Care Home: Freedom Care Ltd (68 Conway Drive)

What the care home does well 68 Conway Drive delivers a highly individualised service, which meets the particular needs of the individual currently living there. Staff receive excellent training, support and management and this enables them to deliver this service very effectively. The person living at the home is supported to make informed choices but is also given appropriate boundaries. One-to-one staff support is available at all times and this can be increased to two or three to one if required.The person living at the home is being well supported to pursue their ambitions and interests by attending a local college of education and receiving individual tuition arranged by the home. Good arrangements are also in place to make a nutritionally well-balanced diet available to the person and for them to understand the benefits of eating this. The person is fully involved in developing and reviewing their individual support plan and could make an informed decision about coming to live in the home by being given the opportunity to make visits and ask questions about 68 Conway Drive before they moved in. What has improved since the last inspection? One requirement and one recommendation were made at the previous inspection in relation to the storage and administration of medication. No concerns were identified in these areas at this inspection. CARE HOME ADULTS 18-65 Freedom Care Ltd (68 Conway Drive) 68 Conway Drive Shepshed Leicestershire LE12 9PP Lead Inspector Ruth Wood Unannounced Inspection 18th June 2008 13:10 Freedom Care Ltd (68 Conway Drive) DS0000050638.V366695.R01.S.doc Version 5.2 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Freedom Care Ltd (68 Conway Drive) DS0000050638.V366695.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Freedom Care Ltd (68 Conway Drive) DS0000050638.V366695.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Freedom Care Ltd (68 Conway Drive) Address 68 Conway Drive Shepshed Leicestershire LE12 9PP 01509 821185 01509 821185 joe@freedomcare.org 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) Freedom Care Ltd Mr Joseph Matthew Kinch Care Home 2 Category(ies) of Learning disability (2), Mental disorder, registration, with number excluding learning disability or dementia (1) of places Freedom Care Ltd (68 Conway Drive) DS0000050638.V366695.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th November 2006 Brief Description of the Service: Freedom Care Limited at 68 Conway Drive is in the village of Shepshed. The home is registered for a maximum of two people with learning disabilities and one person with a mental disorder. The home is a converted detached bungalow. To the ground floor of the property there is a lounge, dining room, kitchen, main bath and shower room, and home office. The two bedrooms are situated on the first floor. There is a small garden at the rear of the home. Further information about the home’s services is available in the Statement of Purpose and Service User Guide. This information can be tailored to match individual communication needs. Fees are dependent on the level of support required and are individually negotiated with the placing authority. Freedom Care Ltd (68 Conway Drive) DS0000050638.V366695.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 stars. This means the people who use this service experience excellent quality outcomes. Before the inspection visit an Annual Quality Assurance Assessment (AQAA) was returned to the Commission for Social Care Inspection. This is a selfassessment, that focuses on how well outcomes are being met for people using the service. It also gives us some numerical information about the service. This was comprehensively completed and contained valuable information about how the home is run, it helped us to plan the inspection visit and has informed the content of this report. The inspection visit took place on a weekday between 13:10 and 16:00. 70 Conway Drive was inspected immediately before this and some information about the management and staffing of 68 Conway Drive was collected during this inspection. Currently only one person lives in the home. This has an impact on the amount of detail it would be appropriate to include in this report, as this may compromise the person’s confidentiality. During the visit we were only able to speak to the person briefly as they were fully engaged with their programme of activities but their individual support and health plan was examined and how this is implemented was discussed with the manager and team leader for the home. Records relating to how they are supported to manage their medication and finances were also looked at, together with more general records such as those relating to fire safety and the maintenance of the home. Arrangements for staff recruitment and training were looked at and all areas of the home were viewed. What the service does well: 68 Conway Drive delivers a highly individualised service, which meets the particular needs of the individual currently living there. Staff receive excellent training, support and management and this enables them to deliver this service very effectively. The person living at the home is supported to make informed choices but is also given appropriate boundaries. One-to-one staff support is available at all times and this can be increased to two or three to one if required. Freedom Care Ltd (68 Conway Drive) DS0000050638.V366695.R01.S.doc Version 5.2 Page 6 The person living at the home is being well supported to pursue their ambitions and interests by attending a local college of education and receiving individual tuition arranged by the home. Good arrangements are also in place to make a nutritionally well-balanced diet available to the person and for them to understand the benefits of eating this. The person is fully involved in developing and reviewing their individual support plan and could make an informed decision about coming to live in the home by being given the opportunity to make visits and ask questions about 68 Conway Drive before they moved in. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Freedom Care Ltd (68 Conway Drive) DS0000050638.V366695.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 Freedom Care Ltd (68 Conway Drive) DS0000050638.V366695.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 Quality in this outcome area is excellent Excellent procedures are in place to ensure that people wishing to move to Conway Drive are given comprehensive information about the service and are fully involved in the assessment process. This ensures that the service can meet people’s individual needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Statement of Purpose and Service User Guide is produced in a format tailored to meet the individual communication needs of the person seeking information and contains all necessary information about the home and its services. The admission process for one person was examined. This had various stages, took place over several months and included visits by the registered manager and team leader to the person in their existing placement to discuss their needs and consult with existing support staff, relatives and professionals. The person subsequently visited Conway Drive, accompanied by staff from their existing placement and then sent a series of questions to the registered manager about the kind of life they would have if they came to live there. These included questions about what they would be able to do, how much choice they would have and who would support them. The manager gave detailed responses and visited them again at their existing placement. Finally the person visited Conway Drive, without staff from their existing placement, and decided to move in. Freedom Care Ltd (68 Conway Drive) DS0000050638.V366695.R01.S.doc Version 5.2 Page 9 Throughout this process the person also had access to an independent advocate and continues to have the support of an independent ‘befriender’ from the National Autistic Society. Freedom Care Ltd (68 Conway Drive) DS0000050638.V366695.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is excellent The person’s individual plan accurately reflects their needs and goals and they were fully involved in its production. The clarity of the plan enables staff to support them to maximise their choices but still maintain appropriate boundaries to effectively manage any associated risks. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The person’s individual plan is very detailed, has been compiled with their full involvement and gives clear direction as to how their needs and aspirations should be met. The plan is written from the person’s perspective and uses pictures and photographs, as well as the written word to convey information clearly. The plan also contains a comprehensive communication assessment and clear guidance on the ways in which the person prefers to communicate. Risk assessments are cross-referenced to various aspects of the plan so that an audit trail is available to explain any necessary restrictions on behaviour. The ethos of support is to maximise choice but maintain sufficient boundaries to enable the person to feel safe when making choices. Freedom Care Ltd (68 Conway Drive) DS0000050638.V366695.R01.S.doc Version 5.2 Page 11 Discussion with the key worker and manager indicated that staff had a very clear understanding of the person’s needs in all areas and that appropriate and ongoing training was in place to ensure that staff’s ability to meet these needs was maintained. Detailed notes of the person’s finances are kept and good systems are in place to ensure the person’s financial interests are safeguarded. An advocate was involved with the person during their admission to Conway Drive and the registered manager was able to discuss the complexities of capacity and the implications that this had for supporting the person. The registered manager is looking into the use of an Independent Mental Capacity Advocate (IMCA) to ensure that the person’s rights are continually safeguarded. Freedom Care Ltd (68 Conway Drive) DS0000050638.V366695.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): 12, 13, 15, 16, 17 Quality in this outcome area is excellent The person’s lifestyle reflects their needs and aspirations and enables them to take part in age, peer and culturally appropriate activities within the local community. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The person has an individual programme of activities based upon what they wish to achieve. For example they wish to further their musical education and to this end the home has obtained a piano, arranged private piano lessons and supported them to enrol for a B-Tech Diploma in music at a local college. One-to-one support will be given by the home’s support staff at college. The complexities of providing this while still ensuring that the person can interact and mix with their own peer group were discussed with the team leader. The person has a very structured activity plan; on the day of the inspection they spent time baking with a staff member before going out on a long bike ride and for lunch, returning briefly before going out to play badminton. Freedom Care Ltd (68 Conway Drive) DS0000050638.V366695.R01.S.doc Version 5.2 Page 13 The person is supported to maintain appropriate contact with family and friends and has recently attended a college reunion, again supported by staff. Responsibilities in terms of housekeeping tasks are clearly identified in the person’s individual plan. Emphasis is placed on helping them to understand the different foods available and what constitutes a nutritionally balanced diet. As part of this process the person is involved in growing vegetables and preparing food on a regular basis. Freedom Care Ltd (68 Conway Drive) DS0000050638.V366695.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is excellent Individual personal care, health and medication needs are well met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Health and personal care details are contained within a health action plan, which the person has been actively involved in compiling. Information about the kind of support they would like and require accessing GP, optical and dental services is outlined and a record is kept of all medical appointments. Currently the service is trying to access additional services to ensure that the person receives the most appropriate support. The person has consented to staff administering their medication. All medication administration records were found to be completed fully and accurately and a record is made of medication being received into and leaving the home. Amendments to Regulations relating to the Misuse of Drugs mean that the home must have separate storage for controlled medication. This should be a metal cupboard of specified gauge with a specified double locking mechanism. It should be fixed to a solid wall or a wall that has a steel plate mounted behind it with Rawl or Rag bolts. No controlled medication is currently stored or administered in the home. Freedom Care Ltd (68 Conway Drive) DS0000050638.V366695.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good Good procedures and practice ensure that people are protected and can voice any concerns. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All staff receive training in recognising adult abuse and the protection of vulnerable adults, which is updated annually. Staff also receive regular training in responding appropriately to behaviour that may challenge. It is recommended that the manager and staff access training provided by the Local Authority in the multi-disciplinary protocols for safeguarding adults, to ensure that they are fully aware of current local practice in this area. Staff demonstrated an awareness of what they would do to keep people safe and the complexities of maintaining safety while promoting independence. All staff have criminal records bureau checks and have their names checked against the protection of vulnerable adults register. This helps to make sure that only suitable people work at 68 Conway Drive. The complaints procedure is clearly written and the person living at the home has a personal copy and knows how to make a complaint. There are various ways in which the person is able to express their views about the service they receive including regular, written quality surveys and regular meetings with their key worker. A complaints log is available and all complaints and concerns are noted, although none have been received by the home or by CSCI since the previous inspection. Freedom Care Ltd (68 Conway Drive) DS0000050638.V366695.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is good The home is clean, comfortable and well furnished and reflects the taste of the person living there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Before the person moved in they were asked how they wanted their bedroom furnished and decorated and given catalogues, colour charts and samples to facilitate this process. The person is very pleased with their room, which reflects their own individual tastes and interests. The rest of the home is also comfortable and well furnished. The majority of staff have received training in infection control and the home appeared fresh and clean throughout. The home has been recently inspected by the Local Authority Environmental Health officer and gained three stars – the highest level - for its food hygiene. Freedom Care Ltd (68 Conway Drive) DS0000050638.V366695.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35, 36 Quality in this outcome area is excellent The person living in the home receives excellent support from a very well trained, effectively managed staff team. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a clear plan for workforce development, which looks at the needs of individual staff based on the needs of the person living in the home and developing an overall plan to ensure that the workforce has the necessary, ongoing skills to support that person. Courses recently attended by staff include how to be an effective key worker, key counselling skills and responding to behaviour that may challenge. All staff members have or are undertaking National Vocational Qualifications in supporting people; the team leader for the home is currently undertaking an NVQ at level 4. All staff have an individual performance and development plan and receive regular supervision from the registered manager. As part of the supervision process staff fill in a pre-supervision form to help identify areas to focus on and also complete a form to give feedback on how they feel the process went and if their support needs are being met. Formal supervision such as this takes place Freedom Care Ltd (68 Conway Drive) DS0000050638.V366695.R01.S.doc Version 5.2 Page 18 once every three months but the registered manager is ‘very hands on’ and is available for staff to consult with on an ongoing basis. This is a small staff team and the person living in the home always has one-toone support but occasionally has two-to-one or three-to-one support. Interaction between the person who lives in the home and staff was observed to be friendly and open and it was clear that a good, trusting relationship had developed. Staff records were examined – these contained a detailed application form, notes of the interview process, two written references, medication questionnaire and evidence of criminal records bureau checks and checks against the vulnerable adults register. These procedures and check help to ensure that only suitable people work at 68 Conway Drive. Freedom Care Ltd (68 Conway Drive) DS0000050638.V366695.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 42 Quality in this outcome area is excellent Good management and effective quality assurance systems ensure that the home is run in the best interests of the person living there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has over ten years experience of working with adults with learning disability and autism. He holds the Registered Manager’s Award, a National Vocational Qualification in care and support at level 4 and seeks to constantly update his knowledge about current practice through attending relevant training and through research on appropriate websites such as the CSCI professional site. Discussion was held with the manager about his efforts to ensure both he and his staff were aware of the implications of the new Mental Capacity Act for how people are supported within the home. The registered manager places great emphasis on ensuring that the person is happy with the service they receive. Each month they complete a satisfaction questionnaire and discuss how things are going with their key worker. As the Freedom Care Ltd (68 Conway Drive) DS0000050638.V366695.R01.S.doc Version 5.2 Page 20 person has only been in the service since November of last year the registered manager is looking to undertake a formal quality assurance assessment such as takes place at the other Freedom Care homes, surveying all other stakeholders involved such as outside professionals involved with their support. A maintenance schedule is in place which details when essential servicing to all systems has been and needs to be undertaken. All staff have received training in food hygiene, moving and handling, first aid and health and safety. Records indicate that fire alarms are regularly tested and risk assessments are in place covering safe working practices in the home. Leicestershire County Council undertook an inspection of the home’s food hygiene standards in June 2008 and awarded the home the highest – 3 star assessment for their management of food hygiene in the home. Freedom Care Ltd (68 Conway Drive) DS0000050638.V366695.R01.S.doc Version 5.2 Page 21 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 4 4 4 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 4 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 X 3 4 4 X X 3 X Freedom Care Ltd (68 Conway Drive) DS0000050638.V366695.R01.S.doc Version 5.2 Page 22 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. 1 Standard OP9 Regulation 13(2) Requirement Secure storage must be put in place for controlled drugs to meet the requirements of the Misuse of Drugs and Misuse of Drugs (Safe Custody) (Amendment) Regulations 2007 Timescale for action 30/09/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA23 Good Practice Recommendations It is recommended that the manager and staff access training provided by the county council in the local multidisciplinary protocols for safeguarding adults to ensure that they are fully aware of current local practice in this area. Freedom Care Ltd (68 Conway Drive) DS0000050638.V366695.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Freedom Care Ltd (68 Conway Drive) DS0000050638.V366695.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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