Care Home: Hardy Drive (23)

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What the care home does well Care plans are `person centred` and reviewed on a regular basis to address the changing needs of individuals. The care planning approach involves the resident and significant others, in order to ensure the needs, wishes and aspiration of the individual are at the centre of service delivery. Each resident has a programme of activities that includes accessing local community facilities and other amenities. Feedback from the questionnaire surveys was positive. All the residents said that they were happy with the services provided and that the staff team was helpful and supportive. Feedback from relatives was also positive. One relative stated the home ` meets the special needs required to care for my son. Keeps him active in the community. He always appear to be happy`. Staff commented that there is good team work to support the residents in meeting their identified needs. In relation to equality and diversity, the home has this policy in place and staff spoken to were aware of it and ensured that people were treated equally irrespective of their age, race, disability, religious beliefs, cultural background and sexual orientation. What has improved since the last inspection? The requirements made in the last inspection were addressed. Liquid soap and disposable paper towels were provided in communal toilets and bathrooms. Window restrictors have now been fitted in residents` bedrooms to reduce the risk of accidental falls from height from the first floor. New carpets have been fitted to one of the resident`s bedroom. What the care home could do better: The home must ensure that health and safety regulations are adhered to at all times so that residents are not put at risk. This includes the checking and monitoring of the bath hot water temperature. The walk-in shower should be kept free from damp and mould. Hand washing facilities should be provided in the laundry so as to control the spread of infection. The registered manager must ensure that a valid Employer`s Liability Insurance certificate is prominently displayed in the care home. One relative commented that the home `should have more meetings to discuss care plans as issues have arisen regarding personal hygiene. The Housing Association could respond more quickly to building repairs`. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Hardy Drive (23) 23 Hardy Drive Royston Hertfordshire SG8 5LZ     The quality rating for this care home is:   one star adequate 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: Bijayraj Ramkhelawon     Date: 1 0 0 6 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 28 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 28 Information about the care home Name of care home: Address: Hardy Drive (23) 23 Hardy Drive Royston Hertfordshire SG8 5LZ 01763243684 01763245972 diane.evans@mencap.org.uk 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) : Royal Mencap Society care home 6 Number of places (if applicable): Under 65 Over 65 0 0 learning disability physical disability Additional conditions: 6 1 This home may accommodate up to 1 place for a person with physical disability associated with learning disability. Date of last inspection Brief description of the care home Hardy Drive is a small home, which accommodates six people who have learning difficulties, one of whom may have a related physical disability. The home is situated on a housing estate in Royston and blends in with the local housing. It offers a large lounge, conservatory, kitchen/dining room, and relaxation/sensory room on the ground floor. One bedroom with en-suite is on the ground floor, which accommodates one service user with a physical disability. There is a chair lift providing access to the first floor for some one with a physical disability. The first floor contains five further bedrooms, a bathroom, shower room and the staff office/sleep-in room. A large garden to the rear of the house offers a relaxing area for service users to enjoy in nice weather. Aldwyck Housing owns the building and is responsible for maintenance. The care service is provided by Mencap. Care Homes for Adults (18-65 years) Page 4 of 28 Brief description of the care home Information about the service provided at 23 Hardy Drive, including the most recent inspection report can be obtained on request from the manager. Each person living at Hardy Drive has a tenancy agreement that sets out his or her individual contribution towards the rent, which is part of a block contract with Hertfordshire County Council. Individual contributions are currently £69.90 per week. Care Homes for Adults (18-65 years) Page 5 of 28 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: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support peterchart Concerns, complaints and protection Environment Staffing Conduct and management of the home Poor Adequate Good Excellent How we did our inspection: This unannounced key inspection was carried out on the 10th June 2009 and took one day. It included talking to staff, examining care plans, staff files, staff training records, fire safety procedures, health and safety practices, medicine records, maintenance records, all other records and documents and a tour of the premises. We looked at all the information we have asked for or received about the home, since the last inspection. This information included the Annual Quality Assurance Assessment (AQAA), sent by and returned to the Commission from the homes manager. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also provides some statistical information about the service.The information provided in the AQAA was also checked against the findings as set out in Care Homes for Adults (18-65 years) Page 6 of 28 the last inspection report. We also sent out questionnaires to a random selection of people who use the service, their relatives and staff who currently work at the care home. 5 questionnaires from people using the service (completed with the help of staff), 2 from relatives and 5 from staff were received. Comments from these questionnaires are reflected in this report. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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 8 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 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. Current and prospective residents can be assured that their needs would be assessed and met. Information about the home is available so that people would be able to make a decision whether to move in or not. Evidence: Adequate information about the home including a copy of the Statement of Purpose and Service Users Guide was available to current and prospective residents. Care plans examined showed that an assessment of individuals needs was carried out prior to moving in. Mencap have comprehensive polices and procedures in place for ensuring the needs of individuals moving into one of their homes can be met. This would include the opportunity to meet the other residents and try out the service. Care Homes for Adults (18-65 years) Page 10 of 28 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. Residents can be assured that their identified needs would be met and that they would be enabled to live the lifestyle they choose. Evidence: New care plans with pictures and texts were being devised for implementation. The current plans of care are reviewed on a regular basis with the staff at the day centre. These include the assessment of needs, various risk assessments, goal and action plan incorporating household tasks, dietary needs, social needs, behaviour and medication taken. Daily records are kept in a form of a diary for each individual. Each person has a person centred plan of care based on their views about how they wish to be supported from day to day and longer term goals. Family, advocates and Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: professionals from specialist services are also involved in the assessment process and reviews. The support plans reviewed demonstrated that individual procedures are in place for situations that require staff to promote positive behaviour and independence in challenging situations. Residents are reminded of the steps they must take to ensure their personal safety when out and about in the community. As stated in the AQAA, the registered manager will within the next twelve months ensure that each residents support plan is reviewed on a monthly basis to reflect their changing needs and the risk assessments to be cross- referenced within the care plan, thus enabling residents to be supported in taking risks and remaining safe as part of an independent lifestyle. Care Homes for Adults (18-65 years) Page 12 of 28 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. People using the service are supported to engage in appropriate activities, accessing local community amenities and that their rights are respected. Evidence: Residents have a range of activities as detailed in their individual support plan. They are enabled to actively participate in educational and leisure activities during the day as well as attending activities of daily living in the evening and at weekends. Five residents who completed the surveys, with the support of staff, said they enjoyed living at Hardy Drive and the home does well in ensuring that residents do go out. Two residents attend the day centre in Baldock, one receives outreach service from the college, another attends the free church in Letchworth and one attends the Quaker day centre. At the time of the inspection all residents were out of the house attending to various activities as per support plan. People using the service and staff are aware of Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: the house rules on seeking permission before entering each others rooms. Residents picked up their own post when they arrived home. The Hardy Drive pets provide a point of interest and caring for the residents. As stated in the AQAA, the registered manager will within the next twelve months introduce a Health Awareness Champion who will liaise with other professionals so that residents can be supported in maintain good health. Care Homes for Adults (18-65 years) Page 14 of 28 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 are able to express their individual personalities through the choices they make regarding personal care, food, clothing and accessories. They are able to access local community health services to maintain and promote a healthy lifestyle. Evidence: Individuals receive personal and healthcare support using the person centred approach with support provided based upon identified needs including the rights of dignity, privacy, choices and respect. Care plans examined showed that residents identified needs were being met and that all residents are registered with a G.P. Each persons support plan sets out how their personal needs, associated with personal hygiene and specific health care needs, such as seizures or weight loss, are to be met. Each person has a health action plan folder providing details of their past and current medical history and how they prefer any required interventions or procedures to be carried out. The records, which, are in written and also in pictorial form, can be taken Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: to hospital and GP appointments to ensure consistent information is available. Overall, there are good systems in place for ordering, storing and administering the medication that each resident requires. The systems meet the required standards and were found to be satisfactory on the day of inspection. Residents are encouraged to plan the weekly menu with the assistance of pictures of meal options. Advice and guidance was given on healthy options and preferences. The care records confirmed that the dietary needs of each resident are assessed and dietetic and medical advice obtained as necessary. As stated in the AQAA, the registered manager will within the next twelve months develop a All About Me booklet for each resident to enable other professionals to support the residents better. Care Homes for Adults (18-65 years) Page 16 of 28 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. The process for staff recruitment, training, supervision and the policies and procedures in place should protect residents from harm. Evidence: The home has a complaints procedure and information on complaints is also included in the Service Users Guide. Residents meetings are held and a simplified version of the complaint process is discussed on a regular basis to remind residents of their rights. Four out of the five residents who completed the questionnaires, with the support of staff, said they knew who to speak to if they were not happy. Individuals also have contact with advocacy workers, family and individuals outside the home, who they meet as part of their daytime activities or professional reviews. No complaints have been received since the last inspection. The home has a copy of the Hertfordshire procedures on Safeguarding Adults. Staff spoken to confirmed that they are familiar with the procedures and staff records showed that they have received training on the safeguarding adults. An element of adult protection is also covered in the induction programme for all new staff members and those people undertaking the NVQ assessment. Staff receive training, as part of their induction on recognising and responding to signs Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: of abuse. This also covers their responsibilities as social care workers to speak out if necessary and the protection afforded to them under Mencaps Whistleblowing procedure. Feedback received from residents questionnaires was positive and all said that they were well looked after and staff were very supprotive and helpful. Care Homes for Adults (18-65 years) Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are supported in an environment that is homely, comfortable and safe. Evidence: The home was reasonably well maintained and furnished in a domestic style to provide a homely, comfortable and safe environment. All bedrooms viewed were personalised to reflect individuals interest and sensory needs. There is a sensory room that provides additional relaxing space for residents. A good standard of cleanliness was evident throughout those areas viewed. Food items were appropriately stored in fridges and temperatures, recorded daily. The home has an infection control policy and procedures in place and staff encourage residents to follow good hygiene practice. Arrangements for the storage and disposal of domestic and clinical waste remain satisfactory. Staff members spoken to are conversant with infection control procedures. The effects of damp and mould were noted in the shower room. This should be investigated and eliminated so as to ensure that facilities used by residents are well maintained. There are suitable arrangements in place for residents to manage their Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: laundry. But there is no hand washing facility in this area. A review of hand washing arrangements needs to be carried out according to Department of Health Guidance so that Liquid soap and disposable hand towels need to be available at the point of contact to reduce the risk of infection spreading. Care Homes for Adults (18-65 years) Page 20 of 28 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. People using the service do benefit from the care and support they receive from a competent and qualified staff team and that they feel protected by the homes recruitment policy and practices. There are robust recruitment procedures in place to ensure that suitable people are employed and are given the training they need to work effectively and develop their skills. Evidence: Information gained from duty roster and staff members provides evidence that the day and night staffing levels remain adequate to meet the needs of the residents. Staff members have the necessary skills and they receive appropriate training to meet the varying needs of the residents. Staff spoken with indicated that they have opportunities for relevant training and this gives them greater confidence to do their jobs. Staff were very knowledgeable about the needs of individuals whom they were supporting and caring for. Currently, there are 6 care staff, 3 of whom have completed the NVQ Level 3. Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: Six staff files were examined and these were found to contain all the required documents including two written references and CRB checks were carried before an offer of employment was made. Staff spoken to confirmed that they received one to one formal supervision on a regular basis. Supervision records were maintained. Staff also confirmed that they received support from the management team and that senior members of staff were approachable and available for advice as and when needed. Care Homes for Adults (18-65 years) Page 22 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service can be assured that their health and welfare are protected by policies and procedures but may be at risk if the bath hot water temperature is not reduce to the safe required level. Evidence: The implementation of a number of systems including assessment and admission process, care planning and review, consultation and communication, recruitment, induction, training, supervision and appraisal of staff ensures that the home operates in an manner that benefits people using the service and the staff team. The home has a quality assurance system in place and seek the views of people using the service, relatives, staff and other interested parties. However, it was noted that the bath hot water temperature was 60.8 C and rising. This must be reduced to the safe require level close to 43C so that residents are not put at risk. An immediate requirement was left with the person in charge to ensure that the bath was not to be used until the hot water temperature was reduce to the safe Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: required level. It was also noted that the walk-in shower room had damp and mould. All statutory records were available for inspection and maintained in accordance with legislation. Records inspected were up-to-date and accurate and were held securely. Staff spoken to were aware that people using the service can access their records and information held about them in accordance with the Data Protection Act 1998. There were policies and procedures in place to ensure that the health, safety and welfare of people using the service and staff are promoted and protected. These records were accessible to all staff. All accidents and injuries are recorded in the accident book and RIDDOR forms have been completed where applicable. The Commission has been kept informed of all accidents and admissions to hospital. Regular checks on hot water temperatures (weekly) and moving and handling equipment were recorded. The Employers Liability insurance certificate that was displayed had expired on the 31st May 2009 and a valid insurance certificate must be prominently displayed at all times. As stated in the AQAA, the registered manager will within the next twelve months hold regular meeting with the residents and continue to update and improve the Health Action Plans. Care Homes for Adults (18-65 years) Page 24 of 28 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 25 of 28 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 1 42 13 The bath hot water 12/06/2009 temperature was recorded at 60. 8C and rising. This must be reduced to the safe required level close to 43C so that residents are not put at risk. 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 1 37 25 The Employers Liabilty 28/08/2009 insurance certificate displayed had expired on the 31st May 2009. A valid certificate of Employers Liability Insurance must be displayed at all times in respect of liability which may be incurred in respect of death, injury, public liability damage or other loss. 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 Care Homes for Adults (18-65 years) Page 26 of 28 1 24 The walk in shower room continues to have damp and mould. This should be investigated and elimiated to ensure that facilities used by residents are well maintained. The laundry room does not have a handwash basin. This should be provided so as to control the spread of infection. 2 30 Care Homes for Adults (18-65 years) Page 27 of 28 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. 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