Care Home: Home Covert

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What the care home does well Good management structure and practices in place at the home,with a very enthusiastic staff group that worked positively with people who use the services to improve their quality of life within the home. People within the home looked well cared for and all were appropriately dressed.Staff spoken to had a very positive attitude to the care they deliver. Staff were observed to carry out their duties in a professional manner, showing kindness and consideration for peoples individual needs. The environment looked homely and comfortable providing people with a safe and well maintained place to live. What has improved since the last inspection? The two requirements made on the last inspection had been addressed,they also ensured that the good practice recommendation was achieved. NVQ training as improved and the home have 50% of staff with NVQ level 2 or 3 qualification. What the care home could do better: The home should consider employing an activities person for the two elderly units within the home. Key inspection report Care homes for older people Name: Address: Home Covert The Avenue Bentley Doncaster South Yorkshire DN5 0PS     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: Janet McBride     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 Older People Page 2 of 24 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. 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 Older People Page 3 of 24 Information about the care home Name of care home: Address: Home Covert The Avenue Bentley Doncaster South Yorkshire DN5 0PS 01302875325 01302822831 Home.Covert@dmbc.gov.uk NONE Doncaster Metropolitan Borough Council care home 35 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia learning disability Additional conditions: Date of last inspection Brief description of the care home Home Covert is registered for thirty-five places, providing accommodation and personal care to two different service users groups, learning disabilities and elderly mentally infirm (EMI) aged 36 years to 65 years. The home also offers respite and day care for EMI and residential service users. The Registered provider is Doncaster Metropolitan Borough Council (DMBC) All accommodation is on ground floor level and was designed open plan so people could walk a circuit around the home if they wished. Three units within the home two with twelve beds and one with eleven beds, and each unit has its own lounges and dining facilities, and staffed individually. Fern Unit Provides accommodation for eleven service users ranging from 36yrs to 69yrs old with Learning Difficulties. These service users are independent and go out to day centres Monday to Friday. Rose and Daffodil Unit Provides accommodation for twelve service users who are elderly mentally infirm. The unit is accessed via secured digital locks, Care Homes for Older People Page 4 of 24 Over 65 24 0 0 11 Brief description of the care home and it has its own enclosed courtyard garden so people can walk outside safely. CCTV is fitted to the outside of the building for security purposes. Fees range from £330:00 to£490:00 per week, as of May 2009. Additional charges are made for hairdressing, chiropody, toiletries and magazines/newspapers these costs are variable, for further information contact the home. The Statement of Purpose and the Service User Guide, was available on request, this contained information about the services available at the home. The homes past published inspection reports was available in reception, along with a range of information that may be useful to people using the service or their relatives. Care Homes for Older People Page 5 of 24 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 Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality for this service is 3 star. This means that the people who use the service experience Excellent quality outcomes. One inspector carried out this Key Unannounced Inspection, which took place on the 19th May 2009 starting at 09:45 and finished at 16:15 hours. Prior to the inspection the home submitted an Annual Quality Assurance Assessment this gives information regarding the home and services provided. 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. Care Homes for Older People Page 6 of 24 Pre-inspection work was carried out on the information received and other relevant documentation, for example analysis of statutory notifications and complaint records. During the inspection, documentation and records were examined, for example medication, complaints, accident records, staff rotas and staff training files. Three care plans were cross-referenced with other relevant documentation relating to those people who use the service, to evaluate how well their care needs were met. Information was gathered from as many different individuals as possible that had contact with people within the home, discussion with the manager and six members of staff. Three relatives were also spoken to . They were asked to comment on the standard of care, staff skills, attitude, and how the needs of people using the service were met. Due to the nature of the people living at the home, it is difficult to obtain information directly from some people receiving services. Some judgments about quality of life and choices were taken from discussions with relatives, observation on the visit, followed by discussion with staff and examination of records held at the home. Care Homes for Older People Page 7 of 24 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 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 Older People Page 8 of 24 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 24 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them 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 within the home had been individually assessed prior to admission and they had been assured that the home could meet their needs. Evidence: Information is gathered on pre entry visits to the home and records showed that people that use the service were fully assessed with other professionals involved if needed. Relatives confirmed that their relative had an opportunity to visit the home before making a choice about moving in on a permanent basis and received all relevant information about the home. Care Homes for Older People Page 10 of 24 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans provide staff with the information they need to meet the care needs of people that use the service.This ensures that the majority of peoples needs were identified and met. Evidence: Three care plans that were case tracked and cross referenced with medication records,accident records and any other relevant information. Health,personal and social care needs were set out in an individual plan of care. Lots of information were included in each persons file for example life history,record of capacity to make decisions ,funeral arrangements,weight charts,body maps,fluid charts and bathing checklist. Care plans seen were generally found to be comprehensive concise and easy to follow, with legible records kept. All people had a nominated key worker and their role is to develop the care plan and communicate with relatives. This was confirmed when speaking to relatives who knew who the key worker was for their relative and offered information about what they do, help keep each persons room tidy or take them shopping for any new clothes.Key workers spoken to were able to describe care needs of people, and when they required the input of either GP or district nurses. Care Homes for Older People Page 11 of 24 Evidence: The District Nurse provided the main link to all medical services including pressure area care, continence advice and general health checks as required by the G.P. Referrals to outside professional are used, for example the home had a lot of input from a local mental health liaison team who visited the home on a regular basis to review and offer advise for people who use the service. During this visit there were many examples of good practice, from the staff on duty,.they interacted with people within the home with respect, addressing people by their preferred name. Staff were observed moving people from wheelchairs to lounge chairs during this task they informed each person what they were doing. Comments from people living in the home said, they receive medical support when needed. Comments from relatives seen during the inspection were very positive about all aspects of care within the home.Relatives spoken to said they were kept informed and involved in most care issues. Medication policy and procedure were discussed with members of staff and records checked. An audit of the records and stock were found to be satisfactory.The manager completed monthly audits and the local pharmacist that supplied the medication system visited periodically carried out audits and gave advice to staff at the home when needed. Staff responsible for the administration of medication had completed the accredited medication training. Care Homes for Older People Page 12 of 24 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. 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 were able to enjoy a lifestyle that suits their individual preferences, the home provided stimulation and interest for those people within the home. They were offered a wholesome and appealing balanced diet with a varied selection of food available to meet peoples tastes and choices. Evidence: People receiving the services at Home Covert had different needs on each of the units. Information was available in care plans of peoples hobbies, life events, likes and dislikes. They do not have a dedicated activities person in post however staff make every effort to provide stimulation and interest for those people on the elderly units, but this can be dependent on staffing numbers. Motivation group come every month and staff organize a singer to come in monthly to entertain people on these units.Some people on this unit said they would like to grow vegetables so the manager as bought a greenhouse for the garden. People on Fern unit seemed to have a good choice of activates, most go out to various day centres five days a week. Five are going on holiday to Scotland and four are going to Butlins all of which is their choice. Their evenings and weekends are filled with their own choice of leisure activities, supported by staff therefore can go to cinema,walks Care Homes for Older People Page 13 of 24 Evidence: ,shopping trips or shows if they wish. Doncaster advocacy are involved with people on fern unit and visit some people every few months. Food and mealtimes were discussed with the cook, who gave examples of food available, times of meals and confirmed that people had access to food and drinks 24 hours a day. Menus were available and people were asked what they wanted.Special diets were catered for and the kitchen would have a copy the special diet care plan. Observations during mealtimes, the food was well presented lunch was unhurried and assistance was given to people if required. Most people who could comment said the they had enjoyed their meal and liked the food at the home,relatives spoken to confirmed meals were good as they have occasionally have a meal with their relative. Relatives and people in the home said visitors were always made welcome and that they could see their relative in private, and they were able to bring personal possessions into the home with them for their bedrooms. Relatives confirmed that regular meetings take place at the home minutes of meeting were available and showed that staff group and residents meetings had taken place on a regular basis. Care Homes for Older People Page 14 of 24 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home had a written complaints procedure, which was displayed within the home, this ensured that people who use the service, and their families had details of how to make a complaint. The home had policies and procedures in place on safeguarding vulnerable adults this promoted and protected the people who use the service. Evidence: The home had a comprehensive concerns complaints procedure (DMBC View Point), this was displayed in the home. There was an appropriate system for recording complaints the outcome and the action taken. Records showed no recorded complaints had been made in the last twelve months. Views of people who were residing at the home said if they were unhappy they would talk to their key worker or the manager. Discussion with relatives confirmed they were aware of the complaints procedure and if they were unhappy or had any concerns they would talk to the manager or staff on duty. Policies and procedures were in place regarding the protection of vulnerable adults. Discussion with staff confirmed they were aware of safeguarding polices and procedures, those spoken to were able to verbalize the action they would take on receiving any allegations. Staff confirmed they had either received safeguarding training of were due to attend a course in the near future. Care Homes for Older People Page 15 of 24 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, 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. 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 use the service live in a comfortable and accessible environment with any specialist equipment they required to maximize their independence. The home was clean and tidy and provided a well-maintained environment. Evidence: The home was purpose built and was designed open plan to suit the service user group. All accommodation is on ground level,corridors internally connect on the two elderly units,so people could walk circuits if they wished. There is also an enclosed courtyard garden off the elderly unit so people could walk safely outside. There are digital locks on the entrance of each unit for security purposes and safety of people within the home. Tour of the premises including bedrooms, found all three units were well maintained,clean and tidy. Since the last inspection the home had completed some re decorating in bedrooms new carpet fitted in corridors, new lounge chairs and a large new TV in Rose unit. Communal rooms were found to be comfortable, homely, with pictures and ornaments in all lounge areas. Bedrooms seen on all the three units were furnished with aids and equipment to meet the needs of the people who use the service. People in the home said they were encouraged to bring personal items, most bedrooms had been personalized with pictures, photos of familiar objects. Keys to bedrooms were available,but on the elderly units some peoples memory did not allow them to benefit from this facility therefore these bedrooms were locked during the day which ensured that other people within the home did not wander in to each others Care Homes for Older People Page 16 of 24 Evidence: bedrooms. The home had a call system in each bedroom, call cords were left within reach of peoples beds, the function of the system was tested on a regular basis. The home had three sluicing facilities one for each unit and a communal laundry that was equipped to meet the relevant standards. Care Homes for Older People Page 17 of 24 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. 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. Staff had the skills and knowledge to fulfill their roles within the home, a stable staff group ensured continuity of care by staff that know the people who use the service. Evidence: The home had a very enthusiastic and stable staff group that worked positively with people who use the service to improve their quality of life within the home,and the staff team were observed to to carry out their duties in a professional manner and showed consideration for peoples individual needs. Staff appeared to be highly regarded by people within the home and relatives. Recruitment records are held at the Councils head offices,four files were requested which were available.The home had a thorough recruitment procedure these files contained all the relevant information including Criminal Records Bureau checks completed and two written references provided. Staff who were spoken to, confirmed they had been interviewed and gone through the recruitment procedure they also said they were given copies of the General Social care Council code of practice. Training files seen showed that each member of staff had an individual training file, these showed what training staff had achieved and confirmed that staff have access to mandatory and refresher training when required. Supervision and appraisal records Care Homes for Older People Page 18 of 24 Evidence: were also seen these were up to date and confirmed that staff had regular supervision from the management team. Records indicated that a number of the staff team had achieved National Vocational Qualification level 2 in care (NVQ) with other members of staff continuing to work towards attaining NVQ levels in care. Discussed with the manager who confirmed that the home have 50 of staff with NVQ qualifications. Also a number of staff had completed Learning Disability Award Framework (LADAF). Staff rotas examined demonstrated there were sufficient staff to meet the needs of people who use the service, one vacant post within the home however this post is being covered by the staff team. Care Homes for Older People Page 19 of 24 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. 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 use the service benefit from a good management structure that follow sound management practices to ensure that people in their care are safeguarded and protected. Evidence: Management structure at the home is very good they follow sound management practices to ensure that people in their care are safeguarded and protected.The manager has a wealth of experience and knowledge, she has completed the Registered Managers Award. She said she operated an open door policy, to ensure she was accessible to staff, relatives and people that use the service.She confirmed that requirement made on the last inspection had been addressed and fully actioned. Quality assurance systems are in place and evidence was available to check what audits had been completed. The home uses surveys to gain the views of people who live at the home, relatives and visitors. The last surveys suggested that the manager and staff was very approachable, and stated their satisfaction with the home and care Care Homes for Older People Page 20 of 24 Evidence: provided. number of audits are completed by the manager on a monthly basis for example care plans, medication and accident reports. The team manager from DMBC visits the home and completed a monthly 26-visit report, also carries out audits on a different quality standard each month, all these were available to examine. The financial interests of people were discussed with the assistant manager and three records checked. Not many people were able to manage their own finances, some relatives assisted people within the home with their personal finances. Records showed money is kept in individual wallets with records showing incoming and outgoings of monies, audits of money were completed on a regular basis by staff and yearly audits from DMBC. Supervision of staff was discussed with the manager, staff on duty and records checked, confirmed that staff receive formal supervision, and yearly appraisal on a regular basis. Maintenance and service records examined, these were up to date with current certificates. The service had the required Health and Safety policies and procedures and the relevant notices were displayed throughout the home. Fire safety procedures were in place, records examined showed they were current and up to date. Care Homes for Older People Page 21 of 24 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 Older People Page 22 of 24 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 12 The Registered provider should consider having a dedicated activities person in post. Care Homes for Older People Page 23 of 24 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. 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