Care Home: Flax Cottages 1-2

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What the care home does well The home carries out thorough assessments and obtains good information about people`s needs before they are admitted to the home. People can spend time in the home prior to moving in to help them decide if their needs can be met. The staff make every effort to help people make decisions and choices about all aspects of their lives. The care plans provide good information to the staff giving them clear guidelines on how people`s care and support should be provided. The staff monitor people`s health and make referrals to health care professionals when necessary. Menus are varied, well balanced and special diets are catered for. There are sufficient staff employed who are well trained to meet each person`s needs. People are encouraged to take part in community based activities of their choice and they are well supported to keep in contact with family and friends. Visitors are always welcome in the home. Each person living in the home is supported to go on holiday each year. There are good systems in place to help ensure people`s views are listened to, including relatives and staff. This helps ensure a good service is offered and is run in the best interests of the people living in the home. The staff make every effort to ensure the home is clean, comfortable and provides people with a pleasant place to live. What has improved since the last inspection? A specialist bath has been provided to meet the needs of the people living in the home. New settees, hall carpet, fridge freezer, washing machine and doorguards have been provided. What the care home could do better: People should have their weight checked on a regular basis to protect their wellbeing. Some areas of the home should be redecorated. Written reports should be available from the monthly visits made by the management. This will help ensure standards are maintained and people`s views are taken into account. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Flax Cottages 1-2 1-2 Flax Cottages Scotland Gate Choppington Northumberland NE62 5SR     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Anne Brown     Date: 0 1 0 7 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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 29 Information about the care home Name of care home: Address: Flax Cottages 1-2 1-2 Flax Cottages Scotland Gate Choppington Northumberland NE62 5SR 01670-530247 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : ntawnt.flax@nhs.net Northumberland, Tyne & Wear NHS Trust care home 9 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 9 The maximum number of service users who can be accommodated is: 9 The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Learning disability Code LD, maximum number of places: 9 Date of last inspection Brief description of the care home Flax Cottages is a purpose built home for nine people with severe learning disabilities. The home is located in Choppington, approximately two miles from the town centre of Bedlington and is near to local shops, pub and community centre. The home comprises two connecting bungalows for nine people in total. One bungalow contains five bedrooms and the second contains four bedrooms. People who live in the home have their own bedroom. Both bungalows have their own lounge, dining room, kitchen and bathroom and toilet facilities. There are two large gardens to the rear of the premises that are fully accessible. Care Homes for Adults (18-65 years) Page 4 of 29 Brief description of the care home The fees are £1018.04p per week. Inspection reports and information about the home are readily available. Care Homes for Adults (18-65 years) Page 5 of 29 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 this service experience good quality outcomes. 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. How the inspection was carried out:Care Homes for Adults (18-65 years) Page 6 of 29 Before the visit we looked at:Information we have received since the last key inspection on 12th July 2007. How the service dealt with any complaints and concerns since the last visit. Any changes to how the home is run. The providers view of how well they care for people. The views of people who use the service, staff and other professionals. An unannounced visit was made on 1st July 2009. During the visit we:Talked with people who use the service, staff and the manager. Looked at information about the people who use the service and how well their needs are met. Looked at other records that must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building to make sure it was clean, safe and comfortable. Checked what improvements had been made since the last inspection. We sent surveys to the home to issue to people who live in the home, members of staff and health professionals. We told the manager what we found. 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 Care Homes for Adults (18-65 years) Page 8 of 29 following this report, you can contact them using the details set out 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 9 of 29 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 10 of 29 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. Good information is available about the home and peoples needs are thoroughly assessed prior to them moving in. This helps ensure their needs can be met. Evidence: The Statement of Purpose and the Service Users Guide both contained the full range of information required. This helps people decide if the home is able to meet their needs. The manager had recently reviewed and updated these documents. A copy of the service user guide was available in each bedroom. Two people had been admitted to the home since the last inspection. The home carried out a thorough pre-admission assessment. This included obtaining a Care Management Assessment and, where applicable, information was sought from carers, relatives and relevant health care professionals. Copies were available on the individual case files so staff can refer to these to help ensure individual needs are met. The assistant manager confirmed that both people who had recently been admitted, Care Homes for Adults (18-65 years) Page 11 of 29 Evidence: had been able to spend time in the home prior to moving in permanently. This had helped them decide if their needs could be met. Care Homes for Adults (18-65 years) Page 12 of 29 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. The people living in the home are encouraged to make decisions on all aspects of their lives and good information is provided to help staff deliver care according to personal preferences. Evidence: Comprehensive care plans are in place and clear guidelines are available to the staff to help ensure care and support is delivered according to each persons preferences. Guidelines have also been completed by relevant professionals to help staff meet individual needs. The people living in the home and their relatives are encouraged to become involved in their care plans to ensure their wishes and preferences are taken into consideration. The care plans are evaluated on a monthly basis and the manager reviews them every six months. This helps ensure changing needs are met. Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: The staff support people to take calculated risks to help enhance their lifestyles. Comprehensive risk assessments are in place and these are reviewed regularly. The staff encourage people to make decisions and provide information so they can make informed choices. These include where to go on holiday, menus, what activities they wish to take part in, what to wear etc. Meetings are held every month to discuss all aspects of life in the home. These are minuted so any issues can be followed through. Care Homes for Adults (18-65 years) Page 14 of 29 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. The people living in the home are encouraged to mix with people in the local community and are well supported to participate in activities of their choice. Evidence: Each person living in the home decides how they spend their time and what activities they wish to be involved in. One person attends a day centre where they enjoy arts and crafts. Other activities include going out for meals, shopping and visiting local places of interest. Recent outings include a trip to Seahouses, Sunderland Empire and Woodhorn Museum. One person has recently taken up Carriage Driving which they thoroughly enjoy. Two ladies have a beautician who visits the home to give them a manicure and Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: aromatherapy. Holidays are being arranged for all the people living in the home. Activities in the home include looking after the flower pots in the garden, feeding the birds and squirrels, dominoes, music, knitting and sewing. The staff support people to visit and keep in touch with their family and friends. Visitors are made welcome in the home at any time. The routines were relaxed and the staff were interacting with people and respecting their privacy and dignity. People are encouraged to become involved in household chores according to their capabilities. The menus are based on peoples known likes and dislikes. The staff said they are always trying to find new menus and provide interesting things for people to try. One person said they liked the food served to them and their favourite meal was scrambled eggs. Special diets are catered for and specialist advice is sought when necessary. A speech and language specialist has been involved and feeding plans have been put in place for some people. The specialist felt the staff were helpful and had kept good records to help to monitor peoples experiences. Fresh fruit and vegetables are served in home and drinks and snacks are provided whenever people want them. The staff support people to have the opportunity to eat out at local pubs and cafes. Care Homes for Adults (18-65 years) Page 16 of 29 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. People living in the home are given personal support when they need it and staff monitor and promote their health to promote their well being. Evidence: The health and welfare of people living in the home are constantly monitored by the staff. Details of health checks, hospital appointments, visits to GP, dentist, optician, consultants etc. are recorded on the individual case files. If there are any concerns about someones health appropriate action is taken. Each person living in the home has individual health care plans and these are monitored on a monthly basis. They contain clear guidelines to inform the staff how each persons care and personal support should be delivered. The manager confirmed that some staff have completed training on dementia, diabetes and epilepsy to help them meet the needs of each person living in the home. Three staff hold a certificate in Palliative Care and others are doing basic training. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: A oral hygienist had recently attended a team meeting to give advice to the staff to help meet the needs of people living in the home. The records showed that people had not been weighed for two months as the scales were broken. The assistant manager agreed to look into having the scales replaced as soon as possible to ensure peoples weights are appropriately monitored. The medication records were up to date and appropriately signed. An audit is carried out on a daily basis. The manager confirmed that all permanent staff had completed training on medications. Competency assessments are carried out annually for all staff. Care Homes for Adults (18-65 years) Page 18 of 29 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. Complaints are properly dealt with and training in safeguarding adults has been provided which helps to protect people from abuse. Evidence: The home has an appropriate system for dealing with complaints. A complaints procedure is displayed in the hallway for visitors. A complaints book is maintained to record any complaints that are received and the outcome of the investigation. No complaints have been received since the last inspection. The complaints procedure is available in various formats, for example easy read, audio, large print. The home has a Tell Us policy which helps to support people living in the home to make a complaint if necessary. There is a whistle blowing policy in place and all staff receive training on safeguarding vulnerable adults on a yearly basis. The people living in the home are unable to manage their own finances so their personal allowances are dealt with by the staff. All transactions were fully recorded and signed. Receipts are kept for any purchases made. Care Homes for Adults (18-65 years) Page 19 of 29 Care Homes for Adults (18-65 years) Page 20 of 29 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 clean, comfortable and provides people with a pleasant place to live. The bedrooms reflect the individual tastes of the people who live there. Evidence: Each person has their own bedroom which is decorated according to their taste. The rooms are personalised and reflect the hobbies and interests of each person. All areas in the home were clean and comfortable. The decor in some areas is showing signs of wear and tear and are in need of painting. The gardens are well maintained and provide people with a pleasant place to sit and enjoy the good weather. There are sufficient bathrooms and toilets throughout the premises. A specialist bath has been provided to meet the needs of the people living in the home. Since the last inspection new settees, hall carpet, fridge freezer and washing machine have been provided. Doorguards have been fitted throughout. Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: Infection control forms part of the mandatory staff training. Protective clothing is readily available and liquid soap and paper towels are provided to help prevent the spread of infection. Cleaning rotas are in place for day and night staff to help ensure the premises remain clean and tidy. Care Homes for Adults (18-65 years) Page 22 of 29 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. There are sufficient well trained staff employed in the home to meet the individual needs of the people who live there. Evidence: The staffing rotas showed there were sufficient staff on duty to meet the needs of the people living in the home. The home employs two enablers to help ensure people can access activities of their choice. The manager confirmed that criminal record bureau checks and two written references are received before staff are employed in the home. This helps to protect people from abuse. All staff have achieved a National Vocational Qualification (NVQ) Level 2 and three have achieved Level 3. Three staff are currently in the process of completing NVQ Level 3. There are training programmes in place to ensure staff receive mandatory health and Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: safety training and any specialist training required to meet individual needs. Some staff have completed training on dementia, diabetes, epilepsy and palliative care. The manager confirmed that training courses have been booked for Deprivation of Liberty and the Mental Capacity Act. An assistant manager is responsible for ensuring training is kept up to date. A training file is in place which is well organised and provides up to date records on the training that has taken place and that which is booked. The staff on duty were well aware of the individual needs of the people they were caring for. They were interacting with people and good relationships were evident. Care Homes for Adults (18-65 years) Page 24 of 29 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 culture and systems in the home help to ensure that the service is led by the needs and wishes of the people living there, and protect them from harm. Evidence: The manager is registered with the Commission and has experience in working with adults with learning disabilities. She has completed NVQ Level 4 in management and care. Monthly meetings are held to discuss any issues that arise and to ensure the home is run in the best interests of the people living there. Minutes of the meetings were available for inspection. All staff sign to confirm they have read them. There are comprehensive policies and procedures in place to safeguard the rights and best interests of the people living in the home. The routines in the home are flexible and revolve around the needs of the individuals Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: living there. Staff make every effort to seek each persons views and consult relatives when necessary. The manager confirmed that staff at head office or other home managers were carrying out regular audits within the home to ensure standards are met. She confirmed that these were carried out every month but she had not received some of the written reports. The records showed that fire drills are carried out and fire equipment is checked on a regular basis. Accidents are well recorded. The staff on duty confirmed that they receive health and safety training to help protect the safety of themselves and the people living in the home. No unsafe practices were noted during the inspection. Care Homes for Adults (18-65 years) Page 26 of 29 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 27 of 29 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 2 19 39 The weighing scales should be replaced to ensure peoples weight can be monitored on a regular basis. The registered provider should ensure that a written report is available for each monthly visit that is made under Regulation 26. This will help ensure standards continue to be met and peoples views are taken into consideration. Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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