Care Home: Huthnance Park

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What the care home does well Easy read/pictorial information is provided to people about their prospective new home, and opportunities to visit, meet people that already live there, and join in activities are offered where possible. The people that live there are assisted to develop and progress through education and work. The environment offers spacious and comfortable accommodation. What has improved since the last inspection? This was the first inspection of this service. What the care home could do better: More could be done to provide people with the information they need in a suitable format (e.g. how to complain). More can be done to ensure the accuracy of medicine administration records, and a fax facility would be of assistance. Privacy should be ensured in the quiet lounge. The clients and staff would benefit from updated and reviewed policies and procedures. A registered manager must be appointed. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Huthnance Park Nancegollan Huthnance Park Helston Cornwall TR13 0AZ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Alan Pitts     Date: 0 4 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.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: Huthnance Park Huthnance Park Nancegollan Helston Cornwall TR13 0AZ 01326371000 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Spectrum (Devon and Cornwall Autistic Community Trust) Name of registered manager (if applicable) Mrs Lisa Jane Crease Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Service users may be accommodated between the ages of 16 and 25 years only. The maximum number of service users who can be accommodated is 5. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning disability (Code LD) Date of last inspection Brief description of the care home Devon and Cornwall Autistic Community Trust (Spectrum) is a registered Charity that is already registered with the CSCI for a number of provisions in the Cornwall area. Huthnance Park was registered on 12th August 2008 to provide care and accommodation for up to 5 people between the ages of 16-25. The registered manager position is vacant. Mrs Gemma Morris is the manager (elect). Care Homes for Adults (18-65 years) Page 4 of 28 care home 5 Over 65 0 5 Care Homes for Adults (18-65 years) Page 5 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 peterchart Poor Adequate Good Excellent How we did our inspection: This inspection took place on 4th February 2009 over a period of about 5 hours. We met with some of the people that live at Huthnance Park, and the manager and staff. We inspected documentation and toured the building. This service does not have a registered manager. The manager (elect) was present throughout the inspection and showed a good understanding of the care needs of the people that live at Huthnance Park. Overall, the service provides a safe and comfortable home that the people that live there can have confidence in. Care Homes for Adults (18-65 years) Page 6 of 28 Care Homes for Adults (18-65 years) Page 7 of 28 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 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 9 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. Assessment information obtained about people who use the service prior to admission, and information issued to people when they move in is good. This helps to ensure peoples needs are met, and suitable information is issued regarding peoples rights and responsibilities. Evidence: Copies of contracts of care/statement of terms of conditions of residency were present on the files of people we case tracked. Copies of pre-admission assessments were also inspected and these were comprehensive. We were advised that the manager is actively involved in the assessment of new clients, and this was supported by a record of discussions with one person prior to their proposed move to Huthnance Park. Easy read/pictorial information is provided to people about their prospective new home, and opportunities to visit, meet people that already live there, and join in activities are offered where possible. The people that live at Huthnance Park are given the opportunity to decorate and furnish their room to their liking. Care Homes for Adults (18-65 years) Page 10 of 28 Care Homes for Adults (18-65 years) Page 11 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in the home appear to have their individual needs and choices met so they should be able to live a lifestyle according to their wishes and needs. Evidence: Each person has a 6-monthly care review involving the individual, family members and other agencies. The plan of care results from these reviews, and is supported by a monthly planner that reflects the steps needed to achieve the goals/targets set for each client. Each client has a keyworker who writes a monthly report on progress, wellbeing, and achievements. People who use the service seem to be encouraged to make decisions where possible, but more could be done to show and record their involvement in determining their monthly goals/targets. Risk assessments are in place for each individual and their respective activities, including protocols for minimising risk. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: The registered provider looks after some peoples monies, for which suitable records are maintained. Finances are audited monthly. The registered provider acts as an agent for financial benefits/saving accounts for some peoples monies. Personnel at Spectrum headquarters manage government benefits claimed on behalf of people who use the service. Each person living at Huthnance Park has their own bank account. Small amounts are held securely at the home and records are supported by receipts. Care Homes for Adults (18-65 years) Page 13 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. Suitable opportunities for activities, educational opportunities and contact with the wider community are provided so people have the opportunity to live a varied lifestyle. Food provided appears to be to a good standard. Evidence: According to care plans and daily records, people who use the service have a suitable range of activities available to them, and that they participate in. The registered provider has transport available to people living in the home. These enable people to use facilities in the community and to go out on social trips. The people that live at Huthnance Park make use of educational and work facilities. People who use the service can visit friends and relatives, and can also maintain contact via the telephone or post. Visiting arrangements are flexible, and there is Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: suitable space for people to receive visitors privately. Times when people get up and go to bed are flexible, although there does need to be some fixed routines due to the nature of peoples diagnosis. We observed staff working in a manner, which was professional, and respected the privacy and dignity of people who use the service. The daily records made by staff were descriptive and reflected the lifestyle of the people that live there. Personal mail is given to the individual, and assistance is available and provided if needed. We discussed mental capacity and legal rights with reference to the electoral roll, and the manager undertook to follow this up after the inspection. A noticeboard was seen in a corridor, which related specifically to one individual. The manager said she would ensure that this and any similar were located in peoples own rooms. Food appears to be to a good standard and records are maintained regarding food provided. People who use the service have access to the kitchen, with varying degrees of staff support according to peoples needs. There is also a second kitchen intended for use in promoting independence skills. Breakfast offers a choice from cereal, toast, crumpets, and fruit. Lunch is usually taken whilst out on activities. A hot meal is provided in the evening. The menu describes meals on a given day to be a clients choice, but more could be done to show how that choice was made and what options the choice was made from? There are suitable laundry facilities, including an industrial-type washing machine. People using the service are encouraged to participate in doing their laundry with varying degrees of staff support. Care Homes for Adults (18-65 years) Page 15 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. Personal and health care support is delivered to a good standard, and there are suitable links with medical professionals. The management of medication is generally good, although some further work is required. Evidence: People who use the service were seen to be relaxed in their interactions with staff. Any personal care needs are clearly documented in care plans, and staff seem clear regarding what assistance people require. Care plans document appropriate links with GPs, dentists, chiropodists and other professionals. The operation of the medication system is generally satisfactory. Medication is stored securely. Medication is dispensed via a monitored dosage system. Medication records kept are generally appropriate. There is a suitable medication returns system. Staff have received suitable training regarding the handling of medication. However, the staff should liaise with the GP/pharmacist to ensure that the instructions on the Medicine Administration Record (MAR) reflect the FP10 (prescription). A sample seen, for example, was for a medicine to be given 4x a day, but we were advised that in fact Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: this is a PRN medication. Care Homes for Adults (18-65 years) Page 17 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. There are complaints and adult safeguarding procedures in place, though more could be done to ensure their accuracy and promote them. Evidence: The registered provider has a complaints procedure, but this is dated 2003 and provides an out of date contact address for the CSCI. More could be done to ensure that people have the information they need in a suitable format (e.g. audio/visual). There have been no complaints received by the registered provider or the Commission for Social Care Inspection. The majority of staff have attended training regarding the prevention of abuse. Relevant guidance is available at the home for reporting allegations of abuse. The manager is aware of the need for a multi-agency approach to safeguarding. All staff have a Criminal Record Bureau (CRB) check, and a Protection of Vulnerable Adults (POVA) check (the manager undertook to confirm with Spectrum if employment checks include the childrens (POCA) list). Care Homes for Adults (18-65 years) Page 18 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. Huthnance Park provides a suitable environment for people using the service. The premises are well sized, offering ample living space and comfortable accommodation. Evidence: Communal areas are spacious and generous. Lounge/dining room: 39 square metres. Lounge 2: 41 square metres. Lounge 3: 19 square metres. Conservatory: 7 square metres. The total communal space area is 106 square metres = 21 square metres per person. Comfortable settees and chairs were in the lounges. The outside garden area of the home is secure. A shower facility is provided upstairs as a choice for people who do not wish to have a bath. On the ground floor is a downstairs toilet. There are two kitchens in the home. It is intended that the people living at Huthnance will be involved in food preparation in one of the kitchens to aid independent skills. A small laundry area is provided with an industrial washing machine and a tumble drier. The bedrooms are all on the first floor accessed by stairs. The accommodation is not suitable for anyone in a wheelchair. Room 1: 18.5 square metres, en suite bathroom. Room 2: 19.76 square metres, en suite bathroom. Room 3: 13.3 square metres, en Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: suite bathroom. Room 4: 14.4 square metres, en suite bathroom. Room 5: 11.80 square metres, en suite bathroom. Each bedroom includes double electrical sockets. All bedroom doors have suitable locks with keys. A staff sleeping in bedroom is available upstairs. The office is currently located in an empty bedroom. This is also used to store staff belongings. There is a store room available downstairs. Consideration is being given to relocating the office. Care Homes for Adults (18-65 years) Page 20 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. Staffing levels, recruitment checks and staff training appear to suit and protect the people that live there. Evidence: From our observation people who use the service were seen to receive professional and caring support from staff. The people who use the service can display behaviour which could be deemed difficult and challenging. Staff were seen to support people in a positive manner. There were satisfactory numbers of staff on duty on the days of the inspection. There is usually a minimum of 5 staff (6 Monday to Friday), with two staff on duty at night. We checked staff recruitment records and these are maintained to a high standard. There is suitable evidence all staff receive a Protection of Vulnerable Adults First check, a Criminal Records Bureau check, and two written references. Staff are provided with a job description. Staff training is to a good standard. The registered provider has a suitable approach to providing National Vocational Qualifications (NVQ). There is a record of induction when Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: the person starts working at the service (e.g. orientation, how to work with individuals in the home, awareness of policies and procedures, etc). Care should be taken to ensure that this record reflects the actual induction (i.e. different topics covered on different dates, rather than being signed off as done on a single day). Spectrum ensures new staff are shadowed when they commence work alongside more experienced staff. Staff also complete a five day formal induction at the organisations training centre where most of the training required is delivered. Staff then receive follow up and more detailed training according to the needs of people accommodated in the service. Training records for the staff records assessed seemed comprehensive. We were advised that staff also undertake a National Training Organisation compliant induction, though we were not able to confirm this at the time of the inspection. A staff supervision system is in place. We did not assess records of this. Care Homes for Adults (18-65 years) Page 22 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home largely fulfills its purpose and objectives, but the appointment of a registered manager should be a priority. Policies and procedures do not protect staff and clients. Evidence: It is essential that the registered provider submit an application for registered manager for the service as a priority. There has not been a registered manager in place since the service opened in August 2008. The manager (elect) was present at the time of the inspection, and was knowledgeable, helpful throughout, positive, professional and organised. We were encouraged by their approach and openness. This is a new service and the manager has not yet established a quality assurance system. We were advised that the manager plans to use surveys to ascertain the views of stakeholders involved in the service, and would use the feedback as a tool to Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: bring about service improvement. The registered provider has a suitable health and safety policy. Records kept of health and safety checks are satisfactory: OFTEC oil firing servicing and commissioning report (14/04/08). Central Heating Commissioning/Inspection record (10/04/08). Domestic Electrical Installation Certificate (31/03/08) - includes emergency lighting. Fire Crest Commissioning Certificate (4/2/08) for the fire alarm system. Insurance liability valid until 31/03/09. Care Homes for Adults (18-65 years) Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 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 Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 37 8 A registered manager must be appointed. The people that live there and the staff will benefit from the leadership and consistency offered by a registered manager. 01/07/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 The registered provider should do more to show and record the involvement of the people that live at Huthnance Park in determining their own lifestyle (e.g. their involvement in determining monthly goals/targets) The registered provider should ensure that the process and options available are also recorded, as well as the final choice made (e.g. meals) The registered provider should ensure that the medication administration records provide accurate and current information. The registered provider should consider the provision of a fax facility. 2 17 3 20 4 20 Care Homes for Adults (18-65 years) Page 26 of 28 5 6 7 22 24 34 The registered provider should ensure that people have the information they need in appropriate formats. The registered provider should protect the privacy of people using the quiet lounge at the front of the building. The registered provider should ensure that staff are provided with information about the General Social Care Council. The registered provider should ensure that the services policies and procedures are reviewed and amended as necessary. 8 40 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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