Care Home: Highbarn Road (30)

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What the care home does well The home has good information about what it is like so people know what to expect. Before people move in, the provider and other care services make sure that it will be the right place for them to live.Highbarn Road (30)DS0000007559.V374794.R01.S.docVersion 5.2The home is part of a family house. People have the chance to be part of a family if they want. The home helps people to use local shops, centres and church so they can be part of their local community. People can do their shopping with help, so they choose their own food, clothes and any other things. People can choose to spend time in any part of their house and be alone if they want. This small home is brightly decorated, warm and comfortable. People have chosen to paint their bedrooms in the colours that they like. All the rooms are nice. There is only one staff (the provider) who knows the person very well. This means she knows what they like and when they are not well. The provider runs the home in the best interests of the person who lives here. What has improved since the last inspection? There is now a written record of how and when the person has spent their money. This helps to show that his money is safely looked after. What the care home could do better: It might be better if the part of the medication record about incoming medication was completed. This would show that the provider has checked how much medicine was received. Key inspection report CARE HOMES FOR OLDER PEOPLE Highbarn Road (30) 30 Highbarn Road School Aycliffe Newton Aycliffe Durham DL5 6QN Lead Inspector Andrea Goodall Key Unannounced Inspection 20th February 2009 09:00 DS0000007559.V374794.R01.S.do c Version 5.2 Page 1 This report is a review of the 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. 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 older people 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. Highbarn Road (30) DS0000007559.V374794.R01.S.doc Version 5.2 Page 2 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 Highbarn Road (30) DS0000007559.V374794.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Highbarn Road (30) Address 30 Highbarn Road School Aycliffe Newton Aycliffe Durham DL5 6QN 01325 321180 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Frances Ellen Bainbridge Care Home 2 Category(ies) of Learning disability over 65 years of age (2) registration, with number of places Highbarn Road (30) DS0000007559.V374794.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: 30 Highbarn Road is a small care home for up to two older people with learning disabilities. The home is located in School Aycliffe, a residential area on the outskirts of Newton Aycliffe, County Durham. At this time there is one person living at this small home. The accommodation for residents is in an annex of a family house. This means there is a separate living area for the residents, which includes a lounge, two good sized bedrooms and a bathroom. The main premises are the home of the registered provider, Mrs. Frances Bainbridge, and her family. Prior to the Care Standards Act 2000 the home was registered as a ‘small home where a lighter touch to regulation and inspection was applied. As a consequence this very small home has developed its own, common sense, family-lifestyle approach to care. At this time of this visit the fees charged by the home are £345:55 per week, which has been set by Durham County Council. However the provider should be contacted for any future information about fee levels. Highbarn Road (30) DS0000007559.V374794.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. Before the visit: We looked at: • information we have received since the last visit on 16th February 2007 • how the service dealt with any complaints or concerns since the last visit • any changes to how the home is run • the provider’s view of how well they care for people in their annual quality assurance assessment (AQAA). The Visit: An unannounced visit was made to the home on 20th February 2009. During the visit we: • spent time with the person who uses the service, and talked with the provider who cares for them • looked at information about the person and how well their needs are met • looked at other records which must be kept • looked around parts of the building to make sure it was clean, safe and comfortable. We told the provider what we found. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations – but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the service does well: The home has good information about what it is like so people know what to expect. Before people move in, the provider and other care services make sure that it will be the right place for them to live. Highbarn Road (30) DS0000007559.V374794.R01.S.doc Version 5.2 Page 6 The home is part of a family house. People have the chance to be part of a family if they want. The home helps people to use local shops, centres and church so they can be part of their local community. People can do their shopping with help, so they choose their own food, clothes and any other things. People can choose to spend time in any part of their house and be alone if they want. This small home is brightly decorated, warm and comfortable. People have chosen to paint their bedrooms in the colours that they like. All the rooms are nice. There is only one staff (the provider) who knows the person very well. This means she knows what they like and when they are not well. The provider runs the home in the best interests of the person who lives here. 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 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. Highbarn Road (30) DS0000007559.V374794.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Highbarn Road (30) DS0000007559.V374794.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3. (NMS 6 is not applicable.) People using the 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 receive good information and a full assessment of their needs before they move here so that they can be sure that the home at 30 Highbarn Road can meet their needs. EVIDENCE: The small care home at 30 Highbarn Road was registered in 1991 to provide personal care and accommodation for two older people with a learning disability. The home has a Statement of Purpose and a Service Users’ Guide to provide information about the home. The home has contract documents with the local social services department about people’s placement here. The home aims to Highbarn Road (30) DS0000007559.V374794.R01.S.doc Version 5.2 Page 9 provide a family-based setting for people to lead an ‘ordinary’ life and to be as independent as possible. There have been only two admissions to the home since it opened. The two gentlemen lived here together for 17 years until late last year when one resident moved to a nursing care setting because of a decline in their health care needs. It is clear that both admissions, and the transfer of one person, were appropriately managed and involved the relevant social and health care professionals. Highbarn Road (30) DS0000007559.V374794.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People using the 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 receive good support so that their individual personal and health care needs are met. EVIDENCE: The home has copies of detailed care plan documents prepared by the social services department, which set out the resident’s needs and form the basis for the care being provided. Care reviews are regularly held with the relevant social care services, and the most recent was held in April 2008. The reviews continue to confirm the suitability of the placement of the person who lives here and ensures that all support arrangements are in place to meet their needs. Highbarn Road (30) DS0000007559.V374794.R01.S.doc Version 5.2 Page 11 The provider continues to provide the resident with a very good quality of life. Their previous long-term institutional setting and the negative behaviours associated with those settings have been replaced by a far more prestigious and enjoyable lifestyle within a homely, family setting. This improved quality of life has had a very positive effect on their emotional and psychological wellbeing. The provider is very familiar with the health care needs of the person who lives here. This means that she is able to recognise any change in their well-being. She makes sure that the person has an annual medical review with their GP, and supports them to attend any outpatient clinics whenever this is needed. In this way the person has very good support to access community and specialist health care services. The home uses a monitored dosage system to support the resident with their medication. This means that their medication is delivered to the home in blister packs so that it is easy to use. The provider has had instruction in how to manage this system. The provider makes sure that medication is correct when it arrives, although currently there is no record of that check. She also makes sure that medication is given at the right times, and there are records to show when medication has been given. The provider seeks the advice of the GP and pharmacist about medication when necessary. Although she does not have any formal training in medication, she has been managing medication for the resident for 19 years and is very familiar with their health needs. In this way she would be very aware of any changes in the effect of medication. The resident has limited communication but time was spent in their company. It was clear that they are very relaxed and settled in their own small home. There is a comfortable and familiar relationship between the resident and provider (who is also the sole carer). The person who lives here is very able to follow his own preferred lifestyle and routines as he wishes. He is encouraged to make his own choices, for example for daily activities and meals, and he can spend time in private whenever he wishes. In this way his dignity and privacy are respected and upheld by the home. Highbarn Road (30) DS0000007559.V374794.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. People using the 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 good opportunities to make choices about their own daily routines so that they lead a lifestyle that matches their individual preferences. EVIDENCE: The person who lives here continues to choose his own preferred daily lifestyle. He attends a day centre for four days a week. On other days he enjoys spending time reading newspapers, watching television and spending time in the garden in better weather. He is supported by the provider to take a full and active part in weekly grocery shopping and choosing foods that he likes. He is supported to use local community facilities such as shops, leisure centre and church. In this way the home ensures that he is an active member of his local community. Highbarn Road (30) DS0000007559.V374794.R01.S.doc Version 5.2 Page 13 It was clear from discussions and observations that the person who lives here is very able and comfortable in making his own decisions and choices. For example, he is invited to join in family events but is able to withdraw to his own part of the home for peace and quiet whenever he chooses to. There are no formal written menus. The provider makes all the meals based on her many years’ knowledge of the person’s preferences and choices. In discussions it was evident that the person enjoys a wholesome and nutritious diet. The resident is invited to join the family to dine, but if he wishes he may dine in his own dining area in his own lounge. Highbarn Road (30) DS0000007559.V374794.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People using the 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 clear information so they would know how to make a complaint. The provider understands how to protect residents from abuse. EVIDENCE: The home has an appropriate complaints policy and procedure. Information about complaints, such as how and who to make them to, is also provided in the home’s Service Users Guide. There have been no complaints or concerns about this service. The person who lives here can read, although it is not known whether he can comprehend the complaints procedure. However he is able to express his needs and choices to the provider. The provider has a very good understanding of the person’s mannerisms and would be able to recognise if the person was unhappy with a situation. In this way the person can express dissatisfaction, and the provider would be able to respond to any such ‘complaint’. The home also has its own policy and procedure covering abuse and adult protection. The provider is aware of the latest developments of the local Highbarn Road (30) DS0000007559.V374794.R01.S.doc Version 5.2 Page 15 authority Safeguarding Adults protocols, so she would know who to contact if an allegation of abuse arose. Highbarn Road (30) DS0000007559.V374794.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. People using the 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 here live in a homely, comfortable and safe environment so they enjoy a good standard of accommodation. EVIDENCE: The home at 30 Highbarn Road is a large, modern, detached house in a desirable residential area. The accommodation for residents is within a two storey annex of the main family house. This means that residents have their own semi-independent living area that includes a lounge, two good sized bedrooms and a family sized bathroom. The person who lives here also enjoys use of the large family garden at the rear of the house. Highbarn Road (30) DS0000007559.V374794.R01.S.doc Version 5.2 Page 17 The accommodation for residents is well maintained and well decorated. The people who have lived here have been highly involved in choosing colour schemes for all the rooms in their part of the house. The residents’ accommodation is warm, comfortable, clean and safe. Highbarn Road (30) DS0000007559.V374794.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. People using the 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 provider ensures that there is sufficient support to meet the needs of the person who lives here. EVIDENCE: The provider is the sole carer, and no other staff are employed. Occasionally other family members assist with social care tasks. This has been a longstanding arrangement since the home opened. It is clear that this level of support continues to satisfactorily meet the needs of the person who lives here. Highbarn Road (30) DS0000007559.V374794.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. People using the 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 home is well run in a way that promotes the best interests and welfare of the person who lives here. EVIDENCE: The small care home at 30 Highbarn Road is owned and managed by the provider, Mrs. Bainbridge. In this way she is solely responsible and fully involved in the running of the residential care service to the person who lives Highbarn Road (30) DS0000007559.V374794.R01.S.doc Version 5.2 Page 20 here. As she is in full time day-to-day control of the home there is no separate manager. The provider has many years experience of working in a health care setting for people with learning disabilities. She has also provided and managed this service for 19 years. In this way she has acquired a wealth of knowledge of the person who lives here and a common sense approach to managing a small care service. At this time she has no formal management qualifications. She is aware that there is an expectation that she should undertake, from time to time, such training as is appropriate to ensure that she has the experience and skills necessary for carrying on the care home. The provider is able to ensure that the standards and ethos of the home are above the national minimum standards in that she is providing a one-to-one, person-centred service for the one person who lives here. Annual reviews by other relevant health and social care services involved in the person’s welfare also ensure that the home continues to meet the needs of the person who lives here. The provider supports the person with their financial affairs, with the agreement of Durham County Council who fund the person’s placement. She now maintains a written record of the income and outgoings of the resident. These records can be used at annual reviews to ensure his continued financial protection. The premises are well maintained and there were no health & safety issues noted. The resident is generally physically fit and is able to manage all area of the premises independently, including the stairs. Smoke detection is fitted within this small home. Highbarn Road (30) DS0000007559.V374794.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 x 3 x x 3 Highbarn Road (30) DS0000007559.V374794.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP9 OP31 Good Practice Recommendations It would be better if the medicine records included a record of the check of incoming medicines, e.g. quantity and date received. As highlighted in previous inspection reports, the provider should ensure that from time to time she undertakes such training as is appropriate to ensure that she has the experience and skills necessary for carrying on the care home. Highbarn Road (30) DS0000007559.V374794.R01.S.doc Version 5.2 Page 23 Care Quality Commission Yorkshire and Humberside St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: 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. 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