Care Home: Netley Waterside House

What the care home does well There are good systems to assess people`s needs before they visit the service. This helps to assure people that the service will be able to meet their needs. People`s needs are set out in clear care plans and risk assessments. This gives staff the information they need to provide the right care for people. People are supported to take part in an excellent range of activities that are provided as part of people`s holiday experience. The service has good systems to meet people`s personal and health care needs and to manage medication safely. There are good systems for dealing with complaints and responding to allegations of abuse. This helps to keep people safe and gives people confidence that complaints will be taken seriously and responded to. The service is well managed. There are good systems to assess the quality of the service provided and plan improvements. What has improved since the last inspection? Some communal areas of the building and some bedrooms have been refurbished and re-decorated since the last inspection. The systems for checking staff before they start work in the service have been improved. This helps to protect people who use the service. Staff training is now spread throughout the year rather than in two blocks. This helps to ensure staff complete the training courses they need promptly. What the care home could do better: We have not made any requirements as a result of this inspection. The service has a plan of improvements they would like to make and the manager should ensure these are implemented. Key inspection report Care homes for adults (18-65 years) Name: Address: Netley Waterside House Abbey Hill Netley Abbey Southampton Hampshire SO31 5FA     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: Craig Willis     Date: 2 6 0 1 2 0 1 0 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 25 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 25 Information about the care home Name of care home: Address: Netley Waterside House Abbey Hill Netley Abbey Southampton Hampshire SO31 5FA 02380453686 02380455449 hwaller@vitalise.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Vitalise care home 39 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia physical disability Additional conditions: The maximum number of service users to be accommodated is 39 The registered person may provide the following category of service; Care home with nursing (N) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category: Dementia (DE) Physical disability (PD) Date of last inspection Brief description of the care home Netley Waterside House is a holiday centre owned by the charity Vitalise. It is registered as a care home with nursing and can accommodate up to 39 people. People using the service may be accompanied by their carers/relatives. The philosophy of the centre is to provide quality planned breaks for people with disabilities and their carers. That is based on providing the care and support that individuals need as well as arranging a social programme of events and special interest activities. The centres accommodation is arranged on two floors and it is fitted with equipment to meet Care Homes for Adults (18-65 years) Page 4 of 25 Over 65 0 0 39 39 2 2 1 0 2 0 0 8 Brief description of the care home peoples physical needs. Shared and single rooms and suites all have en-suite facilities and the majority are fitted with overhead hoists. The centre is located in the village of Netley, which has shops, pubs and public transport links. Transport is provided for the outings organised by the centre. Care Homes for Adults (18-65 years) Page 5 of 25 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: The evidence used to write this report was gained from a review of the information we have received since the last inspection, including the annual quality assurance assessment completed by the manager. A site visit was made to the service on 26 January 2010 and lated approximately 7 hours. During the visit we spoke with people staying at the service, staff on duty and the manager. We received surveys from 20 people who use the service and 13 staff. We viewed communal areas of the service and a sample of bedrooms and inspected documents relating to the running of the service. Care Homes for Adults (18-65 years) Page 6 of 25 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 7 of 25 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 25 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. There are good systems to assess peoples needs before they visit the service. This helps to assure people that the service will be able to meet their needs. Evidence: Before they visit to the service people complete a booking form in which they or their representative state what their needs are. Information is also obtained from other sources where necessary, for example health professionals and social workers. One of the services nursing staff contacts people by telephone before their stay to confirm the details on the booking form and obtain up to date information on any needs that may have changed. Each person has an assessment with one of the nurses when they arrive for their stay which is used to develop their care plans and risk assessments. During the visit we inspected the records of four people using the service. Each person had a full assessment of their needs that had been completed before their stay and on arrival at Netley Waterside. People spoken with during the visit reported that their needs had been assessed in the manner described. 13 care staff members completed a survey for us. 12 said they always receive up to date information about the needs of the people they support and care for and 1 said they usually do. Care Homes for Adults (18-65 years) Page 9 of 25 Evidence: The manager reported that since last year the brochure has been updated following comments received by people who use the service. Care Homes for Adults (18-65 years) Page 10 of 25 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. The service has good care planning and risk assessment systems that give staff clear information about how to meet peoples needs. Evidence: We inspected the records of four people who were using the service on the day of the visit. Each person had a set of care plans that had been developed from their needs assessments. The plans contained information about how staff should meet the persons assessed needs. The plans were specific to the person, for example including information about specific equipment people use or the way in which people communicate. 20 People who have used the service completed a survey for us. 17 said staff always listen to them and act on what they say, 2 said this usually happens and 1 said it never happens. All 20 said they make decisions about what they do each day. Each person has a set of risk assessments, developed from their initial needs assessment. These documents include clear information about the actions needed to manage any identified hazards. Examples of risk assessments in the files seen Care Homes for Adults (18-65 years) Page 11 of 25 Evidence: included moving and handling, people managing their own medication, mobility and pressure areas. Evidence was seen of the documents being updated during a persons visit as a result in a change in the assessed risk. Care Homes for Adults (18-65 years) Page 12 of 25 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 supported to take part in an excellent range of activities that are provided as part of peoples holiday experience. The service provides a choice of food that most people enjoy. Evidence: Netley Waterside House provides a holiday centre for people and there are activities organised each day and evening. Each day there is a trip organised to a local place of interest and there are evening activities such as musicians, a quiz and karaoke. The centre has books and DVDs that people can use and there is wireless internet access in some parts of the building. The centre operates theme weeks where there is an emphasis an a particular type of entertainment. Details of the entertainments and themes are available in the centres publicity material. 20 people who have used the service completed a survey for us. 18 people said they could do what they want to during the day, in the evening and at the weekends. One Care Homes for Adults (18-65 years) Page 13 of 25 Evidence: person said they would like different activities in the evenings and 1 person did not answer the question. Comments received from people included that the service provides good food choices and good days out, provide a very good holiday, caters extremely well for my individual needs, I am always treated with dignity and respect and the trips are really good. The service has a planned menu that offers a choice of meals. People spoken with said the food was good and they enjoyed sharing meals with other guests. Peoples specific dietary needs are assessed when they arrive at the centre and recorded in the care plan to ensure the right support is provided. Care Homes for Adults (18-65 years) Page 14 of 25 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. The service has good systems to meet peoples personal and health care needs and to manage medication safely. Evidence: The care plans inspected during the visit contained details of peoples personal care needs and how they should be met. People spoken with reported that staff were aware of their needs and were able to meet them in a manner that maintained their privacy and dignity. People spoken with also confirmed that volunteers did not provide support they were not trained to do, for example supporting people to use a hoist. We spoke with two volunteers during the visit who confirmed that they did not provide any moving and handling support. Comments received from people using the service included, care excellent, staff make sure my needs are met and overall the care is very good. Of the 20 people who have used the service that completed a survey for us, 18 said they were always treated well my the manager and staff and 2 said they usually were. Information about peoples specific medical conditions is obtained from their GP or specialist nurse as part of the assessment process. The service has an arrangement Care Homes for Adults (18-65 years) Page 15 of 25 Evidence: with a local GP who holds a surgery in the service each week and is available for consultations at other times. One person staying at the service on the week of the visit had become ill and was admitted into hospital for a night. The records for this person included the discharge notes from the hospital and details of a change to their prescribed medication. Staff had contacted the persons family member to inform them of the situation and to pass on information about the need for a follow up GP appointment when they returned home. People are able to manage their own medication following an assessment that it is safe for them to do so. Details of this assessment were seen for one person whose records were inspected. Where people do not want to or are not able to manage their own medication staff hold and administer it. The service has a clinical room with medication trolleys and cupboards for secure storage. There is a medication fridge that is regularly checked to ensure it is at the right temperature. The medication administration records for the week of the visit were inspected and had been fully completed. All medication was recorded when it was received into the service, administered to people and returned to them at the end of their stay. At the time of the visit the service did not hold any controlled drugs for people. There was a suitable controlled drug cupboard and controlled drug register that was used when necessary. Care Homes for Adults (18-65 years) Page 16 of 25 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 service has good systems for dealing with complaints and responding to allegations of abuse. This helps to keep people safe and gives people confidence that complaints will be taken seriously and responded to. Evidence: The service has a complaints procedure, which is provided to people at the start of their stay. 20 people who recently used the service completed a survey for us and 19 reported that they know who to speak to if they are not happy and how to make a complaint. People spoken with during the visit reported they were confident that any complaint they made would be taken seriously and investigated. Complaints are recorded in a log, with details of the outcome of investigations and what action was taken as a result. Complaints are reviewed internally for trends and action is taken to resolve common issues, for example, additional staffing has been provided to ensure people receive prompt support in the evenings at the end of events. The service has procedures in place to respond to allegations of abuse and has a copy of the Hampshire safeguarding procedures. Records are kept of any safeguarding concerns. Staff spoken with demonstrated a good understanding of different types of abuse and actions they should take if abuse is witnessed, reported or suspected. Care Homes for Adults (18-65 years) Page 17 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service provides a clean, comfortable and safe environment for people on their holiday. Evidence: All of the communal areas of the service were inspected during the visit, along with a sample of the bedrooms. Since the last inspection of the service, one of the wings and several bedrooms have been re-decorated. All of the areas seen were clean and well maintained. All but three of the bedrooms have overhead hoists, enabling people to transfer between the bed and shower room. The service has infection control procedures in place and there is a laundry capable of safely washing soiled clothing. Of the 20 people who completed a survey for us, 13 said it was always clean and fresh and 7 said it usually was. Care Homes for Adults (18-65 years) Page 18 of 25 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. The service has good systems for checking staff before they are employed and ensuring there are sufficient, well trained staff available. This helps to protect people and ensure their needs are met. Evidence: The manager reported that all care staff who have completed their probationary period have either achieved or are currently undertaking the National Vocational Qualification in care at level 2 or 3. Staff spoken with during the visit reported that staffing levels were generally sufficient to meet peoples needs. The manager reported that they have introduced an additional staff shift in the evening to provide support to people more promptly at the end of evening events. This need was identified following an analysis of trends in concerns and complaints received. People spoken with during the visit reported that there were sufficient staff at all times to meet their needs. Of the 13 staff who completed a survey for us, 10 said there were always or usually sufficient staff to meet peoples needs and 3 said there were sometimes sufficient staff. The manager reported that staffing levels were flexible, depending on the needs of the people that were staying at the service. There are 2 nurses in the morning and 1 in the afternoon and overnight on most days. On Saturday when most people arrive there are usually 5 nurses available to complete the needs assessment process. The number of care staff is determined by the needs of the people accommodated. On the Care Homes for Adults (18-65 years) Page 19 of 25 Evidence: day of the visit there were 6 care staff available during the day. In addition to the paid staff team, the service has a number of volunteers. There are procedures in place setting out the level of personal care support volunteers can provide, which varies depending on their skills and experience. Volunteers are mostly used to provide company and assistance , although some with more experience and training will provide some personal care support. Volunteers spoken with said they did not come under pressure to provide care and support that was beyond their skills and experience. The manager reported that they have changed the process for recruiting new staff since the last inspection to ensure all checks are in place before people start working in the service. We inspected the recruitment records of three newly recruited staff. The service had obtained an enhanced Criminal Records Bureau disclosure, two written references and identification documents for all three before they started work. We also saw evidence that Criminal Records Bureau disclosures had been obtained for volunteers. Once employed staff complete the skills for care common induction standards and other internal training. Volunteers spoken with confirmed that they received a thorough induction about their role and ensuring that they maintain peoples privacy and dignity. Since the last inspection the training programme has been improved and courses are now held each week as opposed to two blocks of training during the year. Courses provided include health and safety, food hygiene, first aid, safeguarding people from abuse, moving and handling, complaints, head injury, epilepsy, vehicle safety, infection control, stoma care, paralysis, Alzheimers and working with volunteers. The manager responsible for training keeps a record of all training completed by staff and dates of when refresher courses are due. Care Homes for Adults (18-65 years) Page 20 of 25 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. The service is well managed and there are good systems to assess the quality of the service being provided and plan improvements. Evidence: The manager has been in post for a number of years and is a registered nurse with management qualifications. Staff spoken with said they receive good support from the management team and said they felt valued in their role. A senior manager for Vitalise visits the service each month to assess the quality of the service being provided. Reports of these visits are sent to the manager and we inspected the last three reports. Each report has a review of actions from the previous report and actions arising out of that visit. Each action has a staff member listed as responsible for its completion. The reports include a review of complaints and any safeguarding issues, the environment, staffing issues and service development issues. Regular audits are completed of the service being provided, including catering, cleaning, care provision, nursing notes and medication. The management team hold a weekly meeting with people using the service to receive feedback about their stay. Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: The results of these audits and meetings are used to create a service development plan, setting out how the service plans to improve. The manager reported that all equipment in the service is regularly serviced and maintained to ensure it is safe. We sampled the servicing records of the gas system and hoists, which were all in date. The service has a set of workplace risk assessments that are regularly reviewed and updated. These set out action that should be taken to manage the identified risks. Care Homes for Adults (18-65 years) Page 22 of 25 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 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 24 of 25 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. Care Homes for Adults (18-65 years) Page 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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