Care Home: Neville Court

What the care home does well The home had a positive, friendly and welcoming atmosphere, and staff were happy to tell us about their experience while working with people who use the service. They were excellent at meeting people`s health and personal care needs. A relative spoke highly of the manager and her staff and expressed complete satisfaction. The staff are very good at implementing strategies to manage people`s behavious and they act swiftly to ensure `Deprivation of Liberty` procedures are implemented. They have clear evidence to confirm they act in people`s best interests which includes comprehensive risk management systems. Staffing levels were appropriate to the needs of the service and staff have the skills and competencies to ensure they can meet people`s needs. The service have good systems to ensure information is shared which includes regular team meetings and one to one supervisions. What has improved since the last inspection? There were no requirements from the last inspection. The manager shows a genuine commitment to driving up the quality of service provided to people and she has a dedicated workforce which follows her guidance and leadership. What the care home could do better: The service could improve the numbers of staff who have attained National Vocational Qualifications (NVQ`s) as they currently have less than the required 50% qualified care staff. The organisation has recognised the shortfalls and they are planning to undertake their own assessments once they have trained sufficient staff to become NVQ assessors. Key inspection report Care homes for adults (18-65 years) Name: Address: Neville Court Neville Avenue Kendray Barnsley South Yorkshire S70 3HF     The quality rating for this care home is:   three star excellent 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: Valerie Hoyle     Date: 2 2 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: Neville Court Neville Avenue Kendray Barnsley South Yorkshire S70 3HF 01709565822 01709565824 doakes@exemplarhc.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Barnsley Healthcare Ltd Name of registered manager (if applicable) Ms Dawn Oakes Type of registration: Number of places registered: care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia physical disability Additional conditions: One service user as identified on the variation application dated 30.11.05, may be accommodated at the home. Date of last inspection Brief description of the care home Neville Court is a purpose built home providing care for people with physical and mental disabilities. The ground floor accommodates the entrance area, a meeting/visitors lounge and a activity room. The upper two levels are the Bretton and Cannon suites; each wing accommodates 10 people. The wings are spacious and can accommodate wheelchair users; there are two lounges and a dining area on both wings. The bedrooms are purpose built; they are spacious and include en-suite facilities. There is access to all levels by stairs or passenger lift. There are security Care Homes for Adults (18-65 years) Page 4 of 25 Over 65 0 0 20 20 Brief description of the care home keypads to doors and the lift for the residents safety. The home stands in its own grounds, with gardens and parking space. It is well located to access local shops and pubs and there is public transport close by. The home is situated in the Kendray area of Barnsley; it has easy access to the town, collage, and leisure facilities. The weekly fees for care offered at the home at 22nd January 2010 range from £1427.49 to £3072.56. The homes statement of purpose, service user guide and complaints procedure are displayed within the entrance of the home and are in appropriate formats. Copies of previous inspection reports can be obtained from the manager. 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: three star excellent 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 quality rating for this service is 3 stars. This means that the people who use the service experience excellent quality outcomes. An Annual service Review (ASR) was carried out on the service on 1st August 2008. The outcome of the review confirmed people continued to receive a excellent level of service. This unannounced inspection took place over 5 hours starting at 09:30 finishing at 14.30. The visit included a partial inspection of the home. Two people who use the service, the manager and deputy manager, four staff and a relative were spoken to during this inspection, their views are included within this report. Surveys were not used in this inspection, however we were provided with the results of the homes quality assurance surveys. Care Homes for Adults (18-65 years) Page 6 of 25 Occupancy at the home on the day of this inspection was 16, with 9 people receiving care on Bretton unit and 7 people on Cannon unit. Two peoples care plans were looked at. Policies relating to medication, complaints, protection and handling of peoples money were looked at. Five recruitment and training records were looked at to assess how people were protected from harm. Procedures and risk assessments relating to health and safety were looked at and discussed with the manager. The Annual Quality Assurance Assessment (AQAA) was sent to the home and returned to us on time, which demonstrates responsiveness and cooperation. An AQAA is a self-assessment and a dataset that is filled in once a year by all providers whatever their quality rating. It is one of the main ways that we will get information from providers about how they are meeting outcomes for people using their services. The AQAA also provides us with statistical information about the individual service and trends and patterns in social care. Care Homes for Adults (18-65 years) Page 7 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 8 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 9 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service receives a full assessment before they are admitted into the home. Evidence: All new people receive a comprehensive needs assessment before admission into the home. The assessments are generally carried out by the manager or her qualified nurses and they all have the skills, competencies and experience working with younger adults. The service was highly efficient in obtaining a summary of any other assessments undertaken through care management arrangements. Individuals and their families are supported and encouraged to be involved in the assessment process. Information is also gathered from a range of sources including relevant health and social care professionals. The assessments looked at focused on acheiving positive outcomes for people. This included ensuring the facilities, staffing and specialist services provided by the home meets the needs of the individual. A visiting relative was able to confirm the admissions process. He told us that the home had provided an excellent environment Care Homes for Adults (18-65 years) Page 10 of 25 Evidence: for their relative to spend their time. He confirmed staff had the skills and competencies to meet their needs and they were caring and efficient. Care Homes for Adults (18-65 years) Page 11 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home promotes philosphies to enable people to meet their full potential, with clear care plans and comprehensive risk assessments to maximise their safety and wellbeing. Evidence: Two care plans were looked at, they were comprehensively written and reflected the individual needs of the people. Staff were able to confirm good knowledge about the needs of individuals and they said they were involved in meetings to review the persons care. Information about the actions and responses required by staff to ensure individuals behaviour was managed was very detailed. This means staff were consistent in their approach. Staff have attended None Abusive Psychological and Physical Intervention (NAPPI) training to a good level which supports them when managing behaviours. Comprehensive risk assessments were in place. They described restrictions on choice and freedom of movement and there was evidence of Deprivation of liberty assessments and best interests meetings which had taken place. Care plans included information relating to nutrition, preferences, handling Care Homes for Adults (18-65 years) Page 12 of 25 Evidence: assessments and hobbies and interests. A keyworker system is in place and staff work closley with individuals to build relationships. They have responsibility for supporting people with their mental health appointments and any other medical appointments. There is clear evidence that the care plans are regularly reviewed, including meetings with multi agencies involved in the persons care. A relative said the staff were very good at keeping them up to date with any care changes. Staff interviewed confirmed they were fully informed about the care needs of people using the service. They said they were supported by the manager and qualified staff and they were able to have regular discussions about how best to support people. Staff were able to support people with their personal monies and we were able to look at the financial management systems. There was clear records which we checked and were accurate and easily auited. Care Homes for Adults (18-65 years) Page 13 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 able to make choices about how they spend their time, and staff support people to access activities which meets their expectations. Evidence: People are able to access a range of activities both in the home and in the community. There is two activity coordinators who work every day in the week between them and they are both able to drive the homes mini bus which helps people to access trips out for meals, discos and places of interests. Transport is also used to help people maintain family links and visits to local shops. Activites within the home included crafts, cooking, bingo and quizes. The coordinators keep good records which help to identify activites that have taken place and indicates if people enjoy the activites and trips. Relatives are encouraged to be part of the home and involved in the care of their Care Homes for Adults (18-65 years) Page 14 of 25 Evidence: relative. One relative said he visited daily and was always made to feel welcome and was invited to have meals with his relative. People are also supported to visit relatives with the support of staff. Holidays away from the home were organised and paid for by the registered providers. Staff provides escorts which is usually more than one to one to ensure people are safe and given good oportunities to take part in activities. The activity coordinator told us recent holidays had taken place in Great Yarmouth and there were plans to go to Butlins for a northern soul festival. Mealtimes were well managed with good staffing levels which ensures people receives the support they need. We observed lunch which was served to the two units via a heated trolley. People were given a choice of fried or poached fish or scampi. The meal was served with mashed or chipped potatoes and there was also a choice of sweet. People said they enjoyed the food at the home. The cook had a good understanding of peoples dietry needs which included likes and dislikes and special diets. Care Homes for Adults (18-65 years) Page 15 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: The qualified staff takes lead responsibility for the healthcare needs of people, although keyworkers also have opportunity to be involved in medical appointments. The care plans are comprehensive regarding peoples mental and physical health, and this helps staff to understand peoples needs and behaviours. Staff confirmed they are provided the support they need to manage peoples mental health. We looked at medcation systems which were well managed. Medication Administration Records (MAR) confirmed people receive their medication as prescribed. There were detailed guidlines for all people as to when PRN medication (as required) should be administered. Medication was securley stored and procedures were in place to safely administer controlled drugs. The qualified nurses have responsibility for administering medication to people and the manager undertakes quality audits to ensure systems are safe. 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. People who use the service have access to a robust, effective complaints procedure, and were protected from abuse, and have their rights protected. Evidence: The home has a complaints procedure that is available to people and their visitors. The AQAA told us that they had received and investigated two complaints which were upheld. As a result of the two complaints the home have taken appropriate actions to improve the service. We discussed the complaints with the manager who confirmed outcomes for people. We looked at the homes quality assurance surveys which confirmed relatives were satisfied with the procedures for raising concerns, and satisfied with the way concerns are acted upon and resolved. There is robust safeguarding procedures which keep people safe from abuse and harm. The manager has responsibilities to ensure staff are familiar with the procedures and the action they would need to take to keep people safe. Staff confirmed they had attended training to recognise the signs of abuse, and they said they would know what action they would take if they suspected an incident of abuse had taken place. The AQAA told us that they had made one referral to safeguarding aduts which had been investigated and resulted in action being taken by the home. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a well-maintained safe, clean and hygienic environment which meets the needs of people who use the service. Evidence: The home was clean and fresh, and the furniture was good quality. People were able to move around the units, and staff helped to provide a calm and homely atmosphere. All areas of the home were decorated to a good standard and there is a rolling programme of refurbishment. The main entrance was being redecorated on the day of the inspection and the corridors were bright and clean. All areas were specifically designed to enable staff to move people comfortably in their chairs. Specialist equipment was available throughout the building and people had a choice of the type of bathing facility, to ensure their safety. Peoples personal space were well designed and the facilities were suitable for people residing in the room. People were encouraged to personalise their room and bring in pictures and small items of furniture to help them feel at home. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home were trained, skilled and in sufficient numbers to support the people who use the service. Robust recruitment procedures ensures people were safe and protected from harm. Evidence: Staffing was arranged to meet the needs of the people who use the service. The levels fluctuate depending on the needs and ocupancy. We were told that there was currently one qualified and four carers on each of the two units during the day and one qualified and two carers on each of the units during the night. The staff interviewed confirmed staffing ratios and they said there was always sufficient to ensure they are able to give quality care to people. Staff are able to access excellent training and the providers have an excellent induction programme which is away from the home and then continues when they start working with people. The induction meets Skills for Care standards which leads onto foundation training. We looked at a training matrix (training plan) which is used to identify gaps in staffs knowledge. We spoke to staff who confirmed there was excellent training opportunities. They said there was also opportunities to attend specialist training to ensure they had the skills and competencies to meet the complex needs of people who live at the home. The AQAA told us that only 5 of the 29 staff Care Homes for Adults (18-65 years) Page 19 of 25 Evidence: employed have acheived National Vocational Qualifications (NVQ). This was discussed with the manager who told us that they are working to address the shortfall by training their own staff to obtain an NVQ assessors award so that they can undertake their own NVQ assessments. The home has good recruitment procedures which ensures staff are employed correctly. We looked at five staff recruitment and training files and they contained the required Criminal Record Bureau (CRB) check, references, application forms and interview records. Staff interviewed were able to confirm how they were recruited and the checks which were requested. Staff said they were fully supported by the manager and qualified staff and they enjoyed working at the home. The manager told us they had a number of vacancies for both qualified staff and care staff, although she said that staff turnover was low and staff morale was high. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service were protected by sound management practises, and their views are actively sought to improve the service. Evidence: The manager was appointed into her post in March 2009 and she has submitted her application to Care Quality Commission for registration. She is a registered Mental Health Nurse, and Registered General Nurse and as completed Registered Managers Award. She has a wealth of experience and knowledge working with younger adults. She operates an open door policy to enable staff, visitors and people who use the service to raise issues and concerns. The manager has a care manager as her deputy and together they lead a dedicated team of staff who are included in decisions about the running of the home. Staff meetings take place at regular intervals and staff interviewed said they feel supported by the senior team. Quality assurance systems were in place including satisfaction surveys, monthly quality audits and visits undertaken on behalf of the registered providers (Regulation 26). We looked at the results of the most recent surveys and they showed high satisfaction levels. Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: The manager has responsibility to ensure staff follows health and safety policies and procedures, and excellent training is provided to staff in all areas to help keep people safe. Risk assessments were seen with regard to fire and general maintenance of the home and they were all up to date. 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. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!