Care Home: Kings Lane (32)

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What the care home does well Residents who completed our survey told us that staff treated them well, listened to them and that they decided what they did each day. One resident we talked to during our visit commented: ` the staff are nice to me I like living here`. Another : `I can do what I want, today I`m going on the bus to Huntingdon`. Relatives who completed our survey felt that the home met residents` needs, that staff had the right skills and experience to look after people. and that the home responded well if they raised concerns. Relatives told us that staff at the home were good at keeping them informed of what is happening and that they are made to feel welcome by staff. One reported: ` when I visit there is always a welcome cup of tea and carers always come and talk to me about how my cousin is doing. I always find Kings Lane is run like a little family home`. Residents` care plans were particularly good with detailed and comprehensive information about how they liked to be supported. Residents were actively involved in drawing up their plans and the plans were reviewed regularly ensuring any changes in their needs were picked up quickly. The staff team are well trained and supported by their managers ensuring residents receive their care from competent staff who enjoy their job. Staff work hard at enabling residents to make genuine choices and promote their everyday living skills. The home responded quickly to two adult protection concerns earlier in the year ensuring that residents safety was paramount at all times. What has improved since the last inspection? No requirements or recommendations were made at out last inspection so this does not apply. The home continues to provide an excellent service for people living there What the care home could do better: Suitable weighing scales should be available for all residents so that their weight can be monitored and their well-being maintained. All residents must be moved safely by staff so they are not put at risk of injury. All parts of the home should be kept free of strong bad smells so that residents live in a pleasant environment. Information about who to contact to report any adult protection concerns should be easily available in the home so that residents their visitors and staff know who to contact should the need arise. Staff should receive an annual appraisal with their line manager to review their performance against their job description and identify any training needs Key inspection report Care homes for adults (18-65 years) Name: Address: Kings Lane (32) Kings Lane (32) St Neots Cambridgeshire PE19 1LB     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Janie Buchanan     Date: 1 7 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 25 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for 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 25 Information about the care home Name of care home: Address: Kings Lane (32) Kings Lane (32) St Neots Cambridgeshire PE19 1LB 01480214928 F/P01480214928 h2m016birks@mencap.org.uk www.mencap.org.uk Royal Mencap Society care home 8 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The three (3) places for LD(E) are for named individuals for the duration of their residency Date of last inspection Brief description of the care home 32 Kings Lane is a large, detached house in a residential area of St Neots. The home is close to the town centre where there are shops and a variety of leisure facilities. The home has six single bedrooms on the ground floor, plus a lounge, dining room, kitchen, bathroom, laundry and staff office. On the first floor there are two bedrooms, a lounge, kitchen/dining room and a bathroom. Car parking space is available at the front of the house and there is a garden with patio and raised flowerbeds at the rear. The service is registered for up to 8 people who have a learning disability, some of whom also have associated physical disabilities. Service users are supported by staff during the day, and waking night staff are provided in case support is needed. 8 Over 65 3 Care Homes for Adults (18-65 years) Page 4 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home 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: For this inspection we (The Care Quality Commission) looked at all the information that we have received about the agency. This included the annual quality assurance assessment AQAA that was sent to us by them. The AQAA is a self assessment that focuses on how well outcomes are being met for people using the agency. It also gave us some numerical information about the home. We also received questionnaires requesting feedback about the home that had been sent to residents living there, their relatives and staff working there. We visited the home and talked with residents, staff and the manager. We toured the premises, checked medication storage and administration, and looked at a range of policies and documents. One requirement and four recommendations have been made as a result of this inspection. Care Homes for Adults (18-65 years) Page 5 of 25 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 Care Homes for Adults (18-65 years) Page 6 of 25 following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 25 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 25 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 homes admission procedures are good and ensure that peoples needs will be met there. Evidence: There is a statement of purpose and service user guide that give good information about the home and the facilities it offers. Copies of these documents are available in each residents room and they are also available in different formats (such as audio tape) so that they can be more easily understood by them. Residents we spoke to told us they had visited the house first to see if they liked it and one told us she had chosen the home as it had fewer people than her previous placement. The home has a comprehensive admission procedure to ensure that they can meet the needs of people who want to live there. We checked the files for three residents and each contained good information about them and showed us that a full assessment of their needs had been undertaken before they moved in. We also noted that each resident had an assured tenancy agreement outlining the terms and condition of their residency. Care Homes for Adults (18-65 years) Page 9 of 25 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. Residents needs are clearly documented in their care plans giving staff excellent guidance in how to meet their needs comprehensively and consistently. Evidence: We checked the care and support plans for three residents and sat with one resident and went through her care plan with her. She told us that her plan was a good description of her needs. The other plans we looked at were detailed, up to date and comprehensive, giving staff clear guidelines in how residents liked to be supported. Residents needs in relation to, amongst other things, their communication, bathing, dressing, eating, transport and housing were all clearly documented. The detail they contained was excellent. For example guidance for staff to help one resident drink was: requires an apron to wear when having a drink, uses a blue plastic cup, has his drinks half full and luke warm. He has 2 sugars in each drink. He likes staff to hand him his plastic cup into his left hand and rest his cup against his chest. The plans were person centered and focused very much on residents strengths. All the plans we checked had been reviewed regularly and meaningfully by staff ensuring that any Care Homes for Adults (18-65 years) Page 10 of 25 Evidence: changes in residents needs were picked up quickly. Parts of the plan were written in simple language and enhanced by pictures to help residents understand them. Other social care professionals also rated the residents care plans. One care manager had written to the home stating: very good comprehensive care plan, the best care plan to be seen yet. Any activities that residents undertake were carefully assessed for their risk and we also viewed comprehensive risk assessments in residents care plans. These clearly documented the action to be taken my staff to make the activity safer and had been regularly reviewed. Staff had signed each individual assessment to indicate that they had read and understood it. Residents who completed our survey told us they make decisions about what they do each day and they can do what they want. One resident told us he likes a lie in and often doesnt get up till 10.30 in the morning. We noted that residents were actively asked if they wanted to come into town that day and some chose not to. All residents have a bank account in their own name and staff support them to withdraw their money when they want. The home keeps small amounts of cash for some residents. We checked a sample of residents cash sheets which showed that written records of all transactions were maintained and appropriate receipts were kept Care Homes for Adults (18-65 years) Page 11 of 25 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. Residents live busy and active lives, and have access to numerous leisure activties.. Evidence: The home employs specific staff to provide activities for residents. One resident told us that activities she enjoyed were bingo, skittles, making birthday cards, playing dominoes and going out for country rides. Despite these activities though she stated she sometimes felt a bit lonely and missed her friends from a day local day centre that had closed. Residents also undertake a number of leisure activities and there have been recent trips to the seaside, theatre, cinema, zoo, raptor centre and Wimpole hall. One resident told us: it was nice at the sea side and we had fish and chips. Three residents went on holiday to Sandringham and more are going later in the year. Two residents also attend local day centres where they undertake gardening, arts projects and literacy skills Care Homes for Adults (18-65 years) Page 12 of 25 Evidence: Staff we spoke to gave many very good examples of how they promote residents independent living skills such as helping them budget, pay their rent, prepare meals and do household chores. We saw staff support residents doing some of these things during our visit. For example one resident asked for help to put on his shoes. The staff member encouraged him sensitively to do it himself ,explaining patiently to him what he needed to do. As a result he managed slowly to do his shoes up himself. At the end of lunch residents were encouraged gently by staff to help with the clearing up and loading the dish washing. Care Homes for Adults (18-65 years) Page 13 of 25 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. Resident health care needs are monitored at the home and staff support them to access a range of health care professionals. Evidence: Residents who completed our survey told us that staff treated them well and they liked the way they were helped by them. One member of the public who had observed staff and residents in the town wrote to the home commenting on: how outstanding the staff were supporting residents, displaying respect and professionalism. One relative stated on their survey staff give very good personal attention to his needs. Residents health care needs are monitored and staff work closely with the community nurse attached to the learning disability partnership. Residents attend well woman and well man clinics and each has a specific health action plan. Care plans that we checked showed that residents see a variety of health care professionals regularly and also that they are weighed to monitor their health. However staff told us that some residents couldnt be weighed as the homes seated weighing scales had been broken for sometime and there was not the money to replace them. Care Homes for Adults (18-65 years) Page 14 of 25 Evidence: We watched two members of staff transfer one person from a dining room chair to their wheelchair. This was a clumsy move and staff put their arms under the persons shoulders to lift them. This move can be dangerous and can cause damage both to the person and staff moving them and should not be used. We checked medication storage and a number of residents MAR (medication administration records) sheets. These were generally good with staff signing clearly when they had administered medication to residents. However we noted the two minor shortfalls. There was a signature gap on the MAR sheet for one person and it was not possible to tell whether or not they had received their creams and we found two very out of date bottles of liquid paracetamol (17/04/08) in the cupboard. These should be returned to the pharmacist to be disposed of safely. Care Homes for Adults (18-65 years) Page 15 of 25 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. Residents feel able to complain and are protected from abuse and neglect. Evidence: The home has a complaints procedure which has recently been updated and sent by Mencap to all residents families and advocates. A copy of the procedure is on display by the homes front door and dining area and is also available in a number of different formats to help residents understand it. Residents who completed our survey told us that their support workers listened to them and acted on what they said, and that they knew how to make a complaint. Those we talked to said they would let the manager know if they were unhappy with anything. The manager reported that they had not received any formal complaints about the service in the last year. We have not received any complaints about this service either. There have been two adult protection incidents in the last year. One concerning inappropriate care that was given to one person and the other concerning missing money. Both these incidents were reported immediately to the relevant authorities and the home took swift and appropriate action in response to them. Training files we checked showed that staff had received training in how to protect vulnerable adults. However although staff felt confident that they would report incidents, some were uncertain about local guidelines and procedures or who to contact should the need arise. This information was not easily available around the Care Homes for Adults (18-65 years) Page 16 of 25 Evidence: home for residents their visitors and staff to access should they wish to report any concerns. Care Homes for Adults (18-65 years) Page 17 of 25 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. Residents live in a well maintained and safe environment with the equipment they need to help help their Independence. Evidence: The location of the home is good providing access to shops and local amenities. One of the residents showed us around the home which was hygienic, well maintained and had been especially adapted to meet the needs of the residents living there. Toilets and bathrooms had pictorial representations on them to help residents find them. Residents bedrooms were personalised and could be locked for privacy. However one persons bedroom smelt very unpleasant and we noted two dark stains in the hallway corridor carpet. There is a small garden to the rear of the property with garden seating for residents to use however some areas needed weeding and looked a bit neglected as a result. One resident told us she loved BBQs and had asked staff to buy one as there wasnt one currently. Care Homes for Adults (18-65 years) Page 18 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported by well trained and competent staff who know them well. Evidence: There are three care staff, one or two activities staff and a manager on duty throughout the day to meet the needs of 8 residents, and one waking and one sleep in staff on duty at night. On the day we visited there were 7 staff members of staff available ensuring that all residents were supported well Staff who completed our surveys told us that they are given training that was relevant to their role and helps them understand residents needs. One member of staff reported: I love training it keeps me up to date with new ways of working. Training files showed us that staff were up to date with all mandatory training and 90 of staff are qualified to NVQ level 2 in care and 50 are working towards NVQ level 3 which is well above the minimum number recommended by our standards. Staff have also received additional training in dementia care and in death and dying so that they can better meet the specific needs of older residents. However not all the staff have received an annual appraisal of their working practices. We checked the personnel files for two recently employed members of staff. This showed us that appropriate references and police checks had been obtained before Care Homes for Adults (18-65 years) Page 19 of 25 Evidence: anyone was employed to work at the home thereby protecting residents living there. Care Homes for Adults (18-65 years) Page 20 of 25 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a well run home where they are regularly consulted about issues that affect their lives. Evidence: The manager was knowledgeable and clearly committed to providing a good service which actively involved staff and residents where possible. Staff told us they felt well supported by her and received regular supervision of their working practices. One commented: supervisions are good, especially if youve got things to rant about.They also confirmed there were regular staff meetings where they could raise any issues. We viewed minutes of recent staff meetings which showed a good attendance and that relevant and meaningful issues were discussed with them. We also viewed minutes from the regular meetings that are held with residents: these showed that residents were consulted about their menu, activities, holidays and repairs to their home. Every year Menacp send out surveys to residents their relatives and other people with an interest in the service to get feedback about how its run. However the surveys have not yet been sent out and are overdue. Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: We checked a number of records in relation to health and safety including portable appliance testing, hoist servicing, hot water temperatures, vehicle fire, and emergency lighting which were all in good order showing us that the home regularly checks and maintains its equipment to ensure its safety. Care Homes for Adults (18-65 years) Page 22 of 25 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 23 of 25 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 19 13 Staff must ensure that they help residents move appropriately. They must do this so that residents are moved safely without risk of injure to themselves or staff, 30/10/2009 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 2 19 23 Suitable weigh scales for all residents should be available so that they can weighed and their health monitored. Information about who to contact to report adult protection concerns should available around the home for residents, their visitors and staff. All parts of the home should be kept free of strong bad smells so that residents live in a pleasant environment Staff should receive an annual appraisal with their line manager to review their performance against their job description and agree development needs. 3 4 30 36 Care Homes for Adults (18-65 years) Page 24 of 25 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. 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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