Care Home: Neil House

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What the care home does well The home has a robust admissions process and staff were very positive about how well people had settled in to the home. An assessment by an autism consultant stated that one service user was "looking remarkably relaxed and comfortable. this is a great achievement on the part of the staff." People`s individual support plans contain detailed information about their needs and preferences giving staff all the information needed to deliver responsive and person centered support. There was evidence of considerable effort being made to support people with their communication. Picture cards were used to help with menu planning and to explain which staff were coming on shift; Support plans contained photos, pictures and symbols to make them more accessible and symbols and pictures were used to identify areas and items around the home. This helps to give people the information they need to make choices about their lives. People living at Neil House have access to a wide range of different activities including music, computers, sailing, visits to the pub and going for walks. One person was involved in a conservation project and there is an allotment that people can visit. People are encouraged to maintain relationships with their families and friends and to develop new friendships and relationships. Staff stated that the people living at Neil House appeared to all be getting on well together and that they have begun to establish a good relationship with their neighbours. The property has recently been fully refurbished and redecorated throughout and is clean, hygienic and well maintained. All of the bedrooms were spacious and comfortable and there was evidence that people were encouraged and supported to personalise their bedrooms to reflect their individual taste and style. Staff undertake a thorough induction and then go on to complete a comprehensive programme of training including first aid, fire prevention, food hygiene, medication awareness, infection control, moving and handling, health and safety, epilepsy, and autism awareness. All staff have completed training on safeguarding adults. One staff member commented "We are a new team but we all work well. I enjoy coming to work." The homes recruitment process is well managed and protects the people who live at Neil House. What has improved since the last inspection? This is the first key inspection to be carried out on this service. What the care home could do better: It is recommended that service user contracts are signed by the service user, or their representative, and the registered manager.The service needs to ensure that the total number of tablets received and balances carried forward are entered on the medication administration records and arrangements for the storage of medication are reviewed to ensure compliance with the latest guidelines from the Royal Pharmaceutical Society of Great Britain. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Neil House 21 High Street Corby Northants NN17 1UX     The quality rating for this care home is:   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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Catherine Perrins     Date: 2 2 0 9 2 0 0 8 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. the things that people have said are important to them: They reflect 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 © (2008) 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: Neil House 21 High Street Corby Northants NN17 1UX 01536403364 01536402253 kathrynclarke@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) David John Smith Type of registration: Number of places registered: Consensus Support Services Ltd care home 4 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: No person falling within the category of MD, Mental Disorder excluding Learning Disability or Dementia may be admitted to Vale House unless that person also falls within the category LD, Learning Disability, ie Dual Disability The maximum number of persons accommodated at Neil House is 4 Date of last inspection Brief description of the care home Neil House is an extended detached property registered to accommodate up to four people with learning disabilities. The home has been closed for a period of time in order to undergo a full renovation and redecoration. It reopened in earlier this year. It is in Corby close to local shops and facilities. Neil House is owned by Consensus Support Services. 4 2 Over 65 0 0 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: 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 is an overview of what we found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. Prior to this statutory inspection, a period of five hours was spent in preparation. This comprised reviewing the Annual Quality Assurance Assessment, a document sent to us by the provider, the service history and other documentation. There have been no complaints or Safeguarding Adults Allegations about this service. Care Homes for Adults (18-65 years) Page 5 of 27 The Commission have a focus on Equality and Diversity and issues relating to this are also included in the main body of the report. Two site visits to the home were conducted the first taking place over a period of four hours. The manager was not present for this visit. A follow up visit was necessary in order to access staff files as these were kept in a locked cabinet for which the manager held the key. The manager was present for the follow up visit which lasted 2 hours. During these visits the inspector made observations and spoke to people living at the home and to staff. A limited tour of the premises was conducted which involved viewing the communal areas and a selection of the private accommodation. Case tracking is the method used during inspection where all aspects of peoples care and experiences was reviewed,including individual plans of care and associated documentation. three people were case tracked during this inspection. The service specialised in the care of people who have learning disability, some have limited communication abilities and as such were unable to recollect or to fully express their views about this service. In these circumstances observations are used to inform the inspection activity. The current fees range from 1,550 to 1,850 pounds per week with extra charges for clothing, toiletries and personal items. What the care home does well: What has improved since the last inspection? What they could do better: It is recommended that service user contracts are signed by the service user, or their representative, and the registered manager. Care Homes for Adults (18-65 years) Page 7 of 27 The service needs to ensure that the total number of tablets received and balances carried forward are entered on the medication administration records and arrangements for the storage of medication are reviewed to ensure compliance with the latest guidelines from the Royal Pharmaceutical Society of Great Britain. 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 8 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 9 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 statement of purpose and service user guide clearly says what service will be offered. Prospective service users can be confident their needs will be assessed, and that the home will meet their needs and aspirations. Evidence: The home has developed good information about life in the home for people who are considering moving there. A detailed Statement of Purpose and Service User Guide were seen. Both were written in plain English and contained symbols, colour drawings and photographs making access to the information easier for the people with learning disabilities. Three people are currently living at Neil House. One person moved in June 2008 and the other two approximately three weeks prior to the date of inspection. Records demonstrated that comprehensive assessments were carried out prior to people moving in to the home. This process involved the person themselves, their family, the staff and management of Neil House as well as other relevant professionals. Staff Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: confirmed that visits and overnight stays occurred prior to people moving in, this allowed people the chance to see what it might be like to live at Neil House before deciding to move in. It also means that staff are able to fully assess people to make sure that Neil House can meet their needs and aspirations. Evidence suggested that the admissions process had been carefully managed. Staff were very positive about how well people had settled in to the home stating that other professionals involved were particularly impressed with the progress made by one service user. An assessment by an autism consultant stated that he was looking remarkably relaxed and comfortable. this is a great achievement on the part of the staff. When they move in people are given a contract which contains clear information about fees and extra charges and detailed the terms and conditions of their placement. The home needs to ensure that the service user or their representative signs these. Care Homes for Adults (18-65 years) Page 11 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 who live at Neil House have detailed and person centred support plans. This gives them opportunities to make everyday choices and to benefit from responsive and individual care and support. Evidence: Each person living at Neil House has an individual support plan. These are detailed and well presented making it easy to access the relevant information. Everyone has a key worker who works closely them and makes sure that their support plan is up to date. This ensures that peoples needs are met and their preferences respected. There was evidence that support plans were being reviewed on a regular basis and updated as required. The individual support plans document details of individuals physical, emotional, cultural and spiritual needs as well as providing information about peoples likes, Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: dislikes and preferences. This gives staff all the information needed to deliver responsive and person centered support to the people living at the home. Daily records maintained by staff are detailed and informative, with up to two written entries per day on each persons daily progress notes. This helps to ensure that staff support is consist and informed. Staff were still in the process of further developing support plans for the newest admissions. There was evidence of considerable effort being made to support people with their communication. Picture cards were used to help with menu planning and to explain which staff were coming on shift; Support plans contained photos, pictures and symbols to make them more accessible and symbols and pictures were used to identify areas and items around the home. This helps to give people the information they need to make choices about their lives. People are able to move freely around the home and to choose how to spend their time. They are encouraged to participate in the running of the home for example assisting with cleaning, cooking and laundry. Individual support plans contain detailed risk assessments. These cover the areas necessary to ensure that people were safe and that unnecessary risks were minimized whilst promoting people to live active and fulfilling lives. Records show that people have access to independent advocates which they can access to help them make decisions if they need to. Care Homes for Adults (18-65 years) Page 13 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 are encouraged to be as independent as possible with a good range of leisure activities available that enable them to lead full and active lives. Evidence: Records show that people living at Neil House have access to a wide range of different activities both inside and outside the home including music, computers, sailing, visits to the pub and going for walks. One person was involved in a conservation project and there is an allotment that people can visit. The home has a vehicle to assist people in getting out to their chosen activities. Each person has a key to their bedroom door and staff were seen knocking and awaiting permission before entering. Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: People are encouraged to maintain relationships with their families and friends and to develop new friendships and relationships. Staff stated that the people living at Neil House appeared to all be getting on well together and that they have begun to establish a good relationship with their neighbours. The menu for the week was observed and looked to be varied and nutritious. On the day of inspection breakfast was cereal and toast, lunch was ham and beetroot wrap with yoghurt and tea was tuna pasta salad and angel delight. On the day of inspection two service users were out at college. Staff explained that when attending college people chose their own packed lunches. Care Homes for Adults (18-65 years) Page 15 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have an individual plan of care, which demonstrates that, their health; personal and social care needs are fully met. Evidence: Records show that service users have access to a range of health and social care professionals such as general practitioners, opticians, podiatrists and psychologists. There was evidence of health promotion and preventative health care such as general health checks, weight monitoring and advice and support to manage specific health issues. Detailed care plans were in place for diet, physical health and tissue viability. Records showed that service users were assessed for managing their own medication. There was evidence that the administration of medication was well managed. Medication Administration Records showed that medication is given as prescribed and records are well maintained, however the service needs to ensure that the total number of tablets received and balances carried forward are entered on the medication administration records. There are adequate arrangements in place for the storage of Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: medication however this should be reviewed to ensure it complies with the latest guidelines from the Royal Pharmaceutical Society of Great Britain. Care Homes for Adults (18-65 years) Page 17 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a robust complaints procedure and good staff awareness and attitudes regarding the Safeguarding of Adults ensuring people are safe and were well protected. Evidence: Service users have access to a complaints procedure that has been written in plain English and uses pictures and symbols to make the information more accessible. It contains appropriate information about the process, times scales and who to contact to make a complaint. A copy of the services whistle blowing policy was displayed in the hallway. Staff were aware of how to raise concerns and their responsibilities under the locally agreed safeguarding adults procedures. Staff training records evidenced that staff have received training on safeguarding adults. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The Standard of the environment is good, providing service users with a safe and comfortable place to live. Evidence: Neil House is an extended detached property that has recently been refurbished and redecorated throughout. The communal areas consist of a lounge, dining room and quiet sitting room all of which are spacious and comfortable. There is also a kitchen, utility room / laundry, two downstairs toilets and an office. There was evidence that these areas were being made homely and staff explained that they were still in the process of adding further personal touches. Each person has their own bedroom with an en suite shower room. All of the bedrooms were spacious and comfortable and there was evidence that people were encouraged and supported to personalise their bedrooms to reflect their individual taste and style. People also have use of a communal bathroom if they wish to take a bath rather than a shower. Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: Outside the property there is a secure garden area which people can access as they wish and a driveway and car park which is shared with the property next door. The home was clean, hygienic and well maintained throughout. The Statement of Purpose for the home states that the property is accessible for people with disabilities who are able to use stairs unaided as the bedrooms are on the first floor and the property does not have a lift. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Suitably trained staff are provided in adequate numbers to ensure service users needs can be met. Evidence: The staff rota demonstrated that there were adequate numbers of staff on duty to meet the needs of the people living at Neil House. Staff explained that the same member of agency staff covered any shortfalls in the rota to ensure consistency. One staff member commented We are a new team but we all work well. I enjoy coming to work. Records show that staff have supervision sessions with the manager every month to six weeks. Staff stated that there was no time limit set on supervision and that staff could discuss any issues they wished to. Staff records show that recruitment practice is robust and protects the people who live at Neil House. The necessary Criminal Records Bureau Checks had been undertaken and references obtained. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: Each staff member had an induction file which shows that they have had a thorough induction in line with the common induction standards. Records show that staff have also attended a comprehensive programme of training including first aid, fire prevention, food hygiene, medication awareness, infection control, moving and handling, health and safety, Protection of vulnerable adults, Epilepsy, and autism awareness. Staff also have access to the Learning Disability Qualification and four staff are currently undertaking National Vocational Qualification level two. 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. Appropriate leadership, guidance and direction means that the home is well managed in the best interests of the people who live there. Evidence: The current manager was appointed on 1st September, 2008 having previously worked as a deputy manager. She will be registering with the Commission as the registered manager for Neil House and is currently undertaking her registered manager award. Staff spoken with felt that the Manager was easily accessible to them and was willing to discuss any issues, guide them in practice and offer support. No hazards were observed in the home and records were well maintained indicating that the required health and safety audits and checks had all been carried out. The manager confirmed that she checks all risk assessments on a monthly basis to ensure that they are up to date and that she conducts a weekly financial audit to check Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: that all the monies are correctly accounted for. The manager explained that the registered provider has a number of quality audits planned for Neil house as part of their routine monitoring. These will include service user questionnaires and a detailed audit against all of the national minimum standards. Care Homes for Adults (18-65 years) Page 24 of 27 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 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 1 20 13 The storage of medication should be reviewed to ensure that it complies with new guidance issued by the Royal Pharmaceutical Society of Great Britain. This is required to ensure that all medication, including controlled drugs, can be stored safely. 26/01/2009 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 5 It is recommended that the home ensure service user contracts are signed by the service user, or their representative, and the registered manager. 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 © (2008) 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. 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