Care Home: Ivy Close

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What the care home does well The manager and his staff like to find out what people living in the home like to do and try to make sure that they can do it and they find out what they like to eat and try to make sure that is what they get If a someone is ill they make sure that they get the right treatment. If someone needs medicines or creams they will make sure they get them. If a someone doesn`t like something they can complain to the manager or his managers and they will look at the problem very carefully. The home is clean and well decorated. The staff are cheerful friendly and helpful and encourage people to enjoy themselves but also try to make sure that they are safe and well looked after. The manager is also cheerful friendly and helpful and does all of the things that help the staff to do their job. . What has improved since the last inspection? This is the first inspection of this home since it was taken over by Midland Heart Ltd. What the care home could do better: No recommendations or requirements have been made as a result of this inspection. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Ivy Close 1 - 4 Ledbury Close Ledbury Road Hereford Herefordshire HR1 1RF     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: Michael Moloney     Date: 2 7 0 1 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 26 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 26 Information about the care home Name of care home: Address: Ivy Close 1 - 4 Ledbury Close Ledbury Road Hereford Herefordshire HR1 1RF 01432274311 01432266789 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) : Midland Heart Limited care home 17 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 17 The maximum number of service users to be accommodated is 17. The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning Disability (LD) 17 Date of last inspection Brief description of the care home Ivy Close is a home for up to seventeen people with a learning disability that is situated on the Ledbury road in Hereford. It is a purpose built group of buildings that were designed to give the impression of being four houses in a cul-de-sac. Three of the houses are the home for four people while the fourth can be used by up to five people for short breaks. It is expected that this respite service will be moved to another facility in the near future. Each of the houses used by longer term residents has four people living in them. In each house three people have upstairs bedrooms and one has a ground floor bedroom. Each of the houses has its own front door and private garden. There is also off road Care Homes for Adults (18-65 years) Page 4 of 26 Brief description of the care home parking available. The home is owned by Midland Heart and is managed on their behalf by Jim Hughston. Care Homes for Adults (18-65 years) Page 5 of 26 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: A range of evidence was used to make judgements about this service. This includes: information from the provider which included a self assessment document that they are required by law to complete, records kept in the home, medication records, discussions with the staff team, tour of the premises, the registration report and talking with as well as observing the care experienced by people using the service. Care Homes for Adults (18-65 years) Page 6 of 26 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 7 of 26 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 8 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who may want to live in this home and their representatives have the information needed to choose a home, which will meet their needs. They have their needs assessed and a contract which clearly tells them about the service the will receive. Evidence: Nobody new has come to live at this home for some time. Should anybody wish to do so information was seen that outlines the service that they would receive, what they could expect of the staff and other information such as how to make a complaint and how much living them would cost them. This information was seen to be in an easy read, pictorial format as well as the more detailed format for more general use. Care Homes for Adults (18-65 years) Page 9 of 26 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 in this home are involved in decisions about their lives and play an active role in planning the care and support they receive. Evidence: The plans for the care of two of the people who live in this home were looked at. They were seen to contain lots of information about how their health would be looked after. There was information about what treatment they need and when they had received it. For instance there was a sheet that showed when someone saw their dentist or their GP, why they had seen them and what the outcome was. Looking at the records and talking with a number of the staff showed that significant progress has been made in creating plans for people in a way that puts their needs at the centre of the planning process. The documentation seen provided clear evidence about how each point had been arrived at and the staff who joined the discussion Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: about the planning talked in such a way that they demonstrated an understanding of this Person Centred Planning process as it is known. Talking with the service users showed that they were enthusiastic about the activities that they are involved in. One in particular talked about how he wanted to move on to live in a place of his own. This had been included in his Person Centred Plan. Risk assessments which would indicate how these individuals could undertake these activities safely were seen to be available for staff to consult. Care Homes for Adults (18-65 years) Page 11 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in this home are encouraged and given the necessary information to make choices about their life style and are supported to develop their life skills. Social, educational, cultural and recreational activities meet individuals expectations. Evidence: Talking with some of the people who live in the home as well as the staff and the management team it was clear that they are able to take part in activities that they enjoy. The planning of these activities was seen to have been developed in a way that focuses on what the individual either wants or needs to do. One person talked about how he had been able to arrange to go to see tribute bands which was something that had been identified as one of the things that he wanted to do. He also said, and the staff confirmed, that he had used this planning process to repeat his wish to be allowed to live in a home of his own. Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: The home was seen to have a vehicle that could be used to take people who live in the home to and from any activities or appointments. Each persons file looked at contained a list of their daily activities and these were seen to have been summarised on a white board in the office as a reminder to the staff to make sure that each person went where they were supposed to. This system allowed non routine appointments and activities to be highlighted to the staff so that they could make any necessary arrangements. Most of the people who live in this home were attending their day activities during the inspection. This included a range of options that included farming and some other rural activities. One person who had not attended his day activities because of another appointment spoke very enthusiastically about what he would normally have been doing at that time. During the visit people who lived in all three of the longer term houses were seen and spoken to. They were also seen and heard talking with the staff who responded in a friendly, caring and professional manner. Talking with the staff and looking at the homes records showed that the weekly menus are decided upon at meetings in each of the houses. This was confirmed by talking with the people who live in the home. The menus seen looked varied and nutritious. Care Homes for Adults (18-65 years) Page 13 of 26 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. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: The records looked at showed when each person had either visited or been visited by a healthcare professional, what for and what the outcome was. Staff giving personal support to people who live in the home show were heard and seen doing so in a discrete, friendly and professional manner. The arrangements for the storage and administration of peoples medication were looked. Storage was seen to be appropriate and records correctly maintained. Each house was seen to have its own storage facility that was seen to be kept secure. No controlled drugs were found to be kept at the home. Staff said that they receive training in the safe handling of medication before they are Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: allowed to give them to people and their records confirmed this. Care Homes for Adults (18-65 years) Page 15 of 26 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 in this home are able to express their concerns and have access to a robust, effective complaints procedure, are protected from abuse and have their rights protected. Evidence: The manager confirmed that the home has received no complaints. A copy of the homes complaints procedure was seen as was the homes service user guide which was available in an easy read version and these contained the information someone would need if they wished to raise a problem with the home or its owners. The manager confirmed that one issue had been referred into the local procedures that are designed to protect vulnerable adults. This issue was not related to any incidents within the home. Although the level of some of the disabilities of the people living in this home means that they are unlikely to be able to access these formal policies, observation of the staff talking with them and each other indicated that they, the staff, would be aware of any dissatisfaction expressed and it was seen that a whistle blowing policy is available to be used. The manager also explained that some of the service users monies are managed by Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: the home. Full records were seen to be kept outlining any transactions and those records are monitored by the homes line manager. Care Homes for Adults (18-65 years) Page 17 of 26 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. The physical design and layout of the home enables people who use the service to live in a safe, well maintained and comfortable environment, which encourages independence. Evidence: Ivy Close is, as the name suggests, a group of houses set in their own cul-de sac. There are four residential areas three of which are for people who have been living in them on a long term basis and the fourth is used for short stay accommodation. Each area has its own front door, kitchen and bathroom facilities. The three long term houses have four bedrooms each. Three of those bedrooms are on the upper floors and one downstairs. Each house also has its own enclosed garden for the people who live there to use. Ivy close has one main laundry area that was fully equipped to deal with the laundry needs of all of the residents. To the front of the houses there is off street parking. Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: During this inspection work was being carried out to replace all of the windows in the buildings. Care Homes for Adults (18-65 years) Page 19 of 26 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. Staff in the home are trained, skilled and in sufficient numbers to support the people who use the service, in line with their terms and conditions and to support the smooth running of the service. Evidence: At the time of the inspection there were seven member of staff on in the home. The manager explained that number of staff on duty varied according to how many people were using the respite facility. Looking at the rota and talking with the staff confirmed that staffing levels varied according to what support was needed by the people who live in the home. Various members of staff were heard chatting to and engaging with the service users in a positive and supportive manner. Talking with the manager, the team leaders and the staff during the inspection confirmed that the majority of the staff had achieved at least National Vocational Qualification level two in care which is a qualification that is considered appropriate for people who work in this kind of service. Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: The training records showed and the manager and the staff spoken to confirmed that training in such things as food hygiene and moving and handling were up to date. There had been no new staff recruited to this home since it was acquired by the new provider and therefore it was not possible to assess the homes recruitment practices. Care Homes for Adults (18-65 years) Page 21 of 26 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. The management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified, competent manager. Evidence: The manager confirmed that he has gained the Registered Managers Award which is an appropriate qualification for someone running a facility such as this. Part of the support that he should receive is the regular completion of the monthly visits by a provider that are required by law which look at a range of issues that may affect how the needs of the service users are met. Staff on duty were able to confirm that such visits had started to take place. Equality and diversity for the service users were seen to be promoted throughout the home within the assessments, care plans and activities. A variety of records were seen that showed that safety issues are constantly monitored. Records of such things as fridge freezer temperatures, fire equipment Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: tests, gas safety tests, hot water temperatures and portable appliance testing were seen to have been maintained. Accident records were looked at and these showed that such incidents were monitored by the senior management. Hazardous materials were seen to have been stored in a locked cupboard. Staff records also showed that the mandatory training that is necessary to keep the service users safe has been taking place. This includes training in such things as food hygiene and fire prevention. Staff spoken to confirmed that these records were accurate. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 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 Care Homes for Adults (18-65 years) Page 25 of 26 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. 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