Care Home: Hawthorns, The

Similar services:

• Polesworth Group Friary Road
• Polesworth Group Pooley Heights
• Polesworth Group 32 Station Road
• Polesworth Group 70 Long Street
• Breme
• Polesworth Group 64 Long Street
• Polesworth Group 68 Long Street
• 10 Whitfield Avenue

What the care home does well The service user guide is written in a way that makes it easier to understand so the people living there know what is provided for them at the home. Care plans have a personal profile of the daily routine and show how people like things to be done and at what time. This makes their plan more personal to them. There is a small core team of staff who knows people well. They provide some consistency and have positive relations with individual`s. A proactive approach is taken by staff to ensure that the health and wellbeing of people living in this home is maintained in a timely and consistent way. People are supported to keep in contact with their family and friends and staff knows that these relationships are important to them. People living in this home are supported through varied life experiences, such as, going abroad on holiday, having bus passes. The registered manager is proactive in looking at individual`s ambitions and aspirations so goals in these areas are aimed for thereby making life more meaningful to individuals. Redecoration has taken place and people have been able to choose colour schemes and these reflect individual`s own personality and interests. All staff have acheived their NVQ Level 2 which exceeds the recommended expectations and means people are cared and supported by a knowledgeable and skilled staff group that understand their individual needs. The registered manager is consistently looking at ways to improve and develop the services in this home to acheive good outcomes for people who live at The Hawthorns. This proprietor is also actively involved in these processes which staff have told us they value as actions where needed are taken in a timely manner. What has improved since the last inspection? Further redecoration has taken place and a company has been employed to do some artwork in one individual`s room that comes alive at night which makes it personalised, stimulating and both relaxing. The registered manager has told us that they are being more proactive in recording both informal and formal supervision sessions that they complete with staff so that we can be sure regular supervision sessions are being held. What the care home could do better: Care plans should be further developed by using pictures and symbols to illustrate individual`s assessed care needs which show that people are able to understand their contents. It should be clear from reading care files what portions of fruit and vegetables are being offered to people on a daily basis to promote nutritious and healthy eating. Staff must monitor people`s weight by recording this on a regular basis so that any losses and gains are recognised in a timely manner so that any underlying medical conditions do not go undetected. Key inspection report Care homes for adults (18-65 years) Name: Address: Hawthorns, The Walkmill Drive Wychbold Worcestershire WR9 7PB     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Sally Seel     Date: 1 9 0 5 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Adults (18-65 years) Page 2 of 33 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 33 Information about the care home Name of care home: Address: Hawthorns, The Walkmill Drive Wychbold Worcestershire WR9 7PB 01527861755 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Yunicorn Limited care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 4 The registered person may provide the following category 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 (LD) 4 Date of last inspection Brief description of the care home The Hawthorns is a detached, residential property situated in a semi-rural area in a private drive off the main Worcester road in the community of Wychbold. The property is of modern design and appearance. There is limited parking at the front of the premises and an enclosed garden at the rear. The property has been operating as a residential care home since August 1995. The home is registered to provide accommodation and personal care for a maximum of four adults with learning disabilities who may also have a mental disorder or a physical disability. The people who use the service are accommodated on the ground and first floor of the building. The communal space includes a combined lounge and dining area, a Snozelen and a conservatory. The people who use the service have needs that fall within the Autistic Care Homes for Adults (18-65 years) Page 4 of 33 Over 65 0 4 Brief description of the care home Spectrum Disorder range of disability, and may also present challenging behaviour. The correct fees charged for living at this home can be obtained directly by contactiing The Hawthorns. Care Homes for Adults (18-65 years) Page 5 of 33 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: three star excellent 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: This was an unannouced key inspection that took place on the 7 May 2009 over one day. The purpose of this inspection is to look at all areas of the service to ensure that the outcome for peole living there is good, safe and appropriate. This inspection also enables us to ensure that the service runs according to legislation and regulations. During the visit we case tracked two people, this involves reading their records, discussing their care with staff as people who live in this home have limited communication abilities. We also looked at policies and procedures related to safeguarding, concerns and compplaints and medication. Any new policies and procedures were also examined. Discussion with the registered manager took place as well as senior support workers and other support workers. Where appropriate information from these discussions have been referred to. Care Homes for Adults (18-65 years) Page 6 of 33 The manager also suppplied us with an up dated Annual Quality Assurance Assessment (AQAA). Each registered service is required to submit an AQAA each year, this is a form of self-assessment. Information from this has been used in the following report. During the process of the inspection we viewed a variety of areas of the home including,dining/lounge areas, other communal areas, such as, toilets and bathrooms, some private rooms of the people who live there and the garden. We would like to thank the people who live at The Hawthorns and staff members for their help and co-operation throughout the inspection process. Care Homes for Adults (18-65 years) Page 7 of 33 What the care home does well: What has improved since the last inspection? What they could do better: Care plans should be further developed by using pictures and symbols to illustrate individuals assessed care needs which show that people are able to understand their contents. It should be clear from reading care files what portions of fruit and vegetables are being offered to people on a daily basis to promote nutritious and healthy eating. Care Homes for Adults (18-65 years) Page 8 of 33 Staff must monitor peoples weight by recording this on a regular basis so that any losses and gains are recognised in a timely manner so that any underlying medical conditions do not go undetected. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 33 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 10 of 33 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. People have information about the home in pictures and symbols which is meaningful to enable individuals to make an informed decision about whether they would like to live there. Pre-admission assessments are undertaken and people are encouraged to visit the home to ensure that people know their needs can be met prior to coming to live at The Hawthorns. Evidence: In the Annual Assurance Assessment, (AQAA), that has been completed by the registered manager it is confirmed, We promote a home from home atmosphere, all our forms and literature are both in written and pictorial format. Introductionary visits will be offered, and if they were satisfactory and we feel confident in that all care needs could be met and they fitted our criteria they would be offered a place. We found that the registered manager has reviewed the statement of purpose and service user guide using pictures to illustrate the written word. This is important as people considering living in this home would not have the abilities to make sense of what the home could offer and or how their needs will be met if these information guides were only produced in the written word. We looked at the statement of purpose and found Care Homes for Adults (18-65 years) Page 11 of 33 Evidence: that it does give people information about what the home is like inside, how their needs could be met and what services are offered to do this, management and staffing details and how to make complaints. It is also positive that individuals do have the opportunity of visiting this home so that they can meet the other people who live here and decide whether the home is right for them. This home provides care and support to people who have learning disabilities. At the time of our visit there were three people living in the home, two females and one male who have lived together for some time now. Therefore no new people have moved into the home since we last inspected which meant that this outcome area could not be fully assessed at this time. There is currently one vacancy. Staff told us:Learnt so much working here, manager and proprietor are great. Training is always encouraged so that we meet clients needs. Care Homes for Adults (18-65 years) Page 12 of 33 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that care plans and risk assessments do reflect the current care needs of individuals. These could be further improved by using pictures and symbols to demonstrate peoples needs. This will ensure individuals are supported to participate in all aspects of their lives which include planning the care they receive in the home and how their needs are met. Evidence: The care and support provided to two people who live in the home was case tracked. Each individual had their own person centred care plan. These plans generally contained satisfactory information to enable staff to meet peoples needs, areas included, routines, personal care, communication, family contact, making choices, meals, behaviour, health, activities and cultural needs. We found that people living in the home had signed to agree to the care plan information. However, these care plans could be further enhanced by producing them using pictures and symbols to illustrate individuals care needs. This is important as it will aid the undertsanding of people living in the home and promote their involvement in having their say on how, when Care Homes for Adults (18-65 years) Page 13 of 33 Evidence: and by whom their care needs will be met. We are confident that the registered manager will now focus upon care plans to further improve them and showed their eagerness to start this on the day we visited. People living in the home have key workers. These are members of staff that build close relationships with individuals. This means key workers become knowledgeable about a persons practical, social, emotional and psychological needs to ensure support and care offered in these areas is consistent in acknowledging individuals preferences. Also people are able to share any issues and or concerns they may have in the presence of a staff member they feel comforatble with. In the surveys completed by staff, positive comments were made about the care provided, this included, We understand individuals needs and We are all trained about the clients, we know how to support their needs. Positive comments were also made by the registered manager who confirmed in the AQAA their approach to ensuring individual needs are met whilst retaining peoples independence by confirming, We are in close contact with the occupational therapist at present, with regard to a ceiling tracking device to enable our client increased mobility around the home therefore promoting her independence. We sampled risk assessments in the care files we looked at. We found that people are supported to take manageable risks, and individuals are encouraged to have an independent lifestyle. Assessments were up to date and included epilepsy, self harm, unpredictable and challenging behaviour and fire. These stated how staff are to support individuals to minimise the risks involved. Risk assessments are reviewed by staff to ensure they should still be in place and or to reflect any changes that need to be noted so all staff viewing risk assessments have up to date information to hand so that people in the home are protected from harm. Behaviour management strategies were in place for individuals. These provided staff with guidance about possible triggers to behaviour, and guidance on how to prevent some behaviours occurring as well as what to do in the event of some behaviours occurring. Guidelines sampled were up to date. We were told that staff are assisted by external professionals in relation to managing individuals behaviour. This means where required staff are proactive in seeking help and guidance to ensure peoples needs are met in all areas of their lives by professionals who have knowledge in a particular subject area. Peoples ability to exercise choice and to make informed decisions is variable, according to their individual needs. Care files sampled showed that individuals are supported to make decisions. Where practicable and safe peoples wishes are acted Care Homes for Adults (18-65 years) Page 14 of 33 Evidence: upon and followed through. Care files looked at and observation of practice indicates that choice is offered to include activities, meals, times of going to bed and getting up. We were shown certificates that one person had been given because they had joined staff who were completing some training in the home. We were told that this person enjoys being part of training sessions and it was nice to see that this person had been given a certificate which is displayed on their bedroom wall. Also in the AQAA it states, All our service users have their individual house keeping tasks, they along with the staff keep their home clean and tidy, their tasks include,shopping, cleaning, dusting, washing up, tidying their own bedrooms, putting their laundry away,and cooking. We found this to be true as in one of the care files we looked at there were recordings where the person had emptied bins, put crockery away and mopped the floor. This shows that people living in this home are encouraged and supported as their abilities allow to take part in the running of their home so that their indpendence is promoted and valued. Care Homes for Adults (18-65 years) Page 15 of 33 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in this home have experienced a wide range of activities which are a reflection of peoples individuality and independence. Staff supported people in taking a holiday abroad to gain new life experiences. People are able to flexibly choose their own meals which are varied and healthy. Evidence: The registered manager has worked hard to provide people at the home with excellent opportunities to experience holidays abroad and in this country. We were told that people have been to Paris and enjoyed the experience so the registered manager is now going to ensure further trips are planned. We found that other activities and interests that are followed in the community range from, horse riding, swimming, discos, visiting the local parks and libraries. People who live in the home have the facility of their own minibus to enable them to access activities and follow their interests in the community but they also have individual bus passes so that choices Care Homes for Adults (18-65 years) Page 16 of 33 Evidence: can be made and experiences developed. Individuals are also encouraged and supported to participate in a wide range of activities in the home, such as, games, jigsaws, playing musical instruments, manicures and pedicures. We were told that an activities physiotherapist regularly spends some time with people to promote their personal development which is also incorporated into peoples person centred plans. Positively in peoples individual care plans we found that any activities that the person no longer enjoyed were noted and in another care file it was confirmed that the person enjoys watching planes fly and is suppported by staff to go to the airport every other week. This reflects that people are given choices and their decisions are respected. Daily records and care files sampled show contact with family and friends is supported. One person was supported to send a photograph and write an invitation for their family to visit them and another person regularly goes on holidays with their family. Relatives are invited to review meetings where appropriate. We were told that there are no regular relative meetings but the registered manager does have an open door policy where family members can call in and or contact by telephone if they wish. This practice ensures good communication links are maintained with relatives. We were told that individuals cultural and spiritual needs are recorded in care files. We found this to be true and people are offered visits to churches and or by local vicars or priests to practice their religions if they wish. It was also good to see that if inidvidual decline this then it remains on care files to prompt staff to ask people again in case in time they change their minds. In each care file we found a daily record of individuals meals and these showed that choices are given and meals looked varied. We were told People come to get their meals at the times of their choices and were provided with individual meal preferences. There are menus but meals are given in a flexible way and in line with what people want on any given day. Any dislikes and likes in relation to eating meals was recorded which included any aids needed to assist people to be as independent as possible when eating their meals. The AQAA confirms, Our service users are given the choice to eat either as a family or on their own, however we do encourage them to eat one meal a day together, this is normally their evening meal with staff members who are on duty. We could not find any daily records that would indicate the fruit and vegetables portions that people are offered to ensure the recommended five a day is practiced to promote healthy and nutritious diets. This was mentioned to the registered manager who will ensure that this is recorded. Staff told us:- Care Homes for Adults (18-65 years) Page 17 of 33 Evidence: We try to different things with people each day. We go on days out, travel on buses, go to the shops, always something going on. Care Homes for Adults (18-65 years) Page 18 of 33 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have access to health care within the home and the local community ensuring individuals health needs are monitored and met effectively. The management of medication is good which ensures people get the right medication at the right time. Evidence: In the AQAA the registered manager confirms, The service users all have their individual healthcare professionals which we can access when required, these are Doctors, Dentist, Physiotherapist, Activities Physiotherapist, Chiropodist, psychiatrist and district and practice nurses their keyworkers along side the manager will accompany them to their appointments which keeps the continuity. We found this to be true as care files provided information about individuals past and present medical conditions so that people living in this home can be confident that their health needs are being consistently met, reviewed and promoted. Weight records showed that staff were not regularly checking peoples weight to ensure they are not losing or gaining a significant amount of weight that could be an indicator of an underlying health need. Therefore we recommend that regular weight checks are completed and recorded. This is particularly essential for people who have limited communication and would not be able to express if they are unwell. Satisfactory plans were seen to be in place in Care Homes for Adults (18-65 years) Page 19 of 33 Evidence: one care file that we looked at in relation to providing staff with information to manage a persons epilepsy with types of seizures noted together with timescales. Hazards were also confirmed, such as, staff to be aware of snowy pictures on television which could bring on a seizure. There were examples where doctors, psychologist, occupational therapists, physiotherapists, dentists, opticians and chiropodists have visited the home and or where people have attended appointments. On the day we visited the registered manager was taking one person to the doctors for their apppointment. We were told that chiropodist appointments are generally every six months and in one care file it confirmed that the person used to go to the chiropodist but now enjoys home visits more. Care plans sampled included information for staff on how to support individuals to meet their personal care and health needs. The people living there were well dressed in good quality clothes that were appropriate to their age, gender and the activities they were doing. There were examples on the care files of what individuals could do independently whilst carrying out their personal care tasks. For example, in one care file it confirmed that the person was able to pull on their own socks, brush own hair and choose own clothes with some help. Care files also held information on what style of clothes individuals preferred and whether they liked to wear jewellery and or make up. This means people are able to be supported to retain their own personal tastes which reflect their personalities. The AQAA informs us that, All staff have updated training of medication and at all times two staff members are present when dispensing and administrating medication. Staff spoken with confirmed this to be the case. We reviewed medications with the registered manager and found that medication is stored in a locked cabinet. The medication is supplied by the pharmacist. Medication Administration Records (MARS) had been signed appropriately and these cross-referenced with the amounts of medications left to take indicating that medication had been given as prescribed. We were told that people had their medication reviewed regularly to ensure that this is still of benefit to them and is effective in meeting their health needs. Care Homes for Adults (18-65 years) Page 20 of 33 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints procedure is comprehensive and is accessible to people should they need to make a complaint. There are systems in place to ensure people are safeguarded and protected from harm. Evidence: The registered manager told us that there have been no complaints made in the last twelve months and this is also confirmed in the AQAA. An easy read complaints procedure is available to each person who lives at The Hoawthorns making it more accessible for people with communication support needs. This included the relevant and required information so it was clear how people could make a complaint if they are unhappy with the service provided at the home. The levels of learning disability of most of the people living in this home indicate that they would require a great deal of support or advocacy to ensure their rights are protected. Therefore the one to one time that people have with their keyworkers must be sustained so importantly individuals are able to comfortably raise any concerns and or complaints knowing these will be listened to and action is taken appropriately. We were told that there are resident and staff meetings where individuals are able to share any complaints and or concerns they may have. There are no relative meetings but the registered manager operates an open door policy for family members to be able to discuss any complaints and or conerns they may have. We were told that questionnaires are given to people who live in the home every four months to see if Care Homes for Adults (18-65 years) Page 21 of 33 Evidence: individuals are happy with the running of the home and staff care pracices. In the AQAA it is confirmed that there have been no incidents of alleged or actual abuse reported. The registered manager informed us that all staff working at the home have recieved adult abuse training. Staff members spoken to on the day of our visit were able to describe the actions that they would take if they witnessed any form of abuse. We sampled two staff records and found that appropriate recruitment and selection checks have been followed. This means that the systems in place for the recruitment of new staff are generally satisfactory which is discussed further in the staffing standards of this report. Care Homes for Adults (18-65 years) Page 22 of 33 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in this home are provided with a homely, clean and comfortable environment. There have been some improvements made to the homes environment so that peoples independence, dignity and safety is promoted. Evidence: The registered manager showed us around the home and we found it to be large, spacious with ongoing redecoration and refurbishment work to ensure that the environment meets the physical needs of the people who live there. For example, a new staircase has been fitted so that a stairlift can now be installed so that all people living in the home are able to access all parts. This will be particuarly valuable for one person who has been getting up and down the stairs by shuffling along. Another person has been visited by the occupational therapist so that a ceiling tracking device can be fitted so that their physical abilities and independence can be promoted giving them more freedom in their home. We were shown some of the bedrooms and found these to be nicely decorated to reflect individuals chosen colour preferences together with their own personal tastes. For example, we saw one persons ceiling had been painted with stars and planets by a company that specialises in this artwork. The stars and planets come alive at night making the room a relaxing and calming place for the person. This decoration was also Care Homes for Adults (18-65 years) Page 23 of 33 Evidence: very personalised as the person had chosen what they wanted to be painted on their ceiling which included their birth sign and Tinkerbell. The small lounge is used as a snoozelan which is a room dedicated to hold equipment and aids to enhance individuals relaxation and stimulate their senses. On the day we visited we saw one person using this room and we were told by staff that they were very fond of sitting in the snoozelan. The lounge area has been redecorated and part of it has comfortable settes and chairs for people to sit and relax and or watch some television as they choose. In the other part there is a table and chairs so that people can eat their meals here if they wish. The kitchen area looked clean and well organised with a table and chairs to give people the choice of eating their meals here and or assisting in preparing meals as they choose. There are toilets, bathrooms with baths or showers so that people can choose how their personal care tasks are completed. These looked clean and had appropriate hand wash facilities such as liquid soap and paper towels so that staff could follow good infection control methods. The conservatory area leads onto the rear garden which is full enclosed and we were told that one of the people who live in the hoome gain enjoyment from helping staff tend to the garden. A new barbecue has been built in the garden so that people are encouraged to use this space particularly in the warmer months as they choose. We were told that the drive at the front of the house is going to be extended to ensure all vehicles staff and visitors alike will be able to park their vehicles without any difficulty. This is important as people who live in this home have their own vehicle aswell. We were told that the homes environment will continue to improve and change where necessary so that people living there will be reassured that their home can meet individuals needs to include their physical and emotional wellbeing. The AQAA tells us that the, Management and staff pride themselves on a clean, happy and friendly enviroment for service users and visitors alike this is evident from comments recieved from family members and professionals. The AQAA also highlights that five staff have received training in infection control as discussed further in the staffing section. On the day we visited we found the home to be clean, hygienic and tidy and provides a homely and welcoming environment to live in. Care Homes for Adults (18-65 years) Page 24 of 33 Evidence: Care Homes for Adults (18-65 years) Page 25 of 33 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A stable, well trained and diverse staff means that individuals needs are competently met. Robust recruitment practices provide the homes commitment to keeping people safe and protected from harm. Evidence: On the day we visited we observed staff helping people where necessary in a respectful manner. We were shown the staffing rotas and told by staff that individuals needs are met appropriately by the numbers of staff on duty at any given time. We were told that there is one staffing vacancy. The rotas do not show any staffing levels falling below what the home confirmed with us. We observed staff interacting with individuals in an unhurried manner and any tasks were completed which further confirms that staffing levels seem to be appropriate for the three individuals living in the home at this time. There seems to be a stable staffing group and this means that people who live in this home have consistency in the support they receive due to building familiar relationships with staff, some of whom have worked at the home for many years. Staff told us:- I have learnt so much. Always encouraged to attend training courses. Care Homes for Adults (18-65 years) Page 26 of 33 Evidence: Two staff records were sampled and we found appropriate recruitment documentation, such as, Criminal Record Bureau (CRB) checks, and completed application forms. Records included two written references for each person and a copy of an application form. This demonstrates that the home has carried out appropriate checks to make sure staff employed by them are suitable to work with vulnerable adults. The AQAA confirms that seven members of staff have achieved their National Vocational Qualification, (NVQ), Level 2 in Care. This exceeds the standard of 50 . The AQAA also confirms, Regular staff supervisions are now taken place. All staff completed their NVQ 2 and now working towards their NVQ 3. The matrix tells us that staff have been maintaining their mandatory training in health and safety, moving and handling, food hygiene, safe handling of medications and fire training. We were told further training has been booked in, equality and diversity, first aid and infection control It was positive to find that some staff have received specialist training in order to meet individuals needs, such as, learning disability qualification, autism, epilepsy, communication and behaviour management. This ensures that people living at The Hawthorns can feel confident that the care and support they receive is provided by a skilled and knowledgeable staff group. All staff spoken with told us that they valued their supervision sessions as an opportunity to gain feedback in relation to their care practices and to check out how they could improve their practices. This is a positive reflection that people living in this home are supported by staff who are fully supervised and recognise their duties and responsibilities within their caring roles. Staff surveys told us:Our manager is always helpiing us to learn more about our job and is always williing to help with teaching with new things and furthering our career. We are getting good support from my manager and proprietor of this home. Care Homes for Adults (18-65 years) Page 27 of 33 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management arrangements ensure that the home is run in a way that benefits the people living there and promotes their best interests. Staff have good direction and appropriate supervision, which means they meet the needs of the people. There have been sustained better outcomes for the people who live at The Hawthorns due to the skilled leadership of the home. There are good arrangements to ensure that the health, safety and welfare of people living in the home is promoted and protected. Evidence: As at the previous inspection Ms. Loraine Summers is the manager of The Hawthorns and is registered with CQC in this role. Ms, Summers has been in post since October 2005 and has previous experience as a registered manager of homes for the elderly, including supporting people with mental health difficulties. Ms. Summers has completed the appropriate training to ensure that they have the skills and knowledge to manage The Hawthorns, such as, autism, first aid, health and safety, fire training, communication, dementia care mapping, and person centred planning. Care Homes for Adults (18-65 years) Page 28 of 33 Evidence: Staff spoke to seemed happy with the registered manager and the way the home was run. We observed people who live in the home and staff conversing with the registered manager in a relaxed and comfortable style. It was clear from speaking with the registered manager that they have knowledge of the people who are living in this home. The registered manager accompanied one person to the dotors for their treatment on the day we visited. This demonstrates that the registered manager enjoys a hands on approach within her management style of the home and is proactive ini ensuring that people who live in this home have new opportunities to increase their independence and learning in life. Some of these opportunities have been reflected throughout this report, such as, holidays abroad, passports, bus passes and going to vote. Staff also valued the presence of the proprietor at staff meetings because staff told us this provided them with the oppportunity of discussing any improvements that may need to be made which could then be actioned immediately by the proprietor. This forum also provided staff with the chance to celebrate their working practices both the negatives and the positives so that people living at The Hawthorns gain good outcomes. The Regulation 26 visits are completed by a person chosen by the provider and on the report it states that these shall take place at least once a month. We looked at the report dated the 07.05.2009 which focused upon, environment including any repairs and or redecoration, health and safety checks, service user and staff meetings, discussions held with staff, care practices, staffing and complaints. These visits are used as part of the registered managers quality assurance together with questionnaires for people who live in the home, annual staff and relative questionniares. The registered manager also ensures that relatives are invited to any of the events that take place. This means that people living in the home, their family members and staff have opportunities of influencing any improvements that are made in the home a further example of the management of this home striving to gain good outcomes for people living in there. The registered manager has also developed and produced an equality policy that the registered manager has developed for people who live in the home by using pictures and symbols so that people are able to understand its contents. This shows the registered managers commitment to promoting equality and diversity in the home in order to further enhance the services offered to meet peoples individual needs. We found that health and safety checks were completed. For example, water temperatures are regulated by valves and staff know what the required temperatures should be to ensure they are not too hot or cold. This ensures temperatures stay Care Homes for Adults (18-65 years) Page 29 of 33 Evidence: within the recommended safe limits so that people were not at risk of being scalded. The water had been tested for Legionnella. A suitably qualified engineer completed the annual test of the gas equipment and stated that it was in a satisfactory condition. An electrician completed the five yearly test of the electrical wiring and stated that it was in a satisfactory condition. The fire risk assessment detailed what action, if any, needs to be taken to ensure that the risks of there being a fire are minimised as much as possible. We also found fire safety assessment in pictorial format which is positive to see. An engineer regularly services the fire equipment to ensure it is maintained in good working order. Regular fire drills are held so that staff and the people living there know what to do if there is a fire. These records show that people are protected from any risks to their health or care needs within peoples living environment. The registered manager has shown throughout our visit and within the completed AQAA that she is determined to make further improvements to the home so that people living there have good quality outcomes. This shows that the registered manager has the best interests of the people who live at The Hawthorns. Care Homes for Adults (18-65 years) Page 30 of 33 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 31 of 33 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 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 6 To further develop care plans which reflect individuals care needs in pictures and symbols to show that people who live in the home are able to have some understanding of their contents, therfore be involved in having their say about their own care needs together with how these are met and by whom. To record daily fruit and vegetable portions that people are offered to promote nutritious and health eating. The recording of individuals weights should be completed on a regular basis so that any losses and or gains can be investigated to promote peoples health and wellbeiing. 2 3 17 19 Care Homes for Adults (18-65 years) Page 32 of 33 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. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 33 of 33 - 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!