Care Home: Heathcotes Care (Kirby)

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What the care home does well We saw staff as being kind and friendly to people who live there, gave them choices as to what they wanted to do and treated people with respect. Care plans contain a wealth of detail as to residents needs and how to deal with all situations relevant to the resident, they are regularly reviewed and updated so that staff follow best practice and are consistent in how to deal with situations that occur. Resident health needs are well covered. There are a good variety of activities that are tailored to residents individual preferences. People are supported to maintain relationships with family and friends. Barry Drive is clean and tidy, and good standards of hygiene are maintained. Members of staff have received training in different areas of care practice to help them improve their skills. What has improved since the last inspection? There were no requirements from the last inspection. What the care home could do better: Complaint recording always needs to outline the outcome of the complaint with action if this is needed. Staffing levels need to increase for times when one to one care is needed to cover residents identified needs. The Provider must ensure that staff do not commence employment prior to the receipt of two written references to ensure residents are protected from unsuitable staff. Residents health and safety is always completely protected, e.g. from fire risks. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Heathcotes Care (Kirby) 6 Barry Drive Kirby Muxloe Leicester LE9 2HG     The quality rating for this care home is:   three star excellent 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: Keith Charlton     Date: 0 1 0 4 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 27 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 27 Information about the care home Name of care home: Address: Heathcotes Care (Kirby) 6 Barry Drive Kirby Muxloe Leicester LE9 2HG 01162245971 Telephone number: Fax number: Email address: Provider web address: enquiries@heathcotes.net www.heathcotes.net Name of registered provider(s): Type of registration: Number of places registered: Heathcotes Care Ltd care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: No one falling within category LD may be admitted into Heathcotes Care (Kirby) where there are 6 persons of category LD already accommodated within this home. No person falling within category MD may be admitted into Heathcotes Care (Kirby) unless that person falls within category LD - ie dual disability. No person to be admitted to Heathcotes Care (Kirby) in categories LD or MD when 6 persons in total of these categories/combined categories are already accommodated in this home. Date of last inspection Brief description of the care home The last inspection of this service was on 2/4/07. 6 Barry Close is set in the residential heart of Kirby Muxloe, Leicestershire. The home provides residential care for six adults with varying degrees of learning disabilities, communication and sensory difficulties and behavioural challenges. 6 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 27 Brief description of the care home The home is a refurbished detached property that offers six large single bedrooms (two rooms situated on the ground floor and four on the first) with en-suite toilet and sink two of which include an en-suite shower. Residents are encouraged to personalise their rooms by choosing their furniture and decor. Other rooms include spacious communal areas such as the lounge and dining room, kitchen, shared bath and shower room situated on the first floor, large wet room with disabled access to toilet and shower on the ground floor as well as a utility room. The garden includes a large patio and grassed area that is secure and private. The home is a short walk from local shops, village pubs, bus stops, leisure centres and supermarkets including Beaumont Leys shopping centre. The home is on the outskirts of Leicester, a five-minute drive from the M1, Fosse Park and Meridian Park, and a tenminute drive from Leicester City town centre. Current fee levels at the home are #1,600 to #3,200 per week. Care Homes for Adults (18-65 years) Page 5 of 27 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 key inspection included a visit to the service. We (the CQC) visited Barry Drive on the 1st April 2009. The Regional Manager and staff in the home helped us during the visit. The main method of inspection we used was case tracking. This means looking at the care given to people in different ways. We did this by, - observation of life in the service. Talking to the people who live in the home was not possible due to communication difficulties that residents have, - talking to staff and management, - looking at records. Care Homes for Adults (18-65 years) Page 6 of 27 We also looked at the Annual Quality Assurance Assessment (AQAA). This is a document the provider (the person who owns the service) sends to us at the CQC, and it tells us what the provider thinks about the service they deliver to people who live at Barry Drive. As well as this, we looked at information that had come to our attention since the last key inspection in April 2007. We observed the people who live at Barry Drive during our visit and spoke to staff. Staff said that they were there to give the residents a good quality of life and to try to ensure residents were happy. They all were very positive about working at Barry Drive and wanted to provide excellent care to the people living there. Their comments were, Management are very good. We are properly supported and respected. Training is positively encouraged. We have enough staff in general though we can be stretched if two of us have to go out with a resident that needs this much support. Everyone is friendly and we try to give residents choices as to what they would like to do. We checked all the standards that the Care Quality Commission has decided are key standards during this inspection. The information below is based only on what we checked in this inspection. We have kept details about individual people out of the report to make sure we respected their confidences. 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 27 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 27 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 living at Barry Drive have had their needs properly assessed before moving into the home. Evidence: We case tracked a person living in the home who had moved in to Barry Drive. We checked that he had received information to help him/his relatives with the choice of home, but because the person had communication problems it was not possible to check he had received this information. The Manager stated in the AQQA that a thorough assessment is done and that they were looking at providing more accessible information for residents who could not read. We also checked that the person now living at the home had their needs properly assessed prior to moving to Barry Drive to ensure that the staff at the home could meet their needs.We found this to be the case as the assessment covered all important issues such as health, behavior, relationships, medication, sleeping, work and play, personal hygiene, safe environment etc. Care Homes for Adults (18-65 years) Page 10 of 27 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. The individual needs and choices of each person living at Barry Drive are well documented and acted upon by staff. Evidence: We looked at the care records of two people living at Barry Drive. We found very detailed plans to support the care given to people who live at the home. There was a variety of useful information available to staff - Person Centred Plans, Listen to Me Workbook, Health Action Plans, Daily and Weekly Activities Logs, What is important to You document, Accident and Emergency Sheets for hospital visits etc. Plans also detailed the mental health conditions of residents and supplied detail to staff as to how to approach any challanging behavior they may meet. There are also a number of risk assessments so that residents can be protected from all identified risks. Care Plans also contain detail as to how to encourage residents independence - keeping their bedrooms tidy, helping in the kitchen etc. Staff said that they read Plans to ensure they can meet residents needs and keeping up to date with Plans is encouraged by management. Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: We saw that care records were routinely up-dated to ensure they reflected the changing care needs of people living in the homes. There are regular eight weekly Meetings with residents families, which the resident can attend if they wish, to review what has been happening to residents and to change Care Plans if needed. The Regional Manager explained the the staff have access to a specialist autism expert to further support the provision of good care to residents. During our visit we observed staff being very friendly to residents and explaining what they were doing to reassure residents. There was some evidence that residents are able to live their own lives, e.g. going out to places in the community, choice of meal, choice of activity etc. Care Homes for Adults (18-65 years) Page 12 of 27 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 at Barry Drive have opportunities to have a varied lifestyle. Evidence: We looked at the life plans of people who live at Barry Drive. These contain weekly activity sheets and daily activities are also recorded so that these can be checked and reviewed as needed to ensure residents needs are met.These showed us that residents are able to experience a varied social life. Some people go to college to learn life skills, and others have a variety of activities in the community to choose from. Residents have annual holidays and are going to Skegness this year. We saw that staff are sensitive to the needs of people living at the homes. They were aware of the preferences of people in their daily activities. We saw staff talk to and interact well with people who live at each home. Staff also were aware of how to effectively communicate with each person, by makaton and using residents communication boards that residents have in their bedrooms. Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: We saw tea being served and people living at the home having a meal of pasta with broccoli and cheese and ham. This meal was slightly dry and the Regional Manager acknowledged that some staff may need training with cooking skills. Menus were in place and had sufficient variety. Vegetables need to be recorded to ensure that this variety can be monitored. There were good supplies of fruit available in the kitchen to help offer residents a healthy diet. Care Homes for Adults (18-65 years) Page 14 of 27 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 who live at Barry Drive receive excellent support in their personal and healthcare needs. Evidence: We looked at the personal and healthcare records of people who live at Barry Drive. We saw that they have good access to healthcare services to meet their personal and healthcare needs as described in individual Health Action Plans. On talking to staff as well as looking at the records, we found that staff act quickly on concerns they have about peoples needs, and these prompt actions have resulted in a better quality of life for those concerned. We looked at medication management and found that staff are administering medication appropriately to people who live at Barry Drive, with only a small number of instances where medication was not signed as given. Records also showed valuable information regarding allergies and regular medication reviews to ensure residents health is promoted. We also looked at how medication is stored and this was stored safely. We saw staff records and these showed us that senior staff have undertaken training in the Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: administration of medication. We were informed that only senior carers are given permission to administer medication to people who live in the home. Care Homes for Adults (18-65 years) Page 16 of 27 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. People, and the families of people who live at Barry Drive, can be confident that their concerns are noted and acted upon, and they are protected from abuse. Evidence: We looked at the complaints procedure and saw that this was written in a format which is helpful for people living at Barry Drive to understand. We saw good interaction between people who live in the home, and staff who support them. The procedure does not give the complainant the choice to go directly to the Lead Agency if they wish, instead of the home. The Regional Manager said this would be quickly rectified. Complaints records generally showed that complaints were properly followed up though the last complaint did not have an outcome to it so it could not be seen that it was properly followed up. The AQAA stated that no complaints had proved to be true. However we found that this was not the case and the Regional Manager agreed that a number of complaints had substance to them. We saw by looking at staff training records, and by talking to staff that staff have a good understanding of safeguarding policies and procedures. Staff know what to do if they suspect that a person who lives in the home is being abused in any way. We also saw by looking at staff records, and by talking to staff that they understand how to work with challenging behaviour. Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: The AQAA told us that people who live in the home have their own bank accounts. Staff support people living at Barry Drive in dealing with their money. We checked the financial records of three people living at the home, and found good recording of money transactions though there was one instance where monies did not completely tally so the Regional Manager took this up with staff to rectify it. Care Homes for Adults (18-65 years) Page 18 of 27 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 living at Barry Drive live in a homely, comfortable environment. Evidence: We looked at the communal areas of the homes and some of the bedrooms of people who live there. We found the communal areas to be satisfactorily decorated and homely. The bedrooms were decorated to reflect the personalities and preferences of the people using them. The AQAA told us that residents choose how they like their bedrooms to be by choosing the decor etc. The Regional Manager talked about how maintenance is followed up by staff recording issues to be acted upon, then the Manager collating this for head office. This is then usually acted upon within a week. We saw that the home was well maintained in general though the first floor bathroom was out of action. We noted that maintenance was called who came to repair this. The garden to the rear is large and looked in a kept condition, with a swing there that we saw a resident use. The Regional Manager said there were plans to install a snoozelum in a large hut in the garden, as residents liked this facility when they used it elsewhere, and that a sensory garden was to be installed this summer to provide added stimulation for residents. Care Homes for Adults (18-65 years) Page 19 of 27 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 who live in the home have satisfactory staffing levels and support from a motivated staff team, though staff references and more training needs to be in place to fully support residents welfare. Evidence: Staff thought the home was well staffed, apart from when a resident needed two staff to one resident when going out, which then left less than one to one support for residents remaining in the home. The Regional Manager said that a plan was already in hand to increase staffing to cover this issue. The staff rota indicated that when all residents were in the home, there were a minimum of five care staff on duty with two awake staff members at night. We talked to staff and saw them supporting people who live in the home. We saw good interaction between staff and people who live in the home, and staff demonstrated a very good understanding of the needs of people living there. Staff staff said they were supported well to do their job by management, and there is detailed induction training and on going training relating to the job they do, with regular supervision, which we found to be the case in staff records. We were told by the Regional Manager that the Company is actively working towards staff having Care Homes for Adults (18-65 years) Page 20 of 27 Evidence: National Vocational Qualifications in Care. Staff spoken to confirmed that there was this encouragement. We looked at a sample of staff records, and saw that not all the necessary checks were made to safeguard people who live at the home as there were no references in place for some staff before they commenced employment. We looked at training records and this confirmed that staff have undertaken relevant training to help them in their roles. Training included health and safety, medication management, working with challenging behaviour etc though not all staff had relevant training.The Regional Manager said that she was taking steps to ensure that this happened and we saw there was a monthly training plan in place to try to ensure that all appropriate training was in place. Care Homes for Adults (18-65 years) Page 21 of 27 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. Health and safety systems are in place to protect residents welfare. Evidence: The previous Registered Manager has moved to a different role in the home. There is a new Manager for the home and the Regional Manager said an application for the Registered Manager role is to be sent to the CQC in the near future. The Manager later confirmed that she was shortly due to have her registration interview. There are quality assurance and monitoring systems in place, and we saw the questionaires that go out to all relevant parties to ascertain peoples views of the service so that improvements can be made if needed. The AQAA informed us of the policies and procedures the service works to, to ensure good health and safety practice in the home. The temperatures of water were seen to be regularly checked to ensure residents are protected from scalding water. Risk assessments are in place for safe working practices and fire risks were seen to be Care Homes for Adults (18-65 years) Page 22 of 27 Evidence: covered by regular testing and a fire risk assessment in place, though one was missing regarding whether fire doors need to be kept shut at all times to protect residents from fire risks, or for approved closures to be installed to hold open the door, which are automatically shut when the fire alarms are activated. Care Homes for Adults (18-65 years) Page 23 of 27 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 24 of 27 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 18 The Provider must ensure that staff do not commence employment prior to the receipt of two written references. To ensure residents are protected from unsuitable staff. 07/05/2009 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 2 17 22 That staff are assessed as to their cooking skills and training given if needed. All complaints need to have information regarding an outcome so it can be seen that the complaint has been properly looked into and residents welfare fully covered. That staffing levels are reviewed to ensure that residents and staff are safe at all times. That the staff training programme continues to ensure that all staff have received training in all relevant issues. The Fire Risk Assessment needs to have a risk assessment in place to cover fire doors that are left open. Page 25 of 27 3 4 5 33 35 42 Care Homes for Adults (18-65 years) Care Homes for Adults (18-65 years) Page 26 of 27 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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