Care Home: Livability

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Annual service review Name of Service: Livability The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection We do an annual service review when there has been no key inspection of the service in the last 12 months. It does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection or annual service review.   Has this annual service review changed our opinion of the service?   No You should read the last key inspection report for this service to get a full picture of how well outcomes for the people using the service are being met. The date by which we will do a key inspection: Name of inspector: Rajshree Mistry Date of this annual service review: 3 0 1 2 2 0 0 9 Annual Service Review Page 1 of 10 Information about the service Address of service: 35 Tudor Way Brackley Northants NN13 6NH 01280843957 01280840049 jlammond@livability.org.uk www.livability.org.uk Livability Telephone number: Fax number: Email address: Provider web address:   Name of registered provider(s): Conditions of registration: Category(ies) : learning disability Conditions of registration: Number of places (if applicable): Under 65 Over 65 3 0 A maximum of three (3) service users in the category of LD may be accommodated in the home at any time. No one in the category of LD may be admitted to the home when three (3) service users in this category are already resident. Have there been any changes in the ownership, management or the No service’s registration details in the last 12 months? If yes, what have they been: Date of last key inspection: Date of last annual service review (if applicable): Brief description of the service Livability is a care home registered to provide personal care and accommodation to three people with a learning disability. The service is one of six homes in the area and owned by Livability and are known as The Brackley Residential Project. The home is on Tudor Way, which is situated in a residential area of Brackley in Northamptonshire. The home is within walking distance of Brackley town centre where community resources include shops, pubs, restaurants, gymnasium and a swimming Annual Service Review Page 2 of 10 pool. The accommodation consists of four single bedrooms and a communal lounge, kitchen and dining area. There is also a well-maintained garden with a patio. The Registered Manager is also the Registered Manager for the sister homes: Hawkins Close, Westminster Croft, Holly Close, Remus Gate and Hanover Drive, where the main office is based. The range of fees for 2009/10 are not known. People who are interested in using Livability should contact the Registered Manager or the home directly for the range of fees. Further information about Livability can be obtained from the home in the form of a Service User Guide and a Statement of Purpose. The latest Inspection Report is available at the home or can be accessed via the Care Quality Commission (CQC) website: www.cqc.org.uk Annual Service Review Page 3 of 10 Service update since the last key inspection or annual service review: What did we do for this annual service review? We looked at all the information that we have received or asked for since the last Key Inspection of the service. This included the Annual Quality Assurance Assessment (AQAA) that was sent to us by the service. This AQAA is a self-assessment that focuses on how well outcomes are being met for the people using the service. It also gave us some numerical information about the service. We assessed the information we have about the service and how the complaints received are managed. We looked at what the service told us with regards to the things that have happened in the service. These are called notifications and are a legal requirement. We looked at the last Key Inspection report dated 1st November 2007, the last Annual Service Review report dated 17th October 2008 and any other visits that we have made to the service in the last 12 months. We looked at the relevant information from other organisations and what other people have told us about the service. We sent out surveys to the people who use the service, which included surveys for their relatives. This was to enable people to give us their views about the quality of service provided at Livability. We also sent out staff surveys. What has this told us about the service? Livability sent us their Annual Quality Assurance Assessment (AQAA) when we asked for it. It was clear and gave us all the information we asked for. We looked at the information in the AQAA and our judgement is that the service is still providing a good service. Livability has demonstrated how it continues to maintain the standards to benefit the people who use the service. The AQAA was completed by the Deputy Service Manager, which provided us with details of what the service does well and the evidence to support the practice. The new developments and practices in place to improve the quality of the service people experience were also included. This showed the service recognises the need to continuously adapt and improve in response to changing needs, concerns, changes in best practice and legislation. The AQAA demonstrated that people considering using the service are given information about Livability in the form of a Service User Guide and a Statement of Purpose. This information is available in written and pictorial format to suit peoples preferred form of communication and comprehension. These documents provide information about the range of services and facilities available to meet individual needs Annual Service Review Page 4 of 10 and aspirations. Both documents are review annually. The AQAA showed that there is a comprehensive pre-admission assessment process to ensure the service is able to meet the individual needs. The assessment process takes into account individual needs, routines and aspirations, which may involve other professionals and organisations. People considering using Livability are encouraged to visit several times and have overnight stays. This enables people to decide if this is the right place for them and ensures a planned move to the home. The people who live at the home are given a contract of stay that has the agreed fee, terms and conditions. This contract has been developed in a pictorial format to suit individual needs. People who use the service make informed choices about their daily lives. Each person has a key worker who works with them on a 1:1 basis providing person centred support. Care plans are developed with individuals taking into account their choices, interests, health and personal care needs and social aspirations. Assessments of risks are completed to ensure peoples independence is promoted safely. The care plans are reviewed monthly with the individual to ensure changes are reflected and they have continued support. The AQAA states people are encouraged to make the home environment comfortable. They choose their own bedroom decor, furnishings and furniture. People also take responsibilities to keep the home clean and tidy. The AQAA states people using the service take control and make decisions about their life. The home environment is comfortable and have home entertainment such as the television and the music centre. One person saved enough money to buy the X-Box game for themselves. Another person has a work placement at the local superstore, one day a week. People use the local amenities in the community ranging from the local shops, health services to places of entertainment. One person continues to observe their faith and has a full social life having made new friends. This helps people to feel valued and part of the local community. The AQAA states people who use the service have at least one holiday a year, with staff. Individual holiday diaries are kept, which can be shared with families and friends. People have one day off a week with staff who support them to pursue their own interests and meet friends for coffee or lunch. People maintain contact with their family. People have developed friendships and relationships and are supported by staff to ensure they understand the importance of being safe. The AQAA states people who use the service all attend the local day centre four days a week, where they have the opportunity to take part in peer and cultural activities. The Link Worker from the day centre meets with the people who use the service and staff to review individual needs, support and aspirations. People who use the service have been supported by key workers to develop a file called My Life. It contains photographs and details of the various activities they have taken part in, their achievements and accomplishments in the year. This will be used Annual Service Review Page 5 of 10 as part of the annual review and enables people to be in control of setting new goals for the following year. People who use the service are involved in menu planning. People help staff with the food shopping and to prepare meals. Individual preferences and dietary needs are recorded to ensure people have a healthy, balanced and varied meals of their choice. Livability has an Activities Co-ordinator who supports people using the service with their individual interests and social aspirations. The AQAA states the people who use the service are supported to be as independent as possible with regards to receiving support with their personal care needs. People are registered with the local General Practitioner (GP) surgery. They also have regular visits to the dentist, optician, podiatrist and the opportunity to have annual health checks. Some people benefit from additional health and social care support from specialist teams. The improvements made include developing peoples morning routines in pictorial format; the life skills assessments carried out by the Community Team and the annual health checks carried out by the GP with regards to promoting health and well-being. Livability has a good system for the management, storage and administration of medication. The staff have accredited medication training and are responsible for administering medication. The AQAA states people are supported to manage their own money and individual budgets, where possible. Individual financial records are kept for people that prefer to have their money held in safe-keeping at the home. The AQAA states the complaints procedure is given to people who use the service in a booklet form, which is available in pictorial format. The complaints procedure is also detailed in the Service User Guide and the Statement of Purpose that is provided to people when they move to the home. The numerical information in the AQAA states Livability received no complaints. The Care Quality Commission received no expressions of concerns or complaints about Livability. The Care Quality Commission has received timely notifications with regards to events or incidents affecting the well-being of people who use the service. These are known as Regulations 37 notifications and are a legal requirement. The AQAA states people who use the service have house meetings every two weeks and private monthly review meetings where they may voice any concerns. All concerns, incidents and accidents are reported to the Operations Manager, the Ordinary Living Team (Care Management) and to the Care Quality Commission. The AQAA states the staff have received training in safeguarding of vulnerable adults (sova) and have supporting policies and procedures in place. Safeguarding means promoting and protecting vulnerable people who use the service from risk, harm and abuse. All staff are aware of their roles and responsibilities with regards to Annual Service Review Page 6 of 10 safeguarding adults. The improvements made includes staff receiving training in Mental Capacity Act and the Deprivation of Libertys. This is to help staff have a better understanding of liberties and capacity. The AQAA states the monthly monitoring visits known as Regulation 26 visits are carried out by the Operations Manager. They look at a range of activities, information and also speak with the people who use the service and staff. They also look at any complaints, concerns and safeguarding matters that affects the well-being of people who use the service. This shows the service has internal communication and monitoring systems in place. Livability is a well-maintained detached property that blends in with the other private residential properties. There is a well-maintained garden with a BBQ area on the patio. People who use the service choose their bedroom furnishings, decor and furniture to reflect their interest and personality. People take responsibilities to keep the home clean and tidy. People have the opportunity to raise concerns at the house meetings with regards to the health and safety issues in the home. The monthly monitoring visits by the Operations Manager also monitors the home environment with regards to health and safety. The improvements made to the home includes creating a memorial in the garden and purchased a new flat screen television with built-in Freeview. The AQAA states Tudor Way has been awarded 5 stars, following the visit from the Environmental Health Officer. The AQAA demonstrated that staff recruitment process is robust, whereby the people who use the service are involved in the recruitment of staff. Pre-employment checks are carried out and maintained on file. These include two satisfactory written references, criminal records bureau (crb) check and the protection of vulnerable adults (pova) check. These checks are to assess the suitability of applicants to work with vulnerable people. The service also uses agency staff who undergo the same preemployment checks to ensure they are suitable to work with vulnerable people. The AQAA states the home has recruited a part-time support worker to work four shifts. This is to provide stability and consistency for the people who live at Livability. The AQAA states all staff complete a 6 to 8 week induction programme and are expected to complete the Learning Disability Qualification (LDQ) within 6 months of employment. The agency staff are required to complete an induction programme before they can work alone. All staff receive mandatory training and updates. The AQAA states all staff including agency staff receive supervisions and an annual performance review. There are regular staff meetings that includes standards agenda items such as safeguarding adults, health and safety, care standards and sharing of information with regards to the things that have happened in the service and the people who use the service. The AQAA sates the Registered Manager is experienced in managing a care home and working with people with a learning disability. She has attained the National Vocational Qualification (NVQ) level 4 and the Registered Managers Award. The management team consists of the Deputy Manager who has attained NVQ 4 and the support Annual Service Review Page 7 of 10 workers, both having attained NVQ 3. The management of the service meets the needs of the people who use the service through good staff recruitment, training and staff deployment. We have been advised that there will be changes to the management team whilst the Registered Manager has sabbatical leave for 3 months and will be returning g in February 2010. They have sent us information with regards to the personnel that will be managing the service, the support systems in place and gave us assurance that people who use the service will not be affected. The AQAA states the policies and procedures are reviewed regularly and some were last updated in July 2009. The AQAA details the range of quality assurance and monitoring systems in place. These include the Operations Managers monthly monitoring visits known as Regulation 26 visits and these are a legal requirement. There are fortnightly house meetings, whereby the people who use the service are consulted and given information about any changes that may affect or influence the quality of life they experience. There are monthly review meetings with the key workers and also the annual reviews conducted by the organisation that financially supports the people at Livability, such as the local authority. We sent out 3 surveys to the people who use the service, which included surveys for their relatives. We received 1 survey from a person who uses the service, which was completed with the support of staff and 1 survey from a relative. All the responses received indicated people were given information about the home and chose to move. All the responses indicated people made decisions about their life and daily routines. All the responses indicated people were supported with their health and personal care needs that promoted their health and well-being. All the responses indicated people know who to speak with if they have any concerns and how to complain. All the responses indicated the home is fresh and clean All the responses indicated the staff treat people well, listen and act on what they say. We received the following comments with regards to what the service does well: Safe and clean environment Freedom of choice Supported with their independence We sent out 3 staff surveys and all were returned. All the responses received indicated staff receive up to date information about the people who use the service and their individual needs. All the responses indicated staff were appointed with satisfactory preemployment checks to assess their suitability to work with vulnerable people. All the responses received indicated staff received induction and training for their job role, providing them with the knowledge and the right skills. All the responses received indicated staff were confident to receive concerns and complaints from the people who use the service and other parties. All the responses received indicated there are good communication systems in place between staff and they receive support from the manager. Annual Service Review Page 8 of 10 The additional comments we received in the staff surveys included: This home offers an excellent standard of service to promote each individual to enable them to reach their full potential towards achievable independence, offering choice and considerations, respecting each persons needs All policies and procedures are up to date and upheld - very high standards in all aspects of care NCH - to Shaftesbury to Groom-Shaftesbury to Livability, have moved forward in their thinking and therefore, give each client the best opportunity for happiness and fulfillment possible We all work hard The clients are given plenty of choice in every area of their lives, they are encouraged to be independent, they have a very good social life and they are both happy living in the house Have more staffing so service users go out individually with support - not always possible in a lone working setting Has a person centred approach in supporting service users We concluded from the responses in the surveys that peoples experiences of service is consistent with the practice detailed in the AQAA, the self-assessment. Livability continues to let us know about the things that have happened since the last Key Inspection. They have show that they have managed issues. They work well with us and have shown that the service continues to provide good quality outcomes for the people who use it. What are we going to do as a result of this annual service review? The next inspection of this service will be based on the Fees and Frequency Regulations 2007 and the assessment of risk of the service. Further clarity will become evident as the new registration and inspection systems under the Health and Social Care Act 2008 is confirmed. Annual Service Review Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Annual service review CQC General Public 0870 240 7535 (national contact centre) Our duty to regulate social care services is set out in the Care Standards Act 2000. The content of which can be found on our website. 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