Care Home: Fossdyke

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What the care home does well The staff are friendly. They meet each persons needs well. Care plans are clear. People get out and about a lot. The bungalow is well looked after. The home is well managed. What has improved since the last inspection? Staff get regular fire training. There is clear information about what it is like staying here. Fossdyke DS0000066716.V377386.R01.S.doc Version 5.2 The manager makes regular checks to see everything is going well. What the care home could do better: There were no new requirements made. Key inspection report CARE HOME ADULTS 18-65 Fossdyke Fossdyke Short Break Service 9 Fossdyke Leam Lane Estate Gateshead NE10 8NJ Lead Inspector Lee Bennett Key Unannounced Inspection 17th July 2009 10:30 Fossdyke DS0000066716.V377386.R01.S.doc Version 5.2 Page 1 This report is a review of the 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. 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 home adults 18-65 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. Fossdyke DS0000066716.V377386.R01.S.doc Version 5.2 Page 2 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 Fossdyke DS0000066716.V377386.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fossdyke Address Fossdyke Short Break Service 9 Fossdyke Leam Lane Estate Gateshead NE10 8NJ 0191 4336067 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Gateshead Council Lee Shaw Foster Care Home 1 Category(ies) of Learning disability (1) registration, with number of places Fossdyke DS0000066716.V377386.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st July 2007 Brief Description of the Service: Fossdyke is a care home run by Gateshead Council. 1 person can stay here. It is for short breaks only. It is a small bungalow, with stairs to the entrance. Bathrooms and toilets are easy to get in and out of. There is one bedroom. Nobody has to share. It is near: - Bus stops - Shops - Pubs - A swimming pool - GP surgeries Fossdyke DS0000066716.V377386.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspector talked to the people who live at the home. The inspector looked documents that have to be kept. He looked at: - Care plans. - Staff files. - Medicine records. - Some of the homes policies and procedures. (Policies are rules about how to do things. Procedures tell people how to follow the rules.) The inspector looked around the home. This was to make sure it was safe and comfortable. What the service does well: What has improved since the last inspection? Staff get regular fire training. There is clear information about what it is like staying here. Fossdyke DS0000066716.V377386.R01.S.doc Version 5.2 Page 6 The manager makes regular checks to see everything is going well. 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. Fossdyke DS0000066716.V377386.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Fossdyke DS0000066716.V377386.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Detailed assessments of need are in place before a person’s stays here, and updated regularly. This is to make sure Fossdyke, and its staff team can meet each persons identified needs. EVIDENCE: Fossdyke is a short breaks service, which currently provides a service for eight people, with one person being accommodated at each stay. To make sure that this is a service that is suitable for each person coming here, before they use this service detailed information is obtained from a social worker. This is to help ensure that their needs can be properly met at the home and that the staff have the right skills and experience. There is also a detailed familiarisation process, so that those people staying at Fossdyke get to know the staff team, the physical environment, and that activities can be planned around each persons preferences and needs. The assessments provided by social workers include important information about diversity needs, such as those relating to disability, gender, race and Fossdyke DS0000066716.V377386.R01.S.doc Version 5.2 Page 9 culture, as do the getting to know you documents completed by key working staff. Each persons needs are periodically reviewed and if necessary reassessed. This is done with the involvement of a social worker, or other care professional, as well. For example, a person may have support from a Speech and Language Therapist, dietitian or community nurse. This is to make sure that Fossdyke remains the right place for people to have a break, and so that staff have clear information to guide their care. It is from these reviews and reassessments that plans of care are developed. There is also clear information available about the home and the terms and conditions about each persons stay. This has been done in an easy read format, that includes picture prompts. This is so people are kept well informed about what it is like to stay here. Fossdyke DS0000066716.V377386.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 people using Fossdyke benefit from well planned care. This means that both service users and staff are well informed about what care is to be offered. EVIDENCE: To help guide the care that staff offer to the people staying here, a care plan file is compiled. All of the people using this service have had one developed. These are all written up, evaluated and reviewed by the manager and a key worker; a member of staff who works with a named service user and takes a lead on the planning and delivery of care. Staff have updated the care plan documents to make sure they are up to date. The care files contain extensive and detailed information on each person’s needs, and are written in a person centred way. Fossdyke DS0000066716.V377386.R01.S.doc Version 5.2 Page 11 Closely linked to care planning arrangements are risk assessments. Again, these are written up by a key worker when there is an identified area of risk, either to the service user, or to others by that persons behaviour or needs. They follow a standardised format, and detail the area of risk, consider the benefits of certain risks being present, and outline how unnecessary risks are to be managed. We found that areas of risk were being documented for relevant aspects, such as eating, behaviours that challenge the service and manual handling, with the underlying aim being to ensure people lead as active a lifestyle as possible. Both care plans and risk assessments are a formal way of documenting decisions about important matters affecting a persons care and lifestyle. The people using this service are only here for short periods, so major decisions about the management of the home are not routinely discussed with them. Nevertheless, staff will support the people living with day to day decisions, such as what activities to do and what to eat at meal times. Routines are flexible to promote choices, as when to go to bed, get up, and so on. Fossdyke DS0000066716.V377386.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): This is what people staying in this care home experience: People using the 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 people using this service are assisted to spend their time in an active and fulfilling way. This can help ensure people have an enjoyable break and help to promote a sense of wellbeing. EVIDENCE: On the day of the inspection, the person coming to stay here had spent their day at a Council run day centre. During their stay people will often continue to use the day care already arranged for them, as well as taking part in activities arranged by staff here. We saw from the evidence in peoples care files that a broad range of leisure opportunities are offered, both within and outside of the service. For example, during one stay a person whose case we looked at in detail had attended their day service, been to the theater, had some shopping trips, an outlining to the coast and gone to a club. Activities Fossdyke DS0000066716.V377386.R01.S.doc Version 5.2 Page 13 are planned around each persons preferences and needs, and will include pre arranged opportunities, as well as new experiences. Should people want to relax at home they can do this as well, and there are interactive games for people to use if they want. As well as going out and about or being occupied whilst in the home, contact with friends and relatives can affect the quality of life enjoyed by people. Although people may come here to have a break away from home and their family, for others regular contact is important. Therefore, staff here will assist people to keep in touch. They also work with family members between stays to keep updated with peoples changing needs. Meals form an important part of peoples daily routine, lifestyle and their stay here. As the ethos of the service is to offer a holiday break, the people staying here do not get actively involved in food preparation and tidying away chores. There is one living room / dining room and if necessary people can eat with help or alone. As food and diet can often have important health implications, and is important in terms of individual choice, culture and so on, the dietary needs of each person are detailed in their care plans. For example, before coming here people are asked what their food preferences are, or if they have any particular needs, such as diabetes or a food allergy. From this information plan of care can be drawn up and staff provided with appropriate dietary information and advice. To monitor this there is a record kept of meals planned and provided. Fossdyke DS0000066716.V377386.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each individuals personal care and healthcare needs are well supported by systems that ensure privacy is respected and that health and welfare is monitored and maintained. Medication is safely handled. EVIDENCE: The people staying at Fossdyke have their personal and healthcare needs explained within their case files. This is so staff are clear about what support they need to offer. Each persons needs are supported and met, where appropriate, in private. Specialist support and input has been sought and obtained where necessary, and multi-disciplinary input (such as that from the Community Learning Disability team) is made available. As well as making sure healthcare advice is sought, staff in the team help the people staying here to access healthcare treatment if this is required, or if it has been pre-arranged during the period of their break. This is so people get the help and healthcare they need to keep well. The results of healthcare Fossdyke DS0000066716.V377386.R01.S.doc Version 5.2 Page 15 visits and routine monitoring are recorded within each person’s care file. This can help ensure that staff follow any advice and guidance that has been made by the healthcare professional. Linked to these health and personal care arrangements is the support given with medication. Due to their levels of need, service users are not able to administer their own medicines, and designated staff will help in this area. The staff here have had medication administration training (the safer handling of medication course). This has been supplemented by in-house guidance and competency testing. The medicines themselves are stored in a locked cupboard to keep them safe. Due to the nature of the service provided here most medicines are received as loose stock, either in bottles or the manufactured blisters. Once given out staff write down who has had what medicine on clear administration records. Given the size of the service, the current storage facilities are adequate for the type and amount of medicines used. However, should this change storage facilities will have to be reviewed. Fossdyke DS0000066716.V377386.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Clear systems help protect people from neglect, abuse and self-harm. EVIDENCE: A clear, written complaints procedure is available at the home. There have been no complaints reported to us since the last inspection, and none made regarding care standards. Because of peoples communication needs it is not always possible for people to make direct comments on the quality of care they receive. Staff have therefore to be mindful of each persons behaviour, gestures, and body language to gauge how they feel. Work has been undertaken with a Speech and Language Therapist to assist staff in communicating with the people using this service. The staff here have also received training on adult safeguarding and abuse awareness matters. More training on adult safeguarding is planned. The local council’s adult protection procedures are available here for staff to refer to. Staff are aware of the need to document any concerns they have regarding a person’s welfare, and there is specific documentation provided within the Council’s safeguarding procedures to document this. Fossdyke DS0000066716.V377386.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Fossdyke provides a homely and comfortable environment that meets peoples current needs. EVIDENCE: Fossdyke is an adapted care home. It is a bungalow, and has had minor adaptations (such as a bath seat and hand rails) to help ensure it is suitable for the people using the service. There is an enclosed and accessible garden to the rear, and limited parking space to the front. This home is, as far as practical, domestic in style, and has been furnished to a good standard. The manager has plans for redecoration to make sure the home remains fresh looking and an attractive place to stay. The home is clean throughout and there is good odour control. Fossdyke DS0000066716.V377386.R01.S.doc Version 5.2 Page 18 Fossdyke DS0000066716.V377386.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the 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 people staying here are supported by a well trained and qualified staff team. EVIDENCE: There have been three new staff member recruited here recently. We were not able to see the staffing records as these are held elsewhere, however this has been agreed with us, and are periodically checked on a random basis. These checks have found that Gateshead Council has robust pre-employment checks in place, including checks for criminal convictions, against the Protection of Vulnerable Adults List, and reference checks from previous employers. Overall staffing levels and team members have remained reasonably stable. At the time of the inspection, all of the 11 support staff were qualified to NVQ level 2 or higher. The majority are qualified to NVQ level 3. The staff here Fossdyke DS0000066716.V377386.R01.S.doc Version 5.2 Page 20 also undertake periodic training on topics relating to safety and care. We found that all staff had received first aid, health and safety, fire safety and moving and handling training. There is an extensive range of training relevant to the needs of those using this service. Training is one of the topics discussed at each staff member’s supervision session. These are one to one meetings that are held between a staff member and manager to discuss their performance, training needs, personnel and personal matters. Actions are agreed where necessary. These occur on a regular basis, to allow staff to feel supported and informed about developments at the home. Fossdyke DS0000066716.V377386.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from a well managed home, where quality and health and safety matters are regularly checked. This can help ensure the service remains focused on the needs and safety of the people who live here. EVIDENCE: The service is overseen by a full time manager, supported by a Senior Officer, who works across this service and a small specialist day service, which means there are close links between them. The manager is qualified to NVQ level 4 in care and has also obtained an NVQ in management. He attends regular training to ensure he remains up to date with current good practice. Fossdyke DS0000066716.V377386.R01.S.doc Version 5.2 Page 22 As well as ensuring his own knowledge and practice remains up to date, the registered manager undertakes a number of quality checks and audits to ensure the standard of care is up to current good practice levels. More senior managers also carry out periodic inspections. Just as the quality of the care provided is checked, so are matters affecting health and safety. Therefore regular checks on the building are carried out, water and fridge / freezer temperatures are monitored, and working practices that could present a risk are looked at, and safe ways of working (for instance by the use of lifting aids) introduced. Staff receive health and safety related training and undertake fire drills and instruction at least four times a year. During our inspection there were no hazards to health and safety observed by us. Fossdyke DS0000066716.V377386.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 4 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 4 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X 4 X 4 X 3 3 X Version 5.2 Page 24 Fossdyke DS0000066716.V377386.R01.S.doc NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Fossdyke DS0000066716.V377386.R01.S.doc Version 5.2 Page 25 Care Quality Commission Care Quality Commission North Eastern Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries.northeastern@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. 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