live. Evidence: The home is a detached bungalow with good access for people with disabilities. There is an ongoing refurbishment programme and the exterior paintwork has been painted since the last inspection. Service users are encouraged to personalise their rooms which were homely and reflected their personal interests. The manager said that service users had helped to choose the colours to redecorate the communal areas. The home was clean and tidy on the day of the unannounced visit and there were no offensive odours. There is a garden which is accessible to service users. There are infection control policies and procedures in place and procedures for managing clinical waste. Staff have had training in infection control. All care is given in service users rooms and the communal bathrooms and toilets were spotlessly clean. The home does not have a copy of the latest guidance from the Department of Health on infection control which can be obtained from the web site www.dh.gov.uk Care Homes for Adults (18-65 years) Page 17 of 24 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. Service users receive support from well trained and enthusiastic carers. The recruitment procedures should protect service users from unsuitable care staff. Evidence: Carers were observed to be communicating well with service users who were not able to verbalise their feelings and wishes. Carers were aware of behaviours which service users might use to express their feelings. The training records showed that carers had training in communication, autism and epilepsy awareness. The records showed that mandatory training in safe working practices such as moving and handling was also up to date and that an ongoing programme was in place. The atmosphere was relaxed and carers gave service users time to help themselves as they prepared to go out. There was much laughter and residents were clearly enjoying themselves. The manager said that there was one part time vacancy at the moment. Only one shift had been covered by an agency carer who was known to service users during the last two weeks. The staff are flexible and the rotas are constructed around residents needs and their outings, including evening events. The recruitment files of one sessional worker and one permanent member of staff recruited since the last inspection were checked. A summary of the documentation held at the organisations head office was available in the home for the sessional Care Homes for Adults (18-65 years) Page 18 of 24 Evidence: worker. This showed that appropriate checks had been made. The recruitment file for the permanent member of staff held evidence that her identity had been checked and showed that appropriate checks had been undertaken before she started work. Two references had been sought, one from the previous employer. A Criminal Records Bureau disclosure had been received. Interview records had been kept and gaps in her CV had been explored and accounted for. The training records showed that she had had an induction and regular supervision. Care Homes for Adults (18-65 years) Page 19 of 24 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed in the interests of service users. Evidence: The registered manager is away from the home at present and acting arrangements have been put in place. An experienced manager from another home is overseeing both homes with the support of a team leader in each home. She is experienced in the support of people with disabilities and holds the registered managers award at level 4. Staff said that the arrangement was working well. The organisation has a quality assurance programme in place. An operations manager visits the home regularly and records of her visits are kept. Residents and families are asked their views on the running of the home on a regular basis. The organisation has been proactive in addressing the requirements of the previous inspection in a prompt and effective manner. There are health and safety policies and procedures in place and maintenance of essential services and equipment is up to date. Staff are completing the accident book Care Homes for Adults (18-65 years) Page 20 of 24 Evidence: correctly. The training records showed that they have had training in safe working practices including moving and handling and fire safety. Care Homes for Adults (18-65 years) Page 21 of 24 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 22 of 24 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 23 of 24 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 24 of 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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