Care Home: Larch Avenue

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What the care home does well Staff had received training in administering medication safely and had their competency assessed. People were given medication as they liked because there was a good description in their record about how to do this. People`s views were listened to and acted on. The service encouraged discussion about concerns at regular service user meetings so that the service could act on issues raised before they developed into problems and formal complaints. People were assisted to access independent advocacy support to assist them in making some decisions. Staff received training in how to safeguard people, which meant they had the knowledge and understanding of how to protect people from harm and protect their rights and they had done this. What the care home could do better: They must record all medication received into the home, so that people are protected by the home`s medication policies and procedures. Also, they should have a second signature when there is handwritten information about medication, to verify the information is correct. Furthermore, when changes are made to people`s medication there must be a record of this and who had authorised the change. Display the complaints procedure, so everyone can see how they would make a complaint should they wish to do so. Also, keep an inventory of complaints, so that confirming the number of complaints received and where information about the complaint may be foundcould be ascertained. So that safeguarding procedures are followed, the service need to refer concerns directly to the safeguarding authority. Random inspection report Care homes for adults (18-65 years) Name: Address: Larch Avenue 1a Larch Avenue Auckely Doncaster DN9 3NH three star excellent service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Jayne White Date: 1 4 0 4 2 0 1 0 Information about the care home Name of care home: Address: Larch Avenue 1a Larch Avenue Auckely Doncaster DN9 3NH 01302771713 01302775086 caroline.lovell@rdash.nhs.uk www.syha.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Caroline Jane Lovell Type of registration: Number of places registered: Conditions of registration: Category(ies) : South Yorkshire Housing Association Limited care home 6 Number of places (if applicable): Under 65 Over 65 6 learning disability Conditions of registration: Date of last inspection Brief description of the care home 6 Larch Avenue provides residential care for up to 6 adults of either gender with Learning Disabilities. 1a Larch Avenue is a purpose built bungalow with the space, facilities and equipment to accommodate people with additional physical disabilities, including people who use wheelchairs. The accommodation is located at the edge of Finningley village. The home has a minibus enabling access to the wider community. Outings, social events and annual outings are provided for everyone after a risk assessment. Care Homes for Adults (18-65 years) Page 2 of 11 Brief description of the care home The service is provided through a partnership between South Yorkshire Housing Association and Doncaster Healthcare Trust. South Yorkshire Housing Association own and operate the service, with Doncaster Healthcare Trust providing the staff. Everyone has a licence agreement with South Yorkshire Housing Association. This partnership provides and operates three other residential schemes in the Doncaster area. The inspection report is included in the homes Statement of Purpose and information about fees is available from the home. Care Homes for Adults (18-65 years) Page 3 of 11 What we found: This was an unannounced random inspection, to comply with our regulatory processes of inspection of services. A random inspection means we visit the service and look at specific areas. On this inspection it was about the health, safety and wellbeing of people who use the service. We can only change the star rating following a key inspection, therefore, the rating for this service will stay the same following this random inspection. The service had its last key inspection on 16 May 2007 and we gave them a 3 star, excellent rating. We last carried out an Annual Service Review on 5 June 2009, where we looked at information about how well the service was doing. Before we visitied the service we looked at any information we had received since the services last inspection. This included: The services AQAA (Annual Quality Assurance Assessment). This is information the service is required to provide us with to tell us how well they are delivering care. The services previous report and any information from other stakeholders, such as the local authority, relatives and staff and any surveys we received. Staff had assisted people to complete their surveys, so we are aware this could compromise the results. Notifications. These are information a service must give us about any incidents that happen, which may affect peoples wellbeing. Any safeguarding, concerns and complaints information. During the visit we spoke with three people who live at Larch Avenue, a relative, a member of staff and the manager. We observed some care practices and looked at some records and documents. For the purpose of this random inspection we looked at how well the service managed peoples medication, protected people from harm and their rights and whether people could express their concerns and had access to a robust complaints procedure (National Minimum Standards 10, 22 and 23). The surveys returned from people and discussions with them told us that the majority of people knew who to speak to if they werent happy and how to make a complaint. They all said care staff and managers always treated them well and they felt safe and well protected. Their comments included, nice and warm. I like to sit in little lounge. I like the food and drawing with somebody makes me happy. My bedroom is nice. I like my big fluffy dog in my bedroom. I like to lay down on my comfy bed. We spoke to one relative, who told us they felt their family member was safe. They said there was always a staff member they could approach who would listen and respond if they had concerns. They said what they liked about the home was that caring for people Care Homes for Adults (18-65 years) Page 4 of 11 mattered to the majority of the staff. They said most of the staff were friendly, homely and down to earth. The staff surveys that were returned told us staff knew what to do if anyone had concerns about the home. Comments in their surveys about what the service do well included, meets appointments for service users. Meets health and safety requirements. Helps achieve service user wellbeing and promotes and offers choice. Organises trips for service users whenever and wherever possible, care quality, care for the needs of the service user. Staff work together and most of the staff have been here a long time and work well as a team unit, therefore, have the best interests of the service users in mind. I also think we create a nice and safe environment for the service users to live in. In what the service could do better they commented, basic cleaning. Offer a wider range of meal menu, not enough staff at times, staffing levels are an issue and we could do with more full time staff, more full time staff to enable the service users to go out more, we need a better vehicle, so all service users can go out together. We also need provisions for more staff to facilitate 1 to 1 outings and weekends away or day trips. The relative we spoke with also stated they felt that staffing levels were insufficient at times in that there wasnt always staff available to provide stimulation for people, such as taking people out. To improve this the service should consider reviewing their staffing levels to take this into account. We spoke to one member in detail about their understanding of protecting people from harm and protecting peoples rights. They understood very well what to look out for to identify if someone could be at harm of abuse and they knew the right action to take to help people keep safe. We saw that safeguarding people was a topic covered with staff at their supervisions. Safeguarding people means keeping people safe from harm and abuse. Staff had also received training in how to safeguard people and procedures they must follow if an allegation of harm is reported. Discussions with the manager and inspection of peoples care plans told us the service were aware about helping people who are unable to make some decisions for themselves. We saw that on one occasion they had used an independent mental capacity advocate (IMCA) to support someone about medical treatment provided by the NHS (National Health Service). The manager told us they had not had to deal with any complaints in the past 12 months. We could not confirm this, because an inventory of complaints was not held. The manager said the information about complaints would be held on each individuals file, so without looking in every file you couldnt determine the number of complaints and who had made them. The service had, had to make a complaint themselves alleging neglect of a person who lived at the service, whilst they were in someone elses care. The complaint the service made, included reference to a safeguarding referral, but they hadnt made the safeguarding referral themselves. Discussion with the manager told us the complaints procedure was not displayed, which meant that it could not easily seen by everyone. Also, the procedure stated it would not respond to anonymous complaints. The medication procedures that the home were following were not always sufficiently Care Homes for Adults (18-65 years) Page 5 of 11 robust to safeguard people. Nurses were responsible for recording medication received into the home. The amount of medication received into the home for medication not in blister packs was not recorded. Neither was the medication received in blister packs confirmed. Handwritten entries were not verified, to confirm they were correct. We found one medication that was not written on the medication administration record (MAR). Also, although the member of staff was able to state why some medication had not been administered, or there was a post it stuck on the record, there was no information to verify who had authorised the changes and the changes had not been recorded on the medication administration record. The fact that nurses were the ones designated the task of recording medication received into the home, meant that there could be times when people had to wait to start their course of medication. In the main, senior staff were responsible for administering medication. When we spoke to the member of staff and looked at their training record it told us they had received medication training and they were competent to do this. The medication file contained a description of how people liked to receive their medication, which was very good. In addition, there were no gaps in the medication record, which told us people must be receiving their medication at the required time and intervals. What the care home does well: What they could do better: They must record all medication received into the home, so that people are protected by the homes medication policies and procedures. Also, they should have a second signature when there is handwritten information about medication, to verify the information is correct. Furthermore, when changes are made to peoples medication there must be a record of this and who had authorised the change. Display the complaints procedure, so everyone can see how they would make a complaint should they wish to do so. Also, keep an inventory of complaints, so that confirming the number of complaints received and where information about the complaint may be found Care Homes for Adults (18-65 years) Page 6 of 11 could be ascertained. So that safeguarding procedures are followed, the service need to refer concerns directly to the safeguarding authority. 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 2. Care Homes for Adults (18-65 years) Page 7 of 11 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 8 of 11 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, 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 20 13 Where the prescription of peoples medication has changed, there must be information about what this is and who authorised the changes. So that people are protected by the homes policies and procedures for dealing with medication. 16/05/2010 2 20 13 All medication received into 16/05/2010 the home must be recorded. So that people are protected by the homes policies and procedures for dealing with medication. 3 23 13 When there is evidence that suggests someone has been placed at risk of harm, it must be reported directly to the safeguarding authority. So that policies and procedures in place to safeguard people are followed. 16/05/2010 Care Homes for Adults (18-65 years) Page 9 of 11 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 20 The member of staff who signs medication into the home should be reviewed, so that the risk of people having to wait for their medication is reduced. Handwritten medication entries onto a medication administration record should be countersigned to make sure the entry is correct. There should be an inventory of complaints, so that the number of complaints and who made them can be confirmed more easily. 2 20 3 22 Care Homes for Adults (18-65 years) Page 10 of 11 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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