Care Home: Maple Grove Hostel

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What the care home does well The home has a small and experienced staff team who have a good understanding of the individuals needs. They treat people in a warm and respectful manner, which means that they can expect to receive care and support in a sensitive way. People living in the home appear settled and confident in their surroundings and contribute fully to all aspects of daily life in the home. Interactions with staff on duty are friendly and relaxed. Care plans and associated documents are clear, informative and up to date. They describe the support to be given and explain the reasons for it. They show who has been involved in reaching these decisions. Where goals are set, there is evidence that these are met, making the process meaningful and beneficial for people. Effective systems are in place to help ensure that there is consistency in assessing, planning, implementing and evaluating the care when required. The manager, deputy and staff team are working hard to empower people and encouraging them to maintain independence, autonomy and choice. Health care is provided effectively, enabling people with some significant complex needs to receive the best possible advice and treatment for these. The home works diligently on behalf of the people living there to promote their rights to access appropriate support.Families and other relevant professionals are kept involved at all stages. Guidelines on key health issues are set out clearly to help ensure that the right support is given when necessary. The home promotes a good quality of life and focuses on maintaining and developing skills, enabling people to be as independent as possible. A range of experiences and opportunities are offered, including regular access to community activities, which is both enjoyable, stimulating and meets individual preferences and expectations. People maintain family contact and staff encourage family and friends to join in with activities and any outings. People receive a varied and wholesome diet that they are able to influence. The home is clean and comfortable, it provides a safe, peaceful and well maintained environment for the people living there. The bedrooms, communal rooms and facilities are suitable for their purpose and meet the peoples needs. The home promotes staffing levels and skill mix of staff in order to help ensure that people`s needs can be met. The recruitment policies and procedures set up in the home should help ensure that people living in the home are supported and protected. People benefit from a well run home, under the leadership of an effective manager who has suitable knowledge, skills and competencies to ensure that the service continues to meet their changing needs. What the care home could do better: The home is well organised and managed by an effective, stable management team that promotes the views and interests of all people who use the service. The home has continued to improve following the last inspection in order to maintain their three star excellent rating. All of the National Minimum Standards assessed at this inspection were met. No statutory requirements have been made as a result of this inspection. We would like to thank everyone who took part in the inspection, their enthusiasm and support was greatly appreciated. Random inspection report Care homes for adults (18-65 years) Name: Address: Maple Grove Hostel 25-27 Maple Grove Bath Bath & N E Somerset BA2 3AF 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: Wendy Kirby Date: 2 0 0 5 2 0 1 0 Information about the care home Name of care home: Address: Maple Grove Hostel 25-27 Maple Grove Bath Bath & N E Somerset BA2 3AF 01225420548 01225319728 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Ruth Theresa Rowsell Type of registration: Number of places registered: Conditions of registration: Category(ies) : Bath & North East Somerset Council care home 10 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 10 The maximum number of service users who can be accommodated is 10 The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning disability (Code LD) Date of last inspection Brief description of the care home Maple Grove is a Local Authority residential care home for up to ten adults who have a Learning Disability. The home is situated in a quiet location, which provides easy access to local shops on Bear Flat and Moorland Road, Bath. The city centre is approximately one mile away. Maple Grove is two spacious semi detached Victorian Care Homes for Adults (18-65 years) Page 2 of 12 Brief description of the care home houses, which have been connected to form one building. The home has large gardens to both the front and rear of the properties. Care Homes for Adults (18-65 years) Page 3 of 12 What we found: This was a random inspection conducted by one inspector over approximately five hours. In line with the Care Quality Commissions current methodology this random visit was completed instead of a full key inspection. A key inspection reviews all of the key National Minimum Standards. A random inspection is a more focused, targeted visit and no new rating of a service is given. The previous excellent rating awarded for this service in 2007 remains in place at this current time. Prior to the inspection we (The Commission) looked at various pieces of information to gather evidence in preparation for our visit, which included the following: The previous inspection report in 2007 where the home received an excellent rating. The homes inspection record, which gives us an account of any information we have received about the home since the last inspection. The Annual Quality Assurance Assessment, known as an AQAA. The home is requested annually to complete and return this assessment to us by a specified time. We received the AQAA on time, which contained detailed useful information about what the home considers it does well and what plans they have for further improvements in the coming year. We have used examples from the AQAA in this report to support our own observations during our visit to the home. We sent surveys Have Your Say to people who live in the home and staff. Comments received from the surveys will be referred to throughout this report. During our visit most of the people living in the home and staff were out, however, we spoke with two people who live in the home, the registered manager, the deputy and two staff members who were on duty. Comments received will be referred to throughout this report. We looked at individual care files, which included pre admission assessments, care plans and risk assessments. We spent time in all communal areas of the home and looked at the bedrooms. The home is relocating to a new purpose built provision. The new build will accommodate and support people to live more independently. The staff are vigilant in preparing individuals to ensure that the move has a positive impact on their lives. The manager tells us in the AQAA, We will continue to work with other professionals, advocates, families, carers and the housing association in the re-provision of Maple Grove and will take into account and work in a person centered way to assess the individual needs and choices of the clients so that they continue to be well supported throughout the transition period. From the initial pre admission assessments staff had identified needs enabling them to Care Homes for Adults (18-65 years) Page 4 of 12 form written care plans. The plans that we looked at were very detailed and person centered, including personal preferences and likes and dislikes. Plans told us that people had specific requests and routines, this is very good practice and helps demonstrate that people are involved in deciding how they wish to receive care. Each person has a portfolio with person centered assessments, which means that staff put the views, wishes, likes and dislikes of each person at the center of all care provided. The information was informative and useful enabling staff members to provide the appropriate care to support health and social needs. The plans showed consistency in assessing, planning and evaluating care as required. Regular care reviews take place for people living in the home, which can include family members and key workers wherever possible. This allows the opportunity to discuss and evaluate care and any issues or concerns people might have. The AQAA told us, Clients are fully involved in all aspects of their lives. Risk assessments support service users to take risks in their daily life and all service users are supported to be aware of the consequences of their choices. Person centered plans and care plans ensure individual opinions and feelings are heard, acted upon and followed through. Staff demonstrated a clear understanding of peoples individual needs. Through observation and discussions with the staff we saw skills of sensitivity and warmth when communicating and delivering care to people living in the home. Some people have complex needs with varying impairments and learning disabilities. We were told about individual communication requirements and through patience and time the staff had identified effective methods of communication with individuals. Risk assessments were examined and showed us that staff were mindful of keeping people safe within their home and out in the community. Individual risk assessments were detailed and well written. The manager told us that the staff were vigilant in empowering people to promote as much independence as possible but at the same time making sure that they do this as safely as possible. The AQQA told us about how things have improved over the past twelve months, We continue to encourage clients to take part in workshops and life skill work shops that develop and support all aspects of their lives, supporting their awareness of their own personal safety and promoting their independence. More clients attended the Network Partnership board this year with staff, advocates and family members. This gave clients the opportunity to attend individual workshops which looked at housing, personalisation, communication and employment. Many of the clients have been working with People First an independent buddy scheme and this has supported clients to access public transport with an approved buddy and gain more knowledge of the Bath Area. Care files and discussions with staff demonstrated that the home was providing people with opportunities to develop social, emotional, communication and independent living skills. There was information on levels of independence and the level of support that was required by staff to support the people both in and outside of the home. Weekly activities and plans are reviewed with people, staff and families to ensure that they remain relevant to the individual. All individual tastes and preferences are taken into account. The information shared is produced in a lifestyle plans and provides staff with Care Homes for Adults (18-65 years) Page 5 of 12 extremely useful information including, peoples personalities, essential things that are important to individuals, how people express emotions, things that people enjoy and how to support people successfully and keep them safe. Daily routines and activity plans include attending various day centers and clubs in the local community. People regularly go out and enjoy the local community amenities by visiting pubs, clubs, restaurants, swimming baths, shops, and cinemas. People make their own choices at mealtimes with the support from staff. The menus, which they have produced, offer a varied healthy diet plan. Alternatives were also made available and flexibility in meals was evident. People are encouraged to help prepare the meals. Staff in the home are mindful of educating and assisting people in maintaining a healthy balanced diet. We saw that staff monitor peoples weight closely and the care files give very specific information about maintaining adequate nutrition. This includes peoples likes, dislikes and how much support they require from staff. The kitchen was clean, tidy and well equipped. The stores, fridge and freezer had a good supply of food. People living in the home are involved in the shopping and use local amenities for their food supplies. There does not appear to be any unnecessary rules in the home and it was clear that the manager and staff are working towards empowering people and encouraging them to maintain independence, autonomy and choice. Daily routines are flexible within the home, people can get up and go to bed when they like, have their meals in their bedrooms, they can go out when they wish and participate in activities they have a particular interest in. This was confirmed through documentation in care files, in discussion with individuals and through observation during our visit. Staff support and encourage people to express their preferences when purchasing clothes, toiletries and having their hair done. Plans also tell staff whether people prefer male or female carers when receiving personal care and what they like to be called. All personal care is provided in private and bedrooms and bathrooms can be locked from the inside. The home promotes privacy and dignity to all people who use the home. Staff attend training on induction, which covers aspects such as closing doors and pulling curtains when delivering personal care and knocking on doors and waiting for an invitation to enter before going in to their bedrooms. The care plans we looked at gave clear information about individual needs both physically and emotionally. Health Care needs are detailed in the Care Files. Records of visits to the General Practitioner and the outcomes are recorded. Specialist referrals and visits to other health professionals including, Consultants, Chiropractors and Dentists were seen, to help ensure that peoples identified needs are being monitored and met. The manager explained that peoples health care needs are closely monitored in consultation with primary health care services and that access to health screening is undertaken. The home has various recording methods so that they have a quick reference guide and background history for individuals. Information can include a daily account, fluid and nutritional intake and a record of any illness. Short term care is also documented for Care Homes for Adults (18-65 years) Page 6 of 12 example when a person is on antibiotics for a chest infection. The home provides accommodation for up to ten people. We walked around the inside and outside of the home and viewed the bedrooms and the communal areas including the dining room/conservatory and lounge. Room sizes are fairly spacious for their stated purpose. All areas of the home were decorated to peoples taste, clean and well maintained. Attention has been given to ensure that areas are homely, including photographs of the people living there. People had been supported to personalise their bedrooms with pictures and ornaments and they are able to bring items of furniture should they wish. Rooms are lockable so that they can maintain their privacy and keep their personal possessions secure. The lounge area allows for people to be seated together enjoying the entertainment systems on offer. The laundry room and sluice is well equipped. Supplies of gloves and aprons were seen throughout the home. The outside provides a safe, private area for people to relax in. The manager ensures that staffing levels are indicative of the needs and levels of care required and confirmed that levels of staff rise should dependency levels increase. Most of the team are experienced members of staff who have a good knowledge of the people living in the home. We observed some staff carrying out their duties and assisting individuals. Staff were respectful, warm in manner, good humoured and sensitive towards the people within a relaxed homely environment. We know that the home follows good recruitment procedures. This will help ensure that the right people are employed to work at the home, and people living in the home will be further protected. People living in the home are encouraged and supported to be involved in the recruitment of new staff. Records contain completed application forms with a full employment history, at least two written references and Criminal Records Bureau (CRB) disclosures. Staff receive a job description, terms and conditions of employment, and GSCC code of conduct. We spent all day in the company of the registered manager who consistently demonstrated effective leadership skills within her role. Her vast knowledge and enthusiasm of the home, the people living there and all staff who work at the home was second to none. Through observation and discussions it was evident that she is a team invigorator, engendering a productive positive atmosphere throughout the home. Throughout our visit the manager demonstrated good, effective leadership and management skills that relate to the aims and purposes of the home. It was evident the manager and staff are a stable team that supports a commitment to providing quality of care for the benefit of the people living in the home. Survey comments about the management included, I am supported through every part of my role, The manager is very open and honest, is easy to approach and always supports you, I feel that I can approach the manager about any problems I have and Care Homes for Adults (18-65 years) Page 7 of 12 The manager always listens to what you have to say, which makes you feel that you are a valued member of the team. The management team encourages innovation within the staff team and ideas that are generated are respected and actioned, which demonstrates an open and inclusive atmosphere. The home supports people with complex needs and the ethos is to encourage independent living within the scope and abilities of each person. Both the manager and staff spoken with remain clear on these points and it is evident that people living in the home, have made significant progress including improved mobility, social skills, confidence and self awareness and all staff should be commended for their continued efforts. We received eight completed surveys from people that live in the home. Everybody agreed that they were well cared for, that staff treated them well, that they were involved in making decisions, and that they felt safe. Comments included, I am very happy, They look after me well, I am happy living here and I love going shopping when I want to and love having my hair done. We received ten completed staff surveys, which provided us with valuable constructive comments. These comments further supported and evidenced our judgements made as a result of this visit. Comments received included, Maple Grove has a very dedicated, supportive staff team and manager, We run a person centered service where we support clients to make their own choices and express their own views, Maple Grove has a great rapport between clients and staff and We are a client led service, promoting freedom of choice, dignity and privacy. What the care home does well: The home has a small and experienced staff team who have a good understanding of the individuals needs. They treat people in a warm and respectful manner, which means that they can expect to receive care and support in a sensitive way. People living in the home appear settled and confident in their surroundings and contribute fully to all aspects of daily life in the home. Interactions with staff on duty are friendly and relaxed. Care plans and associated documents are clear, informative and up to date. They describe the support to be given and explain the reasons for it. They show who has been involved in reaching these decisions. Where goals are set, there is evidence that these are met, making the process meaningful and beneficial for people. Effective systems are in place to help ensure that there is consistency in assessing, planning, implementing and evaluating the care when required. The manager, deputy and staff team are working hard to empower people and encouraging them to maintain independence, autonomy and choice. Health care is provided effectively, enabling people with some significant complex needs to receive the best possible advice and treatment for these. The home works diligently on behalf of the people living there to promote their rights to access appropriate support. Care Homes for Adults (18-65 years) Page 8 of 12 Families and other relevant professionals are kept involved at all stages. Guidelines on key health issues are set out clearly to help ensure that the right support is given when necessary. The home promotes a good quality of life and focuses on maintaining and developing skills, enabling people to be as independent as possible. A range of experiences and opportunities are offered, including regular access to community activities, which is both enjoyable, stimulating and meets individual preferences and expectations. People maintain family contact and staff encourage family and friends to join in with activities and any outings. People receive a varied and wholesome diet that they are able to influence. The home is clean and comfortable, it provides a safe, peaceful and well maintained environment for the people living there. The bedrooms, communal rooms and facilities are suitable for their purpose and meet the peoples needs. The home promotes staffing levels and skill mix of staff in order to help ensure that peoples needs can be met. The recruitment policies and procedures set up in the home should help ensure that people living in the home are supported and protected. People benefit from a well run home, under the leadership of an effective manager who has suitable knowledge, skills and competencies to ensure that the service continues to meet their changing needs. 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 2. Care Homes for Adults (18-65 years) Page 9 of 12 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 10 of 12 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 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 11 of 12 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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