Care Home: Leonard Cheshire Home

What the care home does well Mickley Hall provides a welcoming and safe home for peoples needs. Staff had close relationships with people living at the home and described peoples needs in depth. Equality and diversity was promoted, each persons differences, likes and dislikes were known and respected. Opportunites were available to all of the people living at the home that took into account their individual needs. People living at the home had a written care plan so that their needs were identified. Peoples health care was monitored and access to health specialists was available to maintain good health. Relatives and friends could visit the home at any time to maintain their relationships. Staff said they worked well together. The health and safety, complaints and adult safeguarding procedures protected people. What has improved since the last inspection? Person centered planning has continued to evolve further enabling staff to focus their plans and care to meet peoples needs. Four bedrooms have been equipped with environmental controls enabling people to be able to increase their personal choice and independence. What the care home could do better: Continue to redecorate the building in accordance with the business plan. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Leonard Cheshire Home Mickley Hall Mickley Lane Totley Rise Sheffield South Yorkshire S17 4HE     The quality rating for this care home is:   three star excellent 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: Ian Hall     Date: 1 1 0 3 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 27 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 27 Information about the care home Name of care home: Address: Leonard Cheshire Home Mickley Lane Mickley Hall Totley Rise Sheffield South Yorkshire S17 4HE 01142369952/3 01142620234 gwen.webster@lc-uk.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Leonard Cheshire Disability Name of registered manager (if applicable) Mrs Irene Gwendoline Webster Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 physical disability Additional conditions: Date of last inspection Brief description of the care home The Leonard Cheshire organisation work with disabled people throughout the world. It offers support and campaigns for the rights of people living with disabilities. Mickley Hall is one of their residential services. It offers long-term support for 40 adults with a physical disability. 40 Over 65 0 care home 40 Care Homes for Adults (18-65 years) Page 4 of 27 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: The quality rating for this service is 3 star. This means that the people who use this service experience excellent quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use the services are not being put at risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The unannounced site visit undertaken as part of the inspection started at 09:30 and concluded at 14:30 on the 11th March 2009. The inspection was conducted by the link Care Homes for Adults (18-65 years) Page 5 of 27 inspector Mr I A Hall. The site visit included a tour of the building, reading records, discussions with staff and people who use the service and observation of meals provided. We also met with the manager and other members of staff. In addition the inspection took account of information received about the service since the last key inspection. This included records of telephone conversations with staff, events notified to CSCI and records of management visits to the home. Prior to the site visit the home carried out a self assessment of the service. This is called the annual quality assurance assessmmennt (AQAA). People spoken with were very happy to assiist with the inspection. Comments were positive when describing the care and motivation of the staff, these included : I like it here, I feel safe; The staff are very good to me; Its great here the staff are absolutely great, my lifes improved so much since I came here, I get to do all sorts of things with the staff they are smashing. At the end of the site visit verbal feedback was gived to the manager. 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 27 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 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service provides people with detailed information to enable them to choose whether the home is the one for the one for them. Detailed assessments ensure peoples needs could be met prior to offering them a place. Evidence: An information pack was available that provides details of the standards of care and services available at the home. This includes useful information about staff, their qualifications, visiting the home, choosing meals, the laundry service and how to raise concerns. We checked three case files. Each contained a detailed needs assessment; this included such things as daily living, personal care, health care, social interests and areas of risk when appropriate. Whenever the need for specialist caring equipment had been identified this had been obtained prior to the person moving into the home. Care Homes for Adults (18-65 years) Page 9 of 27 Evidence: The assessment formed the basis of the initial care plan. People said they had been able to discuss their wishes and the type of help they needed before they had made the decision to live at Mickley Hall. Whenever possible people had been encouraged to visit and spend time at the home so that they could meet members of staff and other people living at the home. This was confirmed by written entries in the case files. Copies of contracts, social work referrals and assessments were available and kept in the case file. Care Homes for Adults (18-65 years) Page 10 of 27 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 were treated with respect and able to make decisions about their lives and take risks as part of an independent lifestyle. Evidence: Three care plans were examined; they were detailed and of a good standard. The format used detailed peoples individual needs including their life history, preferred routines and the methods they used to communicate. The care plans checked had been reviewed regularly. Staff had a sound knowledge of peoples preferred routines, care needs and communication methods and were able to demonstrate how they supported people to make choices within their capabilities. Peoples files contained individual risk assessments that included mealtimes, mobility and travel to minimize risks to people within and outside the home. There were many Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: examples seen of staff helping people to maintain their safety; these included cooking and baking in the kitchen and people going into the community shopping. Staff offered choice in peoples everyday life at mealtimes and other individual activities of daily living. Staff were aware of peoples care plans and could describe individuals needs in detail. People living at the home were aware of their care plan and had signed these; one person said : I know about my care plan and i can look at it whenever i want to. It was clear that people were encouraged to make decisions about their lives. Staff spoke to people respectfully and supported their choices. Several people decided to go out for the day, one to go shopping, or spend time in their room to watch television. These choices were respected. Care Homes for Adults (18-65 years) Page 12 of 27 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 at the home have their personal and social care needs met in a way that respects their privacy and dignity. Evidence: There were opportunities for personal development and fulfilling activities. People were assisted to plan their individual activities and life skills programmes. This was recorded within the care plan for each persons personal development. There were leisure activities both inside and outside the home. People went shopping, visited local places of interest, go to concerts or public houses as they wished. The home has a number of mini busses, this gave staff the opportunity to help people maintain their choice, independence and mobility. Staff support people to enjoy holidays each year. Regular meetings were held for people to discuss the menu, group activities such as Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: celebration of St Patricks Day; this encourages discussion about the running of the home. Discussions with staff and observations demonstrated that the routines within the home were flexible. People were encouraged to make simple choices about activities of daily living for example when they rose or retired and how they wished to spend their day promoting independence and choice. Friends are welcomed. There were facilities for people to have visitors to their home. People have personal items such as televisions and cd players in their bedrooms. People were seen preparing their own food in the activity kitchen with staff. There was a range of fresh fruit available in the dining area. There were facilities for people to make hot drinks and snacks at all times. Menus were continuously reviewed to provide a healthy balanced diet. Mealtimes were flexible to meet peoples needs. The staff spoken to had a good knowledge of peoples likes, dislikes and dietary requirements. Care plans checked incorporated any risks ie swallowing that may be presented to people during mealtimes and detailed records of meals taken. People were encouraged to become involved in the day to day running of the home. Risk assessments were in place for peoples safety both inside and outside the home. Care Homes for Adults (18-65 years) Page 14 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home have their health and personal care needs met in a way that respects their privacy and dignity. Evidence: Three plans of care were examined and found to be comprehensive. They were reviewed at least every six months to meet peoples changing needs. The goals and objectives agreed with each person were regularly monitored and reviewed. People were registered with a GP and are supported to attend the health center. Other health services; dental, chiropody and opthalmic were available in the community with staff accompanying people to appointments. Practitioners visited people at the home if they were unable to visit the practices. Staff had worked very competently to support several people who had experienced Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: major life changing events. They ably facilitated peoples wishes in their personal relationships. Medication was securely stored to keep it safe. We observed staff administering medication and sympathetically assisting people as necessary. All staff that administered medicines were trained to make sure peoples safety was maintained at all times. Care Homes for Adults (18-65 years) Page 16 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home and their representatives feel able to complain and are confident they will be listened to. Evidence: Visiting relatives and some people living at the home were able to describe how they would raise any concerns with staff. They said that any matters they raise however trivial were dealt with promptly by staff and they were happy with the outcome. The complaints procedure was available for people living at the home, their relatives and staff. Comments received included; Im happy here, Ive no complaints; the one minor complaint I had was dealt with very well. Three people had brought their concerns to the managers attention, they were investigated, actions were taken to deal with the minor deficits. They had been investigated and recorded within the homes policy ad procedure. Staff had been provided with training in adult safeguarding procedures to ensure that people were safe and to inform staff what to do if an allegation was made. The inspectors discussions with staff confirmed that they felt confident and able to respond to complaints effectively. Care Homes for Adults (18-65 years) Page 17 of 27 Care Homes for Adults (18-65 years) Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean, comfortable, homely and safe environment suitable to their needs. Evidence: We saw the home was clean and smelled fresh. Soft furnishings, pictures and ornaments were used to provide a homely domestic setting. A range of colours had been used to individualize peoples rooms. People had used many favorite items, posters and memorabilia to personalize their rooms. Bedrooms were lockable with keys available for people who wished to exercise the choice to lock their own door. Four bedrooms had been equipped with environmental controls to increase peoples independence and choice. They are able to remotely control their doors, television, use the telephone and call for assistance. Each room was equipped with an overhead tracking system to enable people to move around their room safely. There is level access throughout the home with ramps provided to ease access to the home and garden areas. Corridor areas were light, bright, wide and equipped with handrails to facilitate peoples mobility and independence. Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: Lounge, activity and dining room areas were well equipped, light, bright and readily accessible by people. Toilet and bathing facilities were conveniently situated and equipped with aids and adaptations to facilitate peoples independence and mobility. People living at the home were able to smoke in the enclosed courtyard garden. It had been landscaped to enable people to access all areas easily. The art school had painted a mural with the participation of people living at the home. Staff confirmed that they were provided with protective clothing when they needed it, and that equipment was in working order, being serviced as required. Low surface temperature radiators had been provided to reduce risk to people of being burnt. We saw rooms being decorated, the manager confirmed the ongoing redecoration and refurbishment programme. Care Homes for Adults (18-65 years) Page 20 of 27 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. People who live at the home are cared for and supported by a group of staff who have been properly recruited, trained and are sufficient in numbers to ensure their needs will be met. Evidence: We met with members of the staff team and the manager during the course of the inspection. We saw staff working with people and noted that there was an atmosphere of mutual respect; their conversations were relaxed and friendly. The staff group were well motivated and enthusiastic about their work. They confirmed that they were supported by the manager and encouraged to train and update their skills. People benefit from the substantial number of volunteers that work at the home. They confirmed that they complete the homes recruitment process and complete a training and induction programme before working with the people who live at the home. Staff we interviewed confirmed that they had completed a criminal records bureau check before commencing employment. Personnel files sampled confirmed that the home follows company staff recruitment procedures. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: Records of staff supervision and their training needs were examined. We saw the staff training and development plan. Training courses completed and planned were seen. These included health and safety, moving and handling, first aid and care for people with Parkinsons disease. Many staff had achieved national vocational qualifications; the remaining staff were working towards the award. Skills for prevention of infection and fire were updated each year. This ensures that staff were trained to meet peoples care needs safely. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that is well managed and takes their wishes into account about how the home should be run. Evidence: We saw there was always a trained nurse on duty at the home with advice and support readily available. Responsibilities for day to day management of Mickley Hall were shared between senior members of the team. People said; I feel the home is well run, and my lifes great since I came to live here. Staff said the manager was approachable, very professional and they felt confident in her. Staff had received management supervision at regular intervals; this is needed to develop staff and monitor care practice. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: A senior company manager visits the home to monitor care and standards at the home. A written report of their findings was available at the home. Management use a quality assurance system to measure standards of care and service provided. Questionnaires were used to seek the views of people and relatives. Regular meetings were held for staff and people who live at the home. These give people living at the home a voice and chance to say how the home should be run. People felt that their views and opinions were taken into account by the staff. The manager handles money on behalf of some people, records with receipts were kept. A second person witnessed each transaction. Policies and procedures met the required standards. Records were mainly up to date and well ordered to ensure the best interests of people. No fire exits were obstructed and hazardous substances were securely stored. Statutory servicing and checks of equipment were complete. Risk assessments were completed to maintain a safe environment. Service records for the moving and handling equipment, fire safety records and other maintenance records were up to date. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 34 Sch 2 All recruitment procedures must be adhered to. 20/12/2006 Care Homes for Adults (18-65 years) Page 25 of 27 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 26 of 27 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. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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