Care Home: Gardens Lane 32-34

What the care home does well People`s views were listened to and acted on. The service encouraged discussion about concerns at regular service user meetings, so that the service could act on issues raised before they developed into problems and formal complaints. Staff received training in how to safeguard people, which meant they had the knowledge and understanding of how to protect people from harm. What the care home could do better: The service user guide must set out clearly the arrangements for charging and paying for using the minibus and staff accompanying people on holiday. This information must also be in the contract provided to people, so that they sign their agreement to thosearrangements. Make sure staff know where on the intranet they can access the polices and procedures for the administration of medicines, so that this can be referred to if necessary, to make sure correct procedures are being followed that safeguard people. So that staff remain competent to administer medicines safely, nursing staff should have assessments of their competency to undertake the administration of medication. There should be a record of the temperature of the room where medication is stored, so that it can be confirmed medication is stored at the correct temperature. Inform staff that if an allegation of harm or abuse is made it must be reported immediately to the local authority safeguarding team, in accordance with South Yorkshire policies and procedures, so that correct procedures are followed. Arrange training for all staff on the Mental Capacity Act and Deprivation of Liberty Safeguards, so that all staff are up to date with current information on the procedures to follow to ensure people`s choices and human rights are maintained. This is because limitations on personal choices and rights must only be made following assessments, best interest meetings, risk assessments and discussion with the person concerned and/or their advocate. Keep documentary evidence of qualifications and training to verify that this has taken place. Random inspection report Care homes for adults (18-65 years) Name: Address: Gardens Lane 32-34 32 - 34 Gardens Lane, Rear Of Health Centre Conisbrough Doncaster DN12 3JX three star excellent service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Jayne White Date: 2 8 0 4 2 0 1 0 Information about the care home Name of care home: Address: Gardens Lane 32-34 32 - 34 Gardens Lane, Rear Of Health Centre Conisbrough Doncaster DN12 3JX 01709770322 01709863036 gardenslane32@rdash.nhs.uk www.syha.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) South Yorkshire Housing Association Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 12 Number of places (if applicable): Under 65 Over 65 12 learning disability Conditions of registration: 12 Five named service users over the age of 65 can remain at the home One specific service user over the age of 65, named on variation dated 8th August 2005, may reside at the home. Date of last inspection Brief description of the care home 32 & 34 Gardens Lane provide care for up to twelve people of either gender with learning disabilities. Six people live at number 32 and a further six at number 34. Both properties are purpose built bungalows with the space, facilities and equipment to accommodate people with physical disabilities including people who us wheelchairs. The home has two adapted minibuses that enable access to the wider community. Care Homes for Adults (18-65 years) Page 2 of 12 Brief description of the care home The accommodation is located in Conisborough, a former mining village close to Doncaster. Doncaster main town is about 4 miles away and Conisborough has local facilities such as shops, libraries and health and community centres close by. People enjoy a range of day care provision including access to a local social centre and social education facilities at St Catherines Hospital Monday to Friday. Annual holidays, regular outings and social events are provided for everyone. The service is provided through a partnership between South Yorkshire Housing Association and Doncaster Healthcare Trust. South Yorkshire Housing Association own and operate the service with Doncaster Healthcare Trust providing the staff. This partnership provides and operates three other such schemes in the Doncaster area. Information about the services provided are available in the Information Pack that contains the Statement of Purpose and Service User Guide. Some of the information has been done in easy read picture format. For further information regarding fees please contact the home. Care Homes for Adults (18-65 years) Page 3 of 12 What we found: This was an unannounced random inspection, to comply with our regulatory processes of inspection of services. The visit started at 09.15am and finished at 11.45am. A random inspection means we visit the service and look at specific areas. On this inspection it was about the health, safety and wellbeing of people who use the service. The excellent star rating for this service was made at the previous inspection visit on 14 June 2007. We can only change the star rating following a key inspection, therefore, the rating for this service will stay the same following this random inspection. However, we can still inspect the service at any time if we have concerns about the quality of the service or the safety of the people using the service. We completed Annual Service Reviews (ASR) for the service on 13 June 2008 and 24 August 2009. We only do an ASR for services rated as excellent or good that have not had a key inspection in the last year. An ASR is part of our regulatory activity and is an assessment of our current knowledge of a service rather than an inspection. The published ASR is a result of that assessment. Our judgement for both of the ASRs was that the home continued to offer excellent outcomes for people using the service. Before we visited the service we looked at any information we had received since the services last inspection. This included: The services AQAA (Annual Quality Assurance Assessment). The AQAA is a self assessment that focuses on how well outcomes are being met for people using the service. It also gives us some numerical information about the service. The outcomes from the previous inspection report and whether the service had met their previous requirements. We also looked at what the service had told us about things that have happened at the service that have affected peoples health, safety and welfare. These are called notifications and are a legal requirement. We also sent out ten surveys to people living at the service and ten surveys to staff. Five were returned from people using the service, but all of them had received assistance from either a relative, advocate or member of staff to complete them. Some of the information and comments were sometimes from these people, rather than the person using the service. During the visit, time was spent walking round the two bungalows and talking to six people using the service, three members of staff and the nurse in charge. We observed some care practices and looked at some records and documents. The outcome was as follows: Information in the AQAA completed by the manager on 1 March 2010 indicated that people have the complaints and safeguarding information available in an easy read Care Homes for Adults (18-65 years) Page 4 of 12 format in the service user information file. This was not easily found and it is suggested one is made more readily available. The AQAA told us one complaint had been received in the last twelve months, that had been resolved within 28 days. None had been received by CQC. When we spoke to people using the service, they told us they were confident raising any issues with the manager or staff. They all said care staff and managers always treated them well and they felt safe and well protected. Peoples surveys told us three people knew how to make a formal complaint, one didnt and one didnt answer. Staff surveys told us they all knew what to do if someone raised concerns about the home. The AQAA and inspection of our records told us there had been no safeguarding allegations made. This means concerns about keeping people safe from harm. The service had the South Yorkshire Safeguarding of Vulnerable Adults in place to refer to if they needed. Information from the staff training matrix the nurse in charge showed us on 28 April 2010 and discussions with staff, told us all staff received training on Safegaurding of Vulnerable Adults from abuse. We spoke to two members of staff and the nurse in charge in detail about their understanding of protecting people from harm and abuse. They understood very well what to look out for to identify if someone could be at harm of abuse and they knew the right action to take to help people keep safe, but it didnt include informing the adult safeguarding authority in accordance with the South Yorkshire policies and procedures. Information in the AQAA told us nursing staff had received training on the Mental Capacity Act and Deprivation of Liberty Safeguards. The nurse in charge confirmed this, but there was no certificated evidence to verify it. Other care staff had not received this training. This could mean staff may not follow procedures identified in the Mental Capacity Act and Deprivation of Liberty Safeguards, so that peoples choices and human rights are only affected following assessments, best interest meetings, risk assessments and discussion with the person concerned and/or their advocate. In our last key inspection report of 14 June 2007 we made the following requirements: The provider must make sure that rooms occupied by people are, maintained, redecorated and equipped with adequate furniture, bedding and other furnishings, including curtains and floor coverings as set out in their information for residents document dated January 2006. If people choose to redecorate and refurnish their own rooms written agreements must be in place to demonstrate this. If the person has communication difficulties their relatives or an advocate must be part of this process. Checks at this visit have deemed this requirement has been met. We spoke to a nurse in charge who told us that until recently this had happened, but they had been instructed that in future the basic requirements set out in the information for residents document must be provided through the household budget. Care Homes for Adults (18-65 years) Page 5 of 12 We also made six requirements about various aspects of the homes policies and procedures for dealing with medication, so that people were sufficiently protected by them. Checks at this visit have deemed these requirements to have been sufficiently met. This is because: We asked the nurse in charge to look at the policy and procedures for dealing with medication. They stated these were now available via the intranet, with the policy procedure specific for Gardens Lane in the front of the medication administrations record. Neither the nurse in charge or the inspector could not find the policy/procedure on the intranet and the policy/procedure in the front of the medications administrations record was insufficient to demonstrate all procedures for medications and clarify it had been reviewed in accordance with The Royal Pharmaceutical Guidelines for the administration of medicines in care homes. However, the aforesaid guidance was available for staff. When we spoke to staff they told us that medication that was prescribed for people who attended day care was supplied directly to the day centre. This means that staff were no longer secondary dispensing medication. When we spoke to staff they told us they had received medication training. There was no certificated evidence of this on their individual files and neither did the training matrix hold this information. We saw evidence that care staff were assessed for their competency to administer medication and these were satisfactory. The nurse in charge stated that currently there is no assessment in place to confirm their ongoing competency to deal with the administration of medicines safely. When we spoke to the nurse in charge they told us there was not a record of the temperature of the room where medication was stored. This means the service had not met this requirement. The inspector made a judgement that today the temperature in the room was an appropriate temperature to store medication. This does not mean that they do not need to keep a record, because on some days it may be significantly warmer, which could mean the medication is not stored at the correct temperature. We spoke to the nurse in charge who told us containers with a short shelf life, such as eye drops, were marked with the date they were opened to help ensure they are not used outside conditions recommended by the manufacturer. We looked at some medications to verify this. In the main, it told us this was usual practice, but there were occassions when it didnt happen. This should be monitored as part of medication audits, to ensure staff maintain good practices when working with medication. The provider must make sure that as far as practicable staff in the home do not act as agent or executor for people living in the home. If there are no relatives then independent advocates must be considered. Checks at this visit have deemed this requirement to have been met. Discussion with the nurse in charge told us that staff at the service are no longer appointees for peoples finances. This responsibility has now been moved to either peoples advocates or the placing authority, Doncaster Metropolitan Borough Council. Comments in peoples surveys about what the service did well included, the staff at 32 Gardens Lane do a very good job looking after all the residents and their individual needs with great care, we are very happy with the care that ... receives in Gardens Lane and know that they are loved and well looked after and very happy themselves, listening to Care Homes for Adults (18-65 years) Page 6 of 12 residents. Treating people with respect. Involving people (residents, family and friends). Interested and motivated staff. Open and inclusive working ethic. A great manager and staff team, ... is enjoying the best quality of life he has ever had now he lives at Gardens Lane, caring staff look after me well and the homes run well. About what the service could do better included, sometimes staff shortages can have implications for residents. I know that staff themselves find this frustrating, get more staff, more staff - they always seem to be on training or courses, so we cant get out or if they are short staffed sometimes staff have to work a lot extra and more staff to do more activities. Comments from staff about what the service do well included, it meets every service users individual needs well. Has qualified staff and manager that are easily approached and easy to talk to and try to maintain high standard of care treating tenants as individuals and taking their views and opinions into consideration, involving them as much as possible in all areas. In what the service could do better one commented, employ more staff to facilitate more outings and activities, especially when staff are attending training courses/updates. The service should seriously look at reviewing their staffing levels, because both people using the service, their advocates and a member of staff feel their needs are not always sufficiently being met with regard to leisure and social activities. During the inspection we found that the cost and charges made to people for using the services transport was different dependent on how many people used the minibus each time. For example, if one person used the minibus, they were charged the rate per mile for using it, but if four people used it each person was charged the same amount. In effect the cost was not split between the people. Staff told us the amount over and above the cost of using the minibus went into a separate account to help pay for the costs of the minibus. This cost and how it was to be charged and used was not identified in the service user guide or peoples contracts. In addition, we were told that residents paid for staff to accompany them on holidays from their own funds. Likewise, there was no description about this in the service user guide or contract. What the care home does well: What they could do better: The service user guide must set out clearly the arrangements for charging and paying for using the minibus and staff accompanying people on holiday. This information must also be in the contract provided to people, so that they sign their agreement to those Care Homes for Adults (18-65 years) Page 7 of 12 arrangements. Make sure staff know where on the intranet they can access the polices and procedures for the administration of medicines, so that this can be referred to if necessary, to make sure correct procedures are being followed that safeguard people. So that staff remain competent to administer medicines safely, nursing staff should have assessments of their competency to undertake the administration of medication. There should be a record of the temperature of the room where medication is stored, so that it can be confirmed medication is stored at the correct temperature. Inform staff that if an allegation of harm or abuse is made it must be reported immediately to the local authority safeguarding team, in accordance with South Yorkshire policies and procedures, so that correct procedures are followed. Arrange training for all staff on the Mental Capacity Act and Deprivation of Liberty Safeguards, so that all staff are up to date with current information on the procedures to follow to ensure peoples choices and human rights are maintained. This is because limitations on personal choices and rights must only be made following assessments, best interest meetings, risk assessments and discussion with the person concerned and/or their advocate. Keep documentary evidence of qualifications and training to verify that this has taken place. 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 set out on page 2. Care Homes for Adults (18-65 years) Page 8 of 12 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 9 of 12 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, 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 1 1 5 The service user guide must 30/05/2010 include the arrangements for charging and paying for using the minibus and staff accompanying people on holiday. This information must also be in the contract provided to people. So that people or their advocates have information to make informed choices about whether to sign their agreement to those arrangements. 2 23 13 Allegations of harm or abuse 30/05/2010 must be reported immediately to the local authority safeguarding team, in accordance with South Yorkshire policies and procedures. So that correct procedures are followed, in order to protect people from abuse. Care Homes for Adults (18-65 years) Page 10 of 12 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 20 There should be a record of the temperature of the room where medication is stored, so that it can be confirmed medication is stored at the correct temperature. So that staff remain competent to administer medicines safely, nursing staff should have assessments of their competency to undertake the administration of medication. Staff should know how to access the policies and procedures for the administration of medicines, so that this can be referred to if necessary, to make sure correct procedures are being followed that safeguard people. All staff should receive training on the Mental Capacity Act and Deprivation of Liberty Safeguards. This will ensure they are up to date with current information on the procedures to follow to ensure peoples choices and human rights are maintained. This is because limitations on personal choices and rights must only be made following assessments, best interest meetings, risk assessments and discussion with the person concerned and/or their advocate. There should be documentary evidence of qualifications and training that staff have undertaken to verify that this has taken place. 2 20 3 20 4 23 5 35 Care Homes for Adults (18-65 years) Page 11 of 12 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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