Care Home: Homeside

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What the care home does well Care records are well kept.Information on the service is produced in pictorial formatThey work to maintain a homely environment and individual bedrooms meet the tastes and choice of the residents.On going training programme is in place. Staff are well supported to ensure they have the skills to meet the residents needs There is a good activity programme in placeThere is a large garden to the rear of the home.The residents are supported to have a least one holiday a year. What has improved since the last inspection? There have been changes to the care planning system to simplify it for staff. The manager has appointed a dedicated activities co-ordinator to oversee and arrange activities both in the home and out in the community. What the care home could do better: Whilst no requirements have been made following this inspection. The manager needs to continue to ensure the environment is kept safe and homely with regular redecoration.To continue to identify different activities for the residents.Ensure risk assessments are in place and updated to protect the safety of the residents Key inspection report Care homes for adults (18-65 years) Name: Address: Homeside 6 Great North Road Welwyn Hertfordshire AL6 0PL The quality rating for this care home is: two star good 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: Alison Butler Date: 2 7 0 8 2 0 0 9 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. The first part of the review gives the overall quality rating for the care home:  3 stars – excellent  2 stars – good  1 star – adequate  0 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. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Care Homes for Adults (18-65 years) Page 2 of 28 Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by:  Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice  Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983  Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services.  Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Homeside 6 Great North Road Welwyn Hertfordshire AL6 0PL 01438716442 01438718929 candourcare@aol.com 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) : Candour Care Services (Homeside Limited) care home 4 Number of places (if applicable): Under 65 Over 65 4 4 learning disability Additional conditions: Date of last inspection A bit about the care home Homeside is registered to provide care and accommodation for up to four adults with a Care Homes for Adults (18-65 years) Page 4 of 28 learning disability, of whom up to four may be over the age of 65 years. The home is owned and operated by Candour Care Services and consists of a detached bungalow, situated in the Oaklands area of Welwyn. There is a parking area to the front and a large rear garden, which can be accessed by residents with appropriate supervision. The home is conveniently situated for local facilities, with public transport available in nearby villages and the shopping and leisure provision of Welwyn Garden City can Care Homes for Adults (18-65 years) Page 5 of 28 be accessed using the homes own minibus. For up to date fees contact the manager. Additional charges are made for hairdressing, personal toiletries and social outings. Information about the service can be obtained from the Statement of Purpose and Service User Guide. These and copies of the previous inspection report are available in the home. Care Homes for Adults (18-65 years) Page 6 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 7 of 28 How we did our inspection: This is what the inspector did when they were at the care home We conducted this inspection with one inspector over a four hour period. A tour of the building was conducted We looked at records. We spoke with residents, staff and manager on duty at the time of the inspection. Care Homes for Adults (18-65 years) Page 8 of 28 We looked at the feedback we received from the questionnaires we sent out. What the care home does well Care records are well kept. Information on the service is produced in pictorial format They work to maintain a homely environment and individual bedrooms meet the tastes and choice of the residents. Care Homes for Adults (18-65 years) Page 9 of 28 On going training programme is in place. Staff are well supported to ensure they have the skills to meet the residents needs There is a good activity programme in place There is a large garden to the rear of the home. The residents are supported to have a least one holiday a year. Care Homes for Adults (18-65 years) Page 10 of 28 What has got better from the last inspection What the care home could do better Whilst no requirements have been made following this inspection. The manager needs to continue to ensure the environment is kept safe and homely with regular redecoration. Care Homes for Adults (18-65 years) Page 11 of 28 To continue to identify different activities for the residents. Ensure risk assessments are in place and updated to protect the safety of the residents If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Alison Butler Care Quality Commission Care Homes for Adults (18-65 years) Page 12 of 28 Eastern Citygate Gallowgate Newcastle upon Tyne NE1 4PA Telephone: 03000 616161 Email: enquiries@cqc.org.uk 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 13 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 14 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live at the home can be assured that their needs will be fully assessed and they are provided with the information to make an informed choice. Evidence: The Statement of Purpose has been updated and provides information to Care Managers and families. The Service Users Guide has been produced into a pictorial format which provides the residents with information about the service in an easy to understand format. No new residents have been admitted to the home since the last inspection, but there are policies and procedures in place to ensure that any future residents have a full assessment completed prior to admission. Care Homes for Adults (18-65 years) Page 15 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience 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 the service can be assured that their personal goals are reflected in the plans of care and they are supported to take risks to live as independent a life as possible. Evidence: From examining the care plans they remain person centred they are written in different formats to ensure that they are meaningful for each resident. The residents are involved in ensuring they meet their personal goals, this is done through their 1-1 discussions, which are held on a regualr basis and recorded on the files of the residents. Care plans include health action plans. The residents receive involvement from other health professionals such as the community nurse who visit the home regualrly to support the staff and the residents in meeting their needs for example epilepsy & challenging behaviour. The care plans are detailed in providing information to the care workers on how the needs of the individuals are to be met. A number of risk assessments are in place to ensure that they are supported to have as independent lives as possible for example trips out in the community, managing challenging behaviour when out and about. The communication for each resident is recorded in their plans. Due to the Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: complex needs of the residents the staff use a variety of methods to communicate with them this includes for example pictures, signs (Makaton) and facial expression to name a few. Staff receive training in communication skills to ensure that they are able to communicate and understand the residents wants and needs. Each key worker is responsible for ensuring the plans are regularly reviewed and kept up to date, this is done on a monthly basis or earlier if the needs of the residents change. The staff are consistently looking at new activities for the residents to try, this can prove extremely difficult due to the complex needs but the staff are keen to ensure that the residents lives are full and enjoyable. The staff were observed providing support to the residents in a positive and patient way. There are four various nationalities of resident in the home and staff have information on how to meet the various cultural and religious beliefs, they also receive information from families to help with this. Care Homes for Adults (18-65 years) Page 17 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use this service can be assured that they are offered opportunities to take part in activities of their choice. They are also offered a healthy diet that meets their needs and choices. Evidence: Each resident has an activity plan in place although these can be changed on a regular basis due to the complex needs of the residents. There is a facility for activities located on site to the rear of the home, which has a multi sensory room, a storage room and an area where other activities such as arts, crafts, puzzles, music etc. can take place. Most activities are done on a 1-1 basis which better supports individual needs. There is an orchard at the back of the garden, where one resident was seen picking some apples to take back and share with the other residents. Staff have tried taking a resident swimming as they had been informed by the family that they would enjoy this. This proved to not be as successful as they hoped as the resident appeared not to like the crowds in the pool. They are going to try again but when the pool is quieter and it is hope that this will be more successful. Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: Three residents and four staff went to Norfolk. Two residents and three staff have been to Wales and further holiday to Wales has been arranged for one resident and four staff due to the residents complex needs and they require 2 staff to be them at all times. The menu is planned by staff and takes into account the differing cultural and religious needs of the residents, any changes to the menu are recorded to ensure that the actual food that is eaten by individuals is recorded. They are supported by the community nurses in ensuring that individual dietary needs are met. On the day of the inspection staff were in the process of planning a fun day which involves the residents of Homeside and the service next door. This was due to take place the following day. This was a new idea and if successful they will plan further ones and involve family and friends of the residents. Staff are also planning an International Day as the home have four people from four different Nationalities. This will include decorating the home with flags and eating food from the different countries. Care Homes for Adults (18-65 years) Page 19 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the service can be assured that there health and personal needs are met in a way that they prefer. Evidence: A examination of the medication administration, storage and recording was conducted and found on the whole to be well kept, with the exception of medication that is taken home by families, it is recommended as good practice that a risk assessment is completed for medication that is taken home by families and that the family are encouraged to sign the risk assessment and also to sign receipt of the medication that they are taking responsibility for administrating to their family member. This was being addressed during the inspection. Medication that is taken to the day centre is signed out and signed back into the home which is good practise. Key workers continually monitor ipeoples health progress and they have a good understanding of the individuals needs and how to respond to them. There are a number of risk assessments in place to ensure and maintain individual safety for when they are going out in the community, assisting in the kitchen to name a few. The staff have regualr contact with the community nurse and local psychiatric services who support them in meeting individual needs and provides specialist advice where necessary. Care Homes for Adults (18-65 years) Page 20 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home can be assured that they are protected and safe and that their views will be listened to and acted upon. Evidence: There is a detailed complaints procedure in place and this has been made user friendly for the residents by making a pictorial version available to them. Each residents meets with their key worker regularly and they discuss their wants and needs and these are acted upon and recorded within the files. There have been no complaints received by the home since the last inspection in 2007. The surveys that we received were very positive about the care and support provided at Homeside making comments such as the home supports the service users well the service is pro-active to seek to improve the service The home have the Hertfordshire County Council Safeguarding policy and procedure in place and staff understand their role in following it if the need arose. Staff files examined showed that they obtained all the required information prior to them commencing employment in the home which ensures the residents are protected and safe as far as is practicably possible. Care Homes for Adults (18-65 years) Page 21 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home can be assured that they live in a comfortable, homely and safe environment which meets their needs. Evidence: During the tour of the home it was noted to be clean and fresh. The manager and staff continue to work hard in maintaining a safe, homely and comfortable environment. This can be extremely challenging due to the complex needs of the residents. The en-suite bathrooms that had been fitted prior to the last inspection have proved to have worked very well in meeting the needs of the residents and reducing the challenging behaviour of the individuals. The staff are continually looking for items to be placed on shelving and on walls, but this can prove difficult at times due to the challenging and autistic needs of individual residents. The activity co-ordinate is looking to paint murals and pictures on one of the residents bedroom walls as their behaviour can lead to items being thrown out of windows etc. The manager has supported them by providing a heavy weighted bed and bedroom furniture that is wall mounted to prevent them lifting it and causing them and possibly others harm. Curtains have been adapted with the use of hook and eye tape as this allows the staff to quickly put back up curtains after they have been removed from the rail due to the autistic tendencies of the residents. The front of the house which is used mainly for car parking, has had the bedding areas removed and shingle has been laid, they are looking at having some raised beds put in to Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: provide some interest to the car parking area. The rear of the house has well kept gardens and the residents are encouraged to assist in the up keep. During the coming year the manager is looking to increase the size of the home from four to five bedrooms, this will only happen following planning permission and completing the Care Quality Commission registration process. Care Homes for Adults (18-65 years) Page 23 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience 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 at the home can be assured that the staff have the relevant skills and are supported to provide the individual needs of the residents. Evidence: Information received from the staff surveys showed that they feel very supported and are provided with the relevant information to meet the residents needs. They feel there is a good team spirit and they are all able to have a say in the running of the home to ensure the residents receive a good quality service. All staff have a minimum of NVQ 2, there are three staff who hold an NVQ 3, a further staff member is working towards NVQ3 and the deputy is working towards the NVQ 4 award. A staff and service development day is held every year in March, this allows staff to have an input into the service provision and discuss what has gone well and where they can make improvements for the coming year. Senior staff hold a meeting once a month and staff meetings are held monthly all minutes are recorded and are available to all staff. Staffing levels are adequate to meet the needs of the residents. They have a sleep in and a waking night staff to cover the nights. There is an on going training programme in place and records are well kept to demonstrate this with certificates and supervision notes providing details. Care Homes for Adults (18-65 years) Page 24 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live, work and visit the home can be assured that the health, safety and welfare is promoted and protected at all times. Evidence: The manager is very pro-active in ensuring the residents have a good quality of life. His approach creates an open and positive atmosphere. Staff feel the home is well run and they are supported in providing a good quality of care and support for the residents. The manager has still to implement the appraisal system, but they are in the process of reviewing the senior carers job descriptions to include the supervision of staff which will release the manager from having to do all supervisions which can be quite time consuming. There is a quality assurance system in place which looks at improvements that can be made to the service including the yearly reviewing and updating of policies and procedures as necessary. All residents have there own bank account and individual records are kept and these are regularly audited to ensure reconciliation. The health and safety of all who live and enter the home is protected through a series of checks and risk assessments are reviewed and updated as appropriate. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes  No  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 26 of 28 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description 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 Description 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 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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