Care Home: Market Place

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What the care home does well The service has completed good pre placement assessments and supported people in a positive manner as they have moved into their new home. Staff are provided with a comprehensive induction and good levels of support. The service has been decorated and furnished to a good standard and is well situated to access the local community. What has improved since the last inspection? x What the care home could do better: No areas requiring improvement were identified during this visit Key inspection report Care homes for adults (18-65 years) Name: Address: Market Place 29 Market Place Coleford Gloucestershire GL16 8AA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Simon Massey     Date: 1 4 1 0 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 21 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 21 Information about the care home Name of care home: Address: Market Place 29 Market Place Coleford Gloucestershire GL16 8AA 01594546505 01594546506 info@stepasidecare.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Step-A-Side Care Ltd Name of registered manager (if applicable) Mrs Tracy Michelle Bedford Type of registration: Number of places registered: care home 2 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is 2. 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 Market Place is registered for two people and provides accommodation over two floors. The service provides seperate kitchen and bathroom facilities and is designed to promote independence for the people accommodated there. It is situated close to the centre of Coleford in the Forest of Dean. 2 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 21 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: two star good 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: This Inspection took place on 26/10/09 and 11/11/09. The Inspector met with the Registered Manager, two members of the staff team, the Responsible Individual and the people living in the service. Records relating to staff recruitment and training, care planning and health and safety were examined. An inspection of the environment was also carried out. This was the first full key inspection of this service since it became registered six months previously. The Inspector was very grateful for the input and cooperation from the people living in this service towards the inspection process. Care Homes for Adults (18-65 years) Page 5 of 21 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 6 of 21 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 7 of 21 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The admission procedure ensures that peoples needs and aspirations are assessed prior to prospective residents moving into the home. Evidence: The service is fully occupied with two people having moved in in recent months, both from services also run by the same Provider. Assessments and pre-placement planning was completed and both people explained how they prepared for the move and how they considered they were ready to move into accommodation that provided greater independence. Both were very positive about how they had settled in and the support they had received during this process from the staff team. Care Homes for Adults (18-65 years) Page 8 of 21 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Detailed care plans ensure that the service users needs are documented and guidance is available to staff. The home takes action to encourage service users to make choices and supports them to take appropriate risks. Increased independence is an objective for all service users that the home supports them to work towards. Evidence: There are detailed care plans in place that cover a range of needs. The process for developing the plans and reviewing them is person centered and fully involves the people living in the service. The individual files contain care plans, placement plans and risk assessments and all are reviewed at appropriate intervals. Each person has an allocated key worker who spends time every month going over the plans with the individual. The service also uses the services of a behavioral therapist who provides input, amongst other things, with the developing of individual plans and goals. Greater clarity could be provided in the risk assessments around the supervision required in the community, independent travel and the supervision required whilst in the home. At present nobody is left unsupervised in the home and travel away from Care Homes for Adults (18-65 years) Page 9 of 21 Evidence: the home is organized in a structured plan. This increased detail and guidance is particularly relevant when the service is developing the independence skills of both of the people living in the service. Care Homes for Adults (18-65 years) Page 10 of 21 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home supports the service users to develop individual lifestyles and plan for the future by encouraging the development of independence skills. Service users appear confident about their right to make choices and decisions about their lives Evidence: At the time of this inspection both people living in the home were attending full time college courses which they both said they throughly enjoyed. Support and guidance to increase independence skills is being provided and their were programmes in place to develop independent travel and shopping in the community. People living the home are expected to take responsibility, with support, for all domestic aspects of daily living. People are supported to have regular contact with their families and have visitors when they choose. Care Homes for Adults (18-65 years) Page 11 of 21 Evidence: Each person has their own kitchen and these were stocked with a selection of fresh and frozen produce. People explained how they are supported to develop their cooking skills and plan their menus. A healthy diet is being encouraged but individual choice is respected Care Homes for Adults (18-65 years) Page 12 of 21 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal care and health care needs are met, promoting their dignity and wellbeing. Satisfactory arrangements are in place for the handling of medication. Evidence: Personal care and support needs are clearly documented and people are being supported to develop their independence in these areas. People are provided with reminders and guidance with regards to their personal care and people said they were very satisfied with this aspect of their support. People said they received the support they needed and that they were treated with respect by the staff team. Records are kept of health appointments and people are supported to have regular check ups. No medication is currently administered in the service but training is provided to staff and appropriate facilities are available if required. Care Homes for Adults (18-65 years) Page 13 of 21 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides and promotes a safe environment for people in which they are respected and treated with dignity. Evidence: All staff have completed training in adult protection and also the managing of challenging behaviors. Staff spoken to said they felt confident to raise concerns and that these would be responded to positively. Both people living in the home said they felt safe where they lived and were able to raise concerns, or complain about things if they wished to. However both people were unclear about the formal complaints process which is available to them and it is recommend that this be regularly explained and recorded. People gave examples of how their privacy was respected and how the staff treated them with respect. Care Homes for Adults (18-65 years) Page 14 of 21 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from a home that is well maintained and decorated throughout and provides a comfortable homely environment. Service users are supported and encouraged to personalize their living space. Evidence: The home has been decorated and furnished to a good standard and people have purchased some of their own furniture and fittings. Each person has what is essentially their own living area, with separate bathroom and kitchen and there own living room. People have personalized their part of the home and are encouraged and supported to take as much responsibility as is possible for the cleaning and maintenance. All parts of the home were clean and hygienic at the time of the inspection. The home is well situated to access local amenities and support the development of independence skills. Care Homes for Adults (18-65 years) Page 15 of 21 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are supported by a staff team that relates well to them and has a positive approach to their care and support. A good recruitment and selection framework helps to safeguard the people living in the home. Evidence: All staff must complete a three month induction which covers a variety of issues and involves training in first aid, health and safety, managing challenging behavior and adult protection. Once a probation period is completed staff are supported to undertake NVQ training. Staff spoken with said they felt well supported and that they received good informal and regular formal supervision. People living in the home were very positive about the staff team and said they got on well and were able to discuss issues or concerns. People stated that staff treated them with respect and were always willing to listen. The recruitment records were checked and evidence was seen that all the required checks were being completed and recorded. Care Homes for Adults (18-65 years) Page 16 of 21 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. Service users benefit from a service that is well managed and organized and committed to providing high quality care and support. Evidence: This was the first inspection of this service since it became registered and it had only been fully occupied for two weeks at the time of this visit. The newly registered manager has established professional systems and working practices. The staff team is being provided with leadership and direction in terms of developing a user led service that is organized to promote independence and personal growth for the people living there. Staff said they found the management of the home, and the Provider, approachable and responsive to issues that are raised and also receptive to new ideas and suggestions. People living in the home were very positive about the manager and said they could talk to them if they wished to about things that concerned them. All the required health and safety checks were being completed and recorded, Care Homes for Adults (18-65 years) Page 17 of 21 Evidence: including fire safety. The home has had regulation 26 inspections undertaken and feedback supplied to the manager. As the service has only been operating for six months no formal quality assurance has been undertaken Care Homes for Adults (18-65 years) Page 18 of 21 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 19 of 21 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 1 9 Greater clarity and detail could be provided in the risk assessments around independent travel and supervision in the community. Regular guidance could be given to the people using the service about the formal complaints procedure that is available to them 2 22 Care Homes for Adults (18-65 years) Page 20 of 21 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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