Care Home: Harvey Lane

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What the care home does well Harvey Lane offers residents a spacious, safe and well designed home to live in. Significant time and effort is spent planning how prospective residents needs can be met at the home and how they move into it. Support plans and risk assessments are of a high standard ensuring that staff have the comprehensive information they need to meet residents` individual needs and keep them safe. Staff work hard to promote residents` independence meet their specific cultural needs. Staff are well trained, competent and feel supported by their manager. What has improved since the last inspection? This is the home`s first inspection since it was registered with us. What the care home could do better: A fridge for drugs that need a cool temperature should be purchased, as should secure storage for controlled drugs so that residents` medication can be kept safely and appropriately. Staff should receive training in local adult protection practices so they have a good understanding of the procedures and the part they play should the need arise. Information about protecting vulnerable adults should also be made available around the home so that staff, residents and visitors know who to contact if necessary. The home`s recruitment procedures must improve and no member of staff must be employed CRB and POVA first checks have been completed and suitable references have been received. This is vital if residents are to be protected and to ensure that only the right people are employed to look after vulnerable people. All staff, and in particular night staff must receive regular fire drill training so they know what to do in the event of a fire starting in the home. The recent high turnover of staff at the home has been unsettling and disruptive for those remaining and more must be done to create a stable staff group to ensure that residents receive consistent care from staff who know them well. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Harvey Lane 9 Harvey Lane Norwich Norfolk NR7 OBG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Lella Hudson     Date: 1 1 0 3 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.csci.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: Harvey Lane Norwich 9 Harvey Lane Norfolk NR7 OBG TBC TBC 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) : Consensus Community Support Ltd care home 8 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 8 The maximum number of service users who can be accommodated is 8 The registered person may provide the following categories of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning Disability - Code LD Date of last inspection Brief description of the care home Harvey Lane was regsitered with CSCI in September 2008 and offers accommodation and support to 8 people who have a learning disabiltiy, complex needs and challenging behaviour. The home has been set up to provide a transition service supporting people from a very structured to a less structured service. It is owned by Consensus Support Limited which is a division of Caring Homes Ltd who own and operate over 50 care homes across England and Scotland. The home itself is situated in the suburbs of Norwich city giving people good access to a range of services and leisure activties, Weekly charges start form £1400 depending upon peoples needs. Care Homes for Adults (18-65 years) Page 4 of 28 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: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: For this inspection we (The Commission for Social Care Inspection) looked at all the information we have received about the home. This included the annual quality assurance assessment (AQAA) that was sent to us. The AQAA is a self assessment that focuses on how well outcomes are being met for people living in the home. It also gave us some numerical information about the home. We also received a number of surveys from staff working at the home and and one person living there. We visited the home and interviewed all the staff on duty, met both residents and talked with some family members who visited during our inspection. We undertook a tour of the premises, checked medication storage and administration and read through a number of the homes policies and procedures. Care Homes for Adults (18-65 years) Page 6 of 28 Care Homes for Adults (18-65 years) Page 7 of 28 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.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. The homes admission procedures are good ensuring that residents needs can be fully met there Evidence: All prospective residents receive a comprehensive assessment of their needs before being admitted to the home and considerable time is spent ensuring their needs can be met there. We checked pre-admission assessments for both residents which were detailed and informative and there was also a lot of information from a range of health care professionals such as social workers, speech and language therapists and from workers at the residents previous placements. Full care plans are drawn up before each resident arrives. Staff told us they had received good information about prospective residents and some staff visit residents in their current placements so that they can learn how to work with them effectively before they move in. The relative of one resident told us that the manager had taken time to Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: meet her sister and explain the service in detail to her and her father. Her father and her sisters social worker also visited the home several times to assess its facilities. Care Homes for Adults (18-65 years) Page 11 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. Support plans are detailed and informative ensuring that staff have the guidnace they need to support residents comprehensively and consistently. Evidence: We checked the care and support plans for both current residents. One residents care plan had been carefully drawn up before he moved to the home and the manager checked it through with his occupational therapist, behaviour specialist and previous key worker to ensure its accuracy and effectiveness. Both plans were of a high standard: individualized and focused very much on peoples strengths. Residents needs were clearly identified as was comprehensive information and guidance for staff in how to meet them. One resident had over 20 individual support plans that covered all areas of his life including his communications needs, his finances, his INTERNET usage and his cooking skills. Staff (including agency staff) sign each individual support plan to ensure they are fully Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: aware of residents current needs. One member of staff told us: yes I read the plans regularly, in fact Ive been reading them today to update myself Risk assessments were also of a high standard; really detailed ensuring staff were fully aware of what to do to prevent residents and others being harmed. There were some very restrictive measures in place for one resident, but these had been discussed at length with him and he had in fact signed his own risk assessments. One resident has epilepsy and there were separate and detailed risk assessments for her seizing during the day, seizing at night and whilst showering. One resident speaks Portuguese and staff have worked hard to learn key words in Portuguese so that they can communicate with her and home has purchased a Portuguese dictionary and picture book. Considerable effort had also gone into ensuring that key documents such as the fire drill and the service user guide had been appropriately translated for her. We talked to family members who were visiting during our inspection. They told us that the staff understood their relatives needs well, even though she had only been in the home a short while.They also told us that staff make them feel very welcome Care Homes for Adults (18-65 years) Page 13 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. Residents are supported to develop their independent living skills are able to make choices about their daily routines. Evidence: There are opportunities for residents to participate in leisure activities. One resident is very active and he told us he regularly goes swimming, ice skating and to a local library three times a week to access the INTERNET . Once a week he attends a work placement at a nature park and has plans to help get the homes own gardens in order. The other resident has only been at the home for a week but already has been shopping, for a meal out and also to a local park. Staff told us they will plan more activities for her once they get to know her and her abilities better. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: Staff actively support residents to be independent and both residents help with shopping, meal planning and preparation. Staff gave us many good examples of how they help and encourage residents to be independent on a very practical level, and care plans furthered evidenced this. One resident has started using public transport for the first time and now knows the number of the bus he is to get and what stop he needs to get off at. He has recently purchased his own bus pass. Daily routines at the home are very flexible. On the day we visited staff respected one residents wish to stay in bed late, and reorganized their schedule to accommodate a family visit for the other resident Care Homes for Adults (18-65 years) Page 15 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. Staff support residents to maintain good physical and mental health. Evidence: Staff at the home work closely with a range of health and mental health specialists to ensure residents needs are met. Each resident has a personal file which includes information about their weight, their oral hygiene, their nutrition risk and also good information about the illnesses specific to them so that staff can have a better understanding of how it affects them. One resident is encouraged to manage his own health care and has large posters that he has created on computer himself on his bedroom wall reminding him when he last went to the dentist, GP and optician. This information is also clearly recorded on his care plan. This resident has some behaviour that is particularly challenging but there is detailed and comprehensive guidance for staff in how to deal with it, which has been drawn up in close liaison with mental health specialists. The support plan in use for the other resident to receive temporary treatment for a urine infection was excellent. It clearly stated what medicine she was to take,the Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: actual time she began the course, when it was to end, when her urine was to be tested again and the actual date the sample was to be dropped off at the GP surgery.There was also an information leaflet available for staff to read. This level of detail will ensure that staff know exactly how to support the resident in her treatment. Staff have undertaken medication training provided by a local pharmacy and they also have their competency to administer medications assessed by the manager. We checked a sample of residents medical administration records. These had been completed satisfactorily, ensuring there was a clear record of what medication had been administered. However, there was no fridge available for storing drugs that require a cool temperature and no secure cabinet for storing controlled drugs should these be needed. Care Homes for Adults (18-65 years) Page 17 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. Residents have access to a complaints procedures and feel able to raise concerns. Evidence: The home has a complaints procedure, copies of which are given to residents on admission. It also available in a simplified picture format to help residents understand it. We spoke to one resident who told us he does feel able to complain and gave us several examples of when he had raised concerns with staff. We saw examples throughout our visit of staff actively ensuring the protection of residents and visitors. For example, when a workman came to check a broken door, one member of staff who was not avail be immediately called another one downstairs so that the workman was not left unsupervised. On another occasion staff were very vigilant of one resident when a small child visited the home. However the homes policy regarding safeguarding was very basic and some of the information was misleading and did not cohere with local safeguarding practices. Staff we spoke, although knowledgeable about the different types of abuse a vulnerable adult could face, were uncertain about local reporting procedures. We have not received any complaints about the home since it opened and there have been no safeguarding issues. Care Homes for Adults (18-65 years) Page 18 of 28 Care Homes for Adults (18-65 years) Page 19 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. Residents live in a large, comfortable and well maintained environment. Evidence: The home is purpose built to a high standard. There are 8 bedrooms all with en suite facilities. In addition to the en suite there is an additional communal bathroom and shower room. There is plenty of communal space for residents to use including a large dining room, lounge and conservatory. However in contrast, the homes the garden areas are very small, and the garden to the rear of the property is not accessible to residents who are wheelchair users. There is a nurse call system throughout the home for residents to use if needed; a specialist spa bath which can raise up and down to prevent staff bending down and one resident has a sensor fitted to his door so that staff can be alerted when he leaves his bedroom. One resident showed us his bedroom which was personalised very much to his taste. However, the home still feels a little bare and devoid of homely items such as pictures, ornaments, books etc but hopefully this will change as more residents are admitted with their belongings. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to support residents, although the homes recruitment procedures do not adequately protect residents. Evidence: The staff we spoke were knowledgeable, competent and professional. One was a very experienced member of staff with good range of formal qualifications for the job, the other member of staff was new to this type of work and had yet to undertake formal qualifications but had an excellent attitude and enthusiasm for her job. We observed her interacting very skillfully with one resident whilst playing Connect 4 with her. The resident was clearly enjoying this game and there was much laughter. Staff training is good with at least half holding and NVQ level 2 or above in care. Files that we viewed showed us that, in addition to all mandatory training, staff had received training in restraint methods, autism awareness and epilepsy. Staff told us the training they received helped them in their work. One commented: the training was very interesting and helpful in my development as a support worker. I am now feeling more confident when I work with service users. Staff told us they generally felt supported, however a number who completed our survey raised concerns about working excessive hours due to a shortage of staff. Staff Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: were also concerned about a high turnover, with many leaving. One told us: theyre leaving at a rate of one every six weeks. The deputy manager left suddenly giving only a weeks notice. Staff also complained to us about the low wages and also that the company does not pay them sick pay. Interactions we observed between staff and residents were encouraging and appropriate. One resident told us that he gets on alright with staff and they understood his needs, although he doesnt like having two accompanying him whenever he goes out. We checked the personnel files for three members of staff. This highlighted some serious concerns. One employee had started working at the home before a POVA first check, references or CRB had been received. Another member of staff had started with only a POVA first check and one reference. Employing staff before these important checks have been undertaken puts residents at unnecessary risk. Staff do receive supervision but files that we checked showed that not all were receiving it as frequently as recommended by the minimum standards. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a well managed home where their health and safety is promoted Evidence: The registered manager has the required skills and experience to manage the home. She has gained the registered managers award and has an NVQ level 3 in Promoting Independence. Staff told us that they felt supported by her and that there were regular team meetings where they could raise concerns. Staff do have access to a range of polices to guide them in their working practices and we viewed policies in relation o medication, safeguarding adults and the use of restraint and, although basic, were satisfactory. We checked a number records in relation to health and and safety (fire, gas, emergency lighting, water and fridge temperatures) which showed us that the home regularly checks its equipment to ensure its safety and effectiveness. However, none of the Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: night staff have practiced a fire drill and should do so they not what to do in the event of a fire happening in the home. 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 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 34 7 Appropriate references and CRB checks must be completed before a member of staff begins employment at the home. This is to ensure that residents are protected and only people who are suitable to work with vulnerable adults are employed. 01/04/2009 2 42 4 All staff must undertake regular fire drills to ensure they know what to do in the event of fire happening in the home 01/05/2009 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 Appropriate storage for controlled drugs and medication requiring cold temperature should be purchased so that medication can be accommodated safely and securely. Care Homes for Adults (18-65 years) Page 26 of 28 2 23 Staff should receive information and training in local adult protection procedures so they know how, and to whom, to report concerns if needed. Staff should receive recorded and regular supervision meetings at least 6 times a year so there is an opportunity to discuss their working practices and identify their training needs. 3 36 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!