Care Home: Durham Street and Endymion Street

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What the care home does well People`s needs are assessed before they move into the home to help make sure that the staff in the home are aware of these and can meet them effectively. People are supported to make decisions in their lives, this includes choosing where to go and what to do. Staff support people to go out in their local community and to maintain important relationships in their lives. We saw that relationships between the people living in the home and the staff team were appropriate and relaxed. There are systems in place to help protect and support people from harm this includes arrangements for identifying and reporting any allegations of harm and for handling people`s money. People live in a home that is clean and comfortable and health and safety checks are made to make sure that the home is safe for people to live in. What has improved since the last inspection? There is now a registered manager in post at the home. This means that there will be a consistent management approach and the staff will be well supported to care for the people who live at the home. What the care home could do better: The company needs to make sure they respond to people`s concerns in a timely manner. This will ensure that people have confidence in the management of the home and that complaints are resolved quickly. Key inspection report Care homes for adults (18-65 years) Name: Address: Durham Street and Endymion Street 49 51 & 53 Durham Street Hull East Yorkshire HU8 8RF     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: George Skinn     Date: 1 1 0 1 2 0 1 0 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 26 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 26 Information about the care home Name of care home: Address: Durham Street and Endymion Street 49 51 & 53 Durham Street Hull East Yorkshire HU8 8RF 01482620214 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): cince@avocettrust.co.uk Avocet Trust Name of registered manager (if applicable) Mrs Shafaq Malik Type of registration: Number of places registered: care home 7 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home The service at 49-53 Durham Street is managed by Avocet Trust who rent the premises from Sanctuary Housing Association. It is one of a small number of similar services that Avocet provides. Avocet Trust is a registered charity. 49-53 Durham Street is registered to provide care and accommodation for up to five (5) adults with a learning disability. The home is in the Holderness Road area, to the east of the city centre. 49-53 Durham Street consists of three (3) separate living units. No. 49 is a ground floor flat for one (1) person, with a bedroom, living room, kitchen, bathroom and rear garden. Nos. 51 and 53 have similar facilities with an additional single bedroom each and are for two (2) adults. No. 51 is at ground floor level. No. 53 is above it, accessed by an internal staircase with own front door. The properties adjoin each other and share a large communal garden at the front. There is parking Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 7 0 3 0 3 2 0 0 9 Brief description of the care home available on the street. 48 Endymion Street is a terraced property for two (2) people that is owned and managed by Avocet trust. The house consists of a small hall, lounge, dining room, kitchen and utility room, and two bedrooms with en-suite facilities. There are a variety of shops, pubs and health facilities nearby. Public transport to various parts of the city is accessible and in addition, people have access to cars arranged through their mobility benefits. Additional charges are made for the following: newspapers/magazines, hairdressing, chiropody, transport for social activities and sweets. Information on the service is made available to current people via the Statement of Purpose, Service User Guide and inspection report. 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 star. This means that the people who use the service experience good quality outcomes. The key inspection has used information from different sources to provide evidence. These sources include reviewing information that has been received about the home since the last inspection and a site visit which lasted four (4) hours. We looked at records relating to the people who live at the home, staff and the management activities. During the visit care practices were observed where appropriate, and time was also spent watching the general activity within the home. This site visit has been brought forward due to the CQCs change in inspection programme for the coming year, this means that we did not send an Annual Quality Assurance Assessment AQAA to the home prior to the site visit being carried out so no Care Homes for Adults (18-65 years) Page 6 of 26 information could be used from this to form our judgements. We sent surveys to the home to be completed and returned to us. We received four (4) surveys from the people who live at the home, these told us that people were happy living at the home and that they could choose how to spend their day, they also told us that people liked going on outings and there was plenty of opportunity for this. We received one (1) survey from a relative, this told that they were generally happy with the care and attention their relative received but that the company was slow in responding to a complaint they had made. We received one (1) survey from a visiting health care professional who told us that the home well run and the staff we caring and professional in their approach. We received six (6) surveys from staff who work at the home. These told us that the staff had received training about how to care for people with a learning disability and that they felt well supported by the management of the home. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future if a requirement is repeated it is likely that enforcement action will be taken. Date of last inspection 03/03/09 The manager was available to assist throughout the visit. Care Homes for Adults (18-65 years) Page 7 of 26 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 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. Peoples needs are assessed prior to moving into the home. Evidence: There have been no new admissions to the home since the last inspection. We looked at the files of those people who currently live at the home and we saw that these contained assessments undertaken by both the placing Local Authority and the home. Care Homes for Adults (18-65 years) Page 10 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples assessed needs are documented in care plans with good risk assessments to enable a measured approach to risk taking. We saw that staff ensure people who live at the home maintain a good quality of life by promoting independence and choice, providing opportunities for activities, occupational stimulation, access to local community facilities, and by ensuring that links to family and friends were maintained. Evidence: We saw that the files we looked at contained a wealth of information from needs assessments, risk assessments, personal profiles, monitoring charts and daily records with which to formulate care support plans to meet peoples identified needs. We saw that each file contained a comprehensive overview of the person and how they preferred to be supported with reference to likes and dislikes. The care plans were detailed and gave good guidance to staff on how to meet peoples needs in a consistent way. We saw that the care support plans were person centred and attention was paid to Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: how people communicated their needs in non verbal as well as verbal means. Pictures were used in the care support plans to make them more accessible to the person they were about. Staff told us how they used pictures and symbols to work with people who live at the home to establish their views on an ideal home for them. We saw that care support plans had been updated when peoples needs had changed or further information had been obtained. We saw that care plans were audited and evaluated on a regular basis with reviews being held internally and with the local placing authority to check progress. Review meetings involved family and relevant health care professionals. We saw that the care file was well organised into sections and easy for staff to access. We saw that each person had a range of relevant risk assessments with clear guidance for staff about how to minimise any perceived or actual risk. We saw that these were kept under review. Care Homes for Adults (18-65 years) Page 12 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. People who live at the home maintained a good quality of life because staff promote independence and choice, provide people with opportunities for activities, occupational stimulation, access to local community facilities, and ensure that links to family and friends are maintained. Evidence: We saw that staff ensure people who live at the home maintain a good quality of life by promoting independence and choice, providing opportunities for activities, occupational stimulation, access to local community facilities, and by ensuring that links to family and friends were maintained. We saw that the people who live at the home had weekly plans in symbol format that detailed their activities such as shopping for food supplies, household tasks, visiting local markets, clothes and personal shopping, lunches out in local cafes, trips to the Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: cinema, drives out to the coast, bowling, visiting garden centres and pubs, having manicures and one to one activities such as puzzles and games. We saw that most people continue to have contact with their families and spent quality time with them. We saw that the people who live at the home enjoyed a holiday each year. People used their mobility allowances for the purchase of cars for their personal use. Staff prepare the meals, we saw that the people who live at the home are supported to shop for food supplies and had input into the menus. Health eating is promoted but this continued to be balanced with special treats, likes and dislikes and individual choices and preferences. We saw that care plans detailed any support required or specialist equipment used. Kitchens were well equipped and each house had a pleasant dining room where meals could be taken together as a group. Care Homes for Adults (18-65 years) Page 14 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 health and personal care needs are planned for and met in the home. Medication is managed in a safe and responsible way. Evidence: We saw that people who live at the home have access to a range of health care professionals this includes GPs, dentists, opticians, community nurses, specialist nurses, dieticians, speech and language therapists and consultants via out-patient clinics. We saw that health action plans had been developed for each person and good records of health interventions and access to services were maintained. Accidents were recorded and body charts completed when any bump or knock resulted in a mark to the skin. We saw that peoples weight was recorded and healthy eating promoted where required. We saw that staff speak to people in a kind and caring way and there was clearly a good rapport between them. Each person who lives at the home has a designated key worker and relationships had been built up between them and the persons close family. We saw that the care support plans provided detailed information about how people wanted to be supported and the preferences they had for rising, retiring, Care Homes for Adults (18-65 years) Page 15 of 26 Evidence: activities, bathing, meals, appearance and clothes. We saw that best interest meetings had been held for when it was decided that people who live at the home were unable to make an informed choice about health care and treatment. These meetings involved advocates, families, health care professionals and the staff and management of the home. None of the people who live at the home self medicate, all of the medication is handled on their behalf by the staff. All staff have received accredited training. We saw that medication is handled safely and people are protected by the procedures in place for the staff to follow. Care Homes for Adults (18-65 years) Page 16 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. People are protected by the homes complaints procedure and kept safe from harm by the homes procedures and policies regarding safeguarding of adults. Evidence: We saw that there continues to be a complaint policy and procedure in place and this displayed around the home. The policy and procedure is also available in the Statement of Purpose and the Service User Guide. The CQC have received no concerns about the service since the last inspection and the home is not subject to any ongoing safeguarding adults investigation by the Local Authority Safe Guarding Team. We saw that all staff have received training about how to recognise abuse and how to report this, this training has been provided by Avocets training department and is part of the ongoing mandatory training the staff receive. A relative survey told us that they had raised a concern and the company was slow to respond. Care Homes for Adults (18-65 years) Page 17 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. People live in a clean warm and comfortable home. Evidence: Durham Street consists of three (3) houses. Two (2) of the houses accommodate one (1) person and the other house accommodates two (2) people. All the people who live at the home have a single room and these are decorated to their tastes and choices. All the rooms contained items of personal belongings. People are able to use their rooms when they wish. All the houses have a well equipped kitchen and a dining room. There are well equipped bathrooms for people to use, these were nicely decorated People have just recently moved back to Durham Street following repair work due to secondary flooding. Endymion Street is an older property that has been refurbished and updated. It provides clean and comfortable accommodation to the people who live there, and people have personalised their rooms. The staff told us that they are continuing to help people to furnish their home with smaller items to make it their own. We saw that records continue to be in place for the checking of fire equipment and alarms, these were up to date. The home continues to be assessed and reviewed by Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: the company health and safety trainer and risk assessments are updated and put in place when required. 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. People are cared by staff in sufficient numbers who are trained and competent to do so. People are protected by the companys recruitment and selection practices. Evidence: The home had sufficient staff on duty throughout the day and night to meet the needs of people living there. Some people who live at the home had one to one support for specific activities funded by the local authority. There was a core group of staff that had worked in the home for several years and knew the people and what their needs were very well. At the last inspection it was noted that there may not be enough waking staff on duty at night and that one of the people who lived at the home was vulnerable. This only affected one person and they have since moved on. The manager told us that any staff vacancies or short falls in the rota were filled by regular bank staff. This means that the people are cared for by a consistent and regular staff group. We saw that staff have access to a broad range of training which is provided by Avocets training department. Newly recruited staff undergo a five day induction training period before they start working at the home. Avocet provides training about the general needs of the people who live at the home including training about epilepsy, autism, challenging behaviour and diabetes. More Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: specialised training can be provided and this is identified during staff supervision and development interviews. We saw that staff have recently undertaken training about Deprivation of Liberty and the Mental Capacity Act and how this can impact on the people they care for. This means that people are cared for by well trained staff who have the skills to meet their needs. Staff recruitment files are located at the companys headquarters and were not assessed at this inspection. However, previous inspections had detailed that the company had robust policies and procedures in place regarding the recruitment of new staff members and ensured that all the required checks were in place prior to the start of employment. 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. People live in a home which is run in their best interest. They are involved with the running of the home as much as possible. Their views and the views of others are used to inform the day to day functioning of the home. Peoples health and safety is promoted and protected as far as reasonably possible by the policies and procedures at the home and the training of staff. Evidence: The home now has a registered manager in post. She is well qualified to undertake the role of manager and staff told us that they found her to be very approachable and supportive. The home uses the company Quality Assurance system. This includes collating the opinions of all those who have an interest in the care the people who live at the home receive and producing an action plan to address any short falls. We saw that the staff continue to complete a monthly monitoring form for each of the people who live at the home that detailed whether there were any health concerns, Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: what appointments they had attended, family contact, if documentation was up to date and whether a review of their care had taken place. We saw that the audits also covered other areas such as the environment, care support plans, accidents, health and safety issues, risk assessments, finances and medication. We saw that all of the equipment used at the home had been serviced in accordance with the manufactures recommendations. We saw certificates which indicated that the electrical wiring and gas installations had been checked at the approved intervals. We saw that staff had completed training about health and safety, first aid, basic food hygiene, fire and infection control. A computerised spread sheet is used to monitor staff training and it is flagged up to the manager when staff need this updating. We saw that the building was secure and any repairs needed were requested via the companys property department. We did not look at peoples finances as this was seen to be satisfactory at the last inspection and no concerns or issues had been raised about this. 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 1 22 The company should respond to concerns and complaints in a timely manner. Care Homes for Adults (18-65 years) Page 25 of 26 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. 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