Care Home: Eden House

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What the care home does well The home is very good at offering care based on a thorough knowledge of each person, good assessments and plans of care which are regularly reviewed. Good risk assessments help people to be as independent as possible. People are assisted with their health care and medicines are safely handled. The key principle of the home is that people using the service are in control of their lives and they direct the service. The care planning process is led by the resident and reflects current and up to date information. Reviews focus on asking questions about what has worked, where there is progress, achievements, concerns and what the plans are for the future. People are continually consulted on how the service runs and are able to influence key decisions in the home whatever their communication style. They are fully involved in decisions about the areas such as staff selection, the day-to-day life of the home. The home understands the importance of enabling people to achieve their goals, follow their interests and be integrated into community life and leisure activities in a way that is directed by the person using the service. People said how much they enjoyed living at Eden House. One person said: `I feel safe here.` Another person said:`Mark and Jill are very kind people. They do everything they can to make a good life for us here.` Complaints are quickly dealt with and people are protected from harm by well trained staff. Staff members are very alert to changes in mood, behaviour and general wellbeing and fully understand how they should respond and take action. The home is clean and well maintained. There is a good ratio of staff to people, and staff are well recruited. The manager described a clear vision of the home based on person centred values and priorities. What has improved since the last inspection? The home continues to offer an excellent standard of care to those people who live there. What the care home could do better: This inspection has generated no requirements and one recommendation. Staff should have updated foundation training. The manager of the home is good at recognising where improvements need to be made and the quality assurance system supports this process. Key inspection report Care homes for adults (18-65 years) Name: Address: Eden House 14 Station Road Filey North Yorkshire YO14 9AR     The quality rating for this care home is:   three star excellent 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: Karen Ritson     Date: 1 3 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 25 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 25 Information about the care home Name of care home: Address: Eden House 14 Station Road Filey North Yorkshire YO14 9AR 01723512790 F/P01723512790 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Mark Cusick,Mrs Jillian Cusick care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: One named service user over 65 years may be accomodated in category LD Date of last inspection Brief description of the care home Eden House is an adapted end of terrace property offering bedroom accommodation on the upper two of its three floors. The ground floor gives sufficient communal space for the residents in the home together with kitchen including laundry area and office. There are two bathrooms and sufficient toilets. The home caters for adults with a learning disability who may have associated health and behavioural problems. The staff seek to provide a holistic care regime offering personal care, help, advice and guidance on daily living skills and activities, a catering service, a laundry service and domestic services. All these services are offered with involvement from residents. Care is offered on the basis of caring with rather than caring for. The staff team has developed good relationships with the Community Learning Disability Team and consultant psychiatrists who provide a valuable resource and input into the home. The home has a statement of purpose and service user guide, which provide information about the scope and nature of the care and facilities on offer. These, with CQC reports, are available on request at the home. The home charges between £500 and £894 each Care Homes for Adults (18-65 years) Page 4 of 25 Over 65 0 5 Brief description of the care home week. Outings and holidays are not included in this fee and a contribution is required towards these. Care Homes for Adults (18-65 years) Page 5 of 25 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: three star excellent 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 inspection for this service took twelve hours. This includes time spent gathering information and examining documentation before and after a site visit and in writing the report. The site visit took place on 13th January 2010 between 10:00 and 15:30. Information for this inspection was gathered from the following. 1.A tour of the premises. 2. Observations of care throughout the day of the site visit. 3. Speaking with people living at the home,. 4. Speaking with staff. Care Homes for Adults (18-65 years) Page 6 of 25 5. Case tracking people on the day of the site visit. 6. Notifications sent to the commission from the home since the last inspection. 7. The Annual Quality Assurance Assessment (AQAA) sent to us by the home. 8. Examining policies, procedures and records kept at the home. 9. Examining information regarding the home on the file kept by CQC. 10. Considering comments made by relatives, health care and social services staff. 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. All key standards were looked at during this inspection. The manager was available throughout the day of the site visit. Care Homes for Adults (18-65 years) Page 7 of 25 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 25 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 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have their care needs very well assessed and people have the right information to make a decision about admission. Evidence: No new admissions have taken place since the last inspection. There are four people living at the home at present. The home has a service user guide and statement of purpose, which clearly state the care on offer and for whom the service is intended. The philosophy of care explains that assessments are carried out on a day-to-day and longer term basis. The owners of the home discuss any potential admission with the other people who live there. One person had a short stay at the home recently but decided that they did not wish to stay longer. The home has had several enquiries about their vacancies but so far the owners have not felt they were in a position to meet the needs of the people already at the home whilst also meeting the needs of the proposed new admission. One person living at the home said: They would never let anyone live here who wasnt the right sort of person for us. We have to be very careful because we all know each other here. Another person said: Ive been here for years and years. I wouldnt want to be anywhere else. Care Homes for Adults (18-65 years) Page 10 of 25 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals are closely involved in decisions about their lives, and play an active role in planning the care and support they receive. Evidence: Care plans are detailed and regularly reviewed with the involvement of people living at the home and health care professionals where necessary. They are written in a narrative style, covering where needs fluctuate and emphasising the areas in which people are independent and how to maintain this. Risk is considered and there are detailed written assessments of risk for each individual living at the home with plans for how people can retain as much freedom and choice as possible. For example, one person might travel by bus unaccompanied but if care needs temperarily alter then staff would accompany or taxis would be used. Care notes are written three times a day and when needs are changing quickly, notes are often extensive. For example, when one person had suffered a period of illness, there were detailed notes on food and fluid intake and comments on general wellbeing throughout the day. This ensures Care Homes for Adults (18-65 years) Page 11 of 25 Evidence: that the care provided remains appropriate, focused on changing needs and that staff have up to date information at all times. People said they had access to their care plans at any time but particularly when they were reviewed. Some had read their care plan. The staff have anticipated future care needs based on specialist knowledge and thorough assessment of each individual. A health care professional said: The staff at Eden house relay information to me when I call and all know each person well. The home know they can contact us whenever they need to and they always contact us appropriately. One person living at the home said: I understand that sometimes I cant do exactly what I want to do. They explain it to me and I understand what they are trying to do to keep me safe. Any restrictions on choice have been agreed following discussion with the people living at the home. This ensures that people retain maximum possible independence and make decisions about the way they live their lives whilst being protected. Care Homes for Adults (18-65 years) Page 12 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use this service are enabled to make choices about their life style, and are supported to develop their life skills. Social, educational, cultural and recreational activities enhance the quality of life of each person. People have a balanced diet they enjoy. Evidence: Some of the people living at the home are encouraged to take part in supported employment and voluntary work. One person enjoys doing conservation work one day a week and helping in the kitchen at Elders Street another. Another person helps at the Salvation Army domino club. Other people attend Basics Plus where they become involved in a range of activities. Some of the people living at the home run errands such as shopping and paying bills in Filey town. One person said: I come home and tell them about baking scones or some other cooking. I enjoy doing it. Another person said. Ive been experimenting with photoshop and have created some artistic Care Homes for Adults (18-65 years) Page 13 of 25 Evidence: designs. Another person said:I love my trains, I go all over train spotting Its great. People also go on shopping trips, and day trips to places of interest. One person enjoys a more relaxed pace of life and prefers pottering in the home, helping in the kitchen, washing up or going into town for a coffee. The home also consults people about where they would like to go on holiday. All the people living at the home have lived there for a number of years and from conversation around the lunch table during the inspection, it was clear they had many shared happy memories of holidays in the past and enjoyed planning where to go in future. Each person completes domestic chores around the house according to their ability. Family and friends are free to visit whenever the person living at the home wants them to. Most people have visitors and although one person has few relatives who visit, the mother of the owner calls on her regularly and they go out for a walk into town. They have known each other for a good many years. From observations on the day of inspection, looking at records and speaking with the people living at the home it was clear that people were living interesting, stimulating and meaningful lives. A midday meal was prepared by one of the people living at the home. This was well prepared and of a good quality. The people living at the home often go shopping for food either with the manager or on their own. Sample menus were seen which showed a good variety of healthy options on offer. Specialist diets are catered for if required, but none of the current residents need this. Staff assist in the choice of menu options with suggestions and guidance only when necessary. In this way people receive a balanced diet, which they enjoy. Care Homes for Adults (18-65 years) Page 14 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive in this service is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: The staff provide a very sensitive and flexible service. Peoples particular needs are written in the care plan and support is offered in a way which is appropriate to the individual. A mental health care professional said: The staff understand each person they work with. They have a good knowledge. They work extremely well with us. Each person gets the support they need and that changes as their care needs change. The health care professional confirmed that any specialist health care requirements were quickly addressed and any changes in health needs were responded to. All access to GPs and other health care professionals is recorded on file along with notes to monitor changes. People have had risk assessments regarding medication and those require help receive it. Medication is well handled. The staff have a good knowledge of the medication each person is prescribed. Each person at the home is empowered to manage their own Care Homes for Adults (18-65 years) Page 15 of 25 Evidence: medication. Records were up to date and accurate. This approach ensures people retain as much independence as possible whilst risk is minimised. Care Homes for Adults (18-65 years) Page 16 of 25 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 who use the service are able to express their concerns and have access to a robust, effective complaints procedure, are protected from abuse, and have their rights protected. Evidence: The home has a good complaints policy and procedure. Both people living at the home and health care professionals said the manager was approachable and would listen to any complaints. One person said: If theres something we re not happy about we tell Mark or Jill. This open approach allows people to feel confident about saying if there is a problem and expecting it to be put right. The home has an abuse policy and procedure. Staff have received safeguarding and deprivation of liberty training. People said they felt safe in the home. The policies and procedures of the home and the approach of the manager and staff ensure that people are kept as safe as possible. Care Homes for Adults (18-65 years) Page 17 of 25 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 who use the service live in a safe, well-maintained and comfortable environment, which encourages independence. Evidence: The home is well maintained and suitable for those living in it. It is located close to the town centre with easy access to transport links. It is attractively decorated and rooms are furnished and presented to individual tastes. People were enthusiastic about their rooms and how they had been decorated. One person said: Ive moved room since you were last here. decorated this with Mark and I chose the colours. I like it better than the last room because the window is bigger and I feel more part of what is going on because it is on a lower floor. Another person said: Ive bought all my own stuff. Ive just bought a new HD TV . Everything in my room is just how I want it. The home has a fire risk assessment to ensure people are kept safe from the risk of fire in the home. The home is kept clean and the manager has developed comprehensive policies on infection control and hygiene. The laundry service is domestic in nature and people complete their own laundry with assistance when required. This approach ensures people live in a clean and well maintained home which is furnished to their tastes. Care Homes for Adults (18-65 years) Page 18 of 25 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. Staff in the home are trained, skilled and in sufficient numbers to support the people who use the service, in line with their terms and conditions, and to support the smooth running of the service. Evidence: There are enough staff on duty at all times. All new staff receive induction and foundation training and whatever specialist training can be accessed in the area. All new staff are interviewed using set questions and views are sought as to the suitability of each candidate from the people living at the home. References are followed up and a criminal records bureau check is carried out on each person prior to employment. This ensures that the home recruits appropriately for peoples needs Staff were observed speaking with people in a friendly and purposeful manner. People said staff understood them well. One person said: When I dont understand something that a member of staff has said, why they are asking me to do something or not do something I can go to Mark or Jill or another member of staff and they will explain. I get on with them all. Staff create a supportive and friendly environment for people to live in. The home is constantly trying to access more appropriate training for staff as there is little on offer Care Homes for Adults (18-65 years) Page 19 of 25 Evidence: other than for older people. Staff have been completing a correspondence training course but the quality of this is not very good. The manager carries out much of the required training himself using his own experience and training. Foundation level training needed to be updated in some areas for some staff. Health care professionals commented that the staff were very knowledgeable about each persons care needs and had good skills at managing changing behaviour. Staff turnover is low. Care Homes for Adults (18-65 years) Page 20 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home is based on openness and respect. Peoples views and preferences underpin practice and they are protected by the health and safety procedures of the home. Evidence: The registered manager, one of two registered providers, was a registered mental nurse. He has also gained the Registered Managers NVQ Level 4 award. Other training has also been undertaken. The registered manager has many years experience in the care of this service user group in both hospital and home settings. Staff are well supported in their role and receive regular one to one supervision. People living at the home said how much they liked and got on with all staff and all were highly complimentary about the manager Mark Cusick and his wife Jill. It was clear that people trusted the staff completely. A number of maintenance documents were seen. Evidence was also submitted on the pre inspection questionnaire that all relevant safety checks had been carried out. The home has comprehensive health and safety policies and procedures. This ensures people are kept safe. Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: The home carries out its quality assurance on a regular basis. Rather than issuing questionnaires to people, the management of the home finds it more productive to ask people about their views as they go about their daily lives and to work towards improving the quality of life for people as a result of the findings of review meetings. These review meetings are held more frequently when the need arises. The manager regularly checks on the building and plans redecoration and maintenance when needed. This approach ensures that quality of care is maximised for each individual. Care Homes for Adults (18-65 years) Page 22 of 25 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 23 of 25 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 32 All staff should have up to date foundation training to ensure people receive correct care. Care Homes for Adults (18-65 years) Page 24 of 25 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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