Care Home: Norfolk Road (28)

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What the care home does well The assessment and care plans for people living at the home are thorough and give good details about how staff should support people. Individuals are very much involved in their care planning and supported to make day to day decision at the home as well as important decision about their lives. People are encouraged to live interesting and fulfilling lives. Staff look for innovative and interesting ideas and encourage people to get the most out of the local community and its resources. People`s health is well supported by the the staff who keep regular checks on their health care needs. They have good health care facilities in their local community. The cleanliness and decoration of the home has improved in the last year. The manager and staff have worked hard to make the home comfortable for everyone. Staff are well trained and feel that the service offers good further training and development prospects. The new manager is managing the home well. What has improved since the last inspection? The decoration and cleanliness has improved over the last year. The lounge has been redecorated and re-carpeted with new sofas and furniture being purchased. What the care home could do better: The manager must make sure that the medication systems at the home are as safe as possible, the medication administration sheets should be printed and not hand written by the staff. This is to make sure that mistakes are minimised. Concerns were expressed that at times the staff felt unsupported by the manager in that she was not always available and worked on shift as a carer. The manager must be able to manage the two homes effectively and must always therefore be supernumerary to a shift. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Norfolk Road (28) 28 Norfolk Road Harrogate North Yorkshire HG2 8DA     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: Linda Trenouth     Date: 2 9 0 4 2 0 0 9 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. 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. 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 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 24 Information about the care home Name of care home: Address: Norfolk Road (28) 28 Norfolk Road Harrogate North Yorkshire HG2 8DA 01423871288 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): ian.norris@st-annes.org.uk St Anne`s Community Services Name of registered manager (if applicable) Mrs Jill Booley Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 4 The registered person may provide the following category of service only: Care Home only, Code PC. To service users of the following gender: Either. Whose primary care needs on admission to the home are within the following category: Learning Disability, Code LD, maximum number of places 4 Date of last inspection Brief description of the care home 28 Norfolk Road is a care home registered by St. Annes Community Services to provide personal care and accommodation for up to four adults with learning disabilities. The home consists of a semi-detached two-storey town house with garden areas to the front and rear including an enclosed area with hard standing for parking. The home is situated on a quiet road approximately one mile from the centre of Harrogate. Local community amenities and facilities, including shops, churches and pubs are within walking distance. Each of the four bedrooms is for single accommodation, none of which has en-suite facilities. These are all on the first floor Care Homes for Adults (18-65 years) Page 4 of 24 care home 4 Over 65 0 4 Brief description of the care home and are accessed by a staircase. Current information about services provided at 28 Norfolk Rd in the form of a statement of purpose, service user guide and the most recent inspection report published by the Commission for Social Care Inspection are available by contacting the home. Information provided by the manager on 13th March 2007 indicated that the current weekly fee for the home is £935.07. Additional costs include toiletries, hairdressing, newspapers, activities, holidays and individuals contribute to the vehicles used for their daily transport. Care Homes for Adults (18-65 years) Page 5 of 24 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 the inspector found during the inspection. The Care Quality Commission inspects care homes to make sure the home is operating for the benefit and well being of the people who live there. More information about the inspection process can be found on our website www.cqc.org.uk. We have reviewed our practise when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Care Homes for Adults (18-65 years) Page 6 of 24 The last key inspection was carried out in April 2008. Before this unannounced visit we reviewed the information we had about the home which included an annual quality assurance assessment (AQAA) that the manager completed. We used this information to help us decide what we should do during our inspection visit. Surveys were sent out to people who live at the home and staff. Nine surveys were returned. Comments from the surveys have been included in the report. One inspector was at the home over two days. During the visit we looked around the home and talked to people who live at the home and staff. We observed how staff interacted with individuals and looked at care plans, the risk assessments, daily records and staff records. Feedback was given to the manager at the end of the visit. 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 set out 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 24 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 24 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. People have a full assessment before they move into the home to make sure the home is right for them and can meet all their needs. Evidence: There have been no admissions to the home for some time. Previously assessments have been undertaken prior to peoples admission to the home and visits were facilitated to make sure that everyone was involved with the decision to move into the home. Everyone has a contract that clearly explain their rights when living in the home and what they can expect to be charged for in addition to their fees. Care Homes for Adults (18-65 years) Page 10 of 24 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. People are supported to be involved in important decisions in their lives. Evidence: People have comprehensive care plans that look at their individual needs. The care plans are person centred, which means that the individual is central to the decision making. Staff had a good understanding of the peoples individual care plans and explained how they supported people in their communication and decision making. Some of the care plans and risk assessments needed updating but annual reviews are held and key worker reviews undertaken in between these times. Staff supported people to make day to day decisions about their lives and helped them plan for important events in their future. We talked to two staff who clearly had a good Care Homes for Adults (18-65 years) Page 11 of 24 Evidence: understanding of individual needs. They were able to give many examples of how they support people to make decisions and take part in their hobbies and interests. From watching people during the day we observed that they are encouraged to be independent and to make their own decisions. Care Homes for Adults (18-65 years) Page 12 of 24 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 have excellent opportunities to enjoy a fulfilling life in the home and wider community. Evidence: The care planning is thorough and looks at how people want to spend their time. The care plans are person centred making sure that people make their own decisions about their care. There were many examples of how people were encouraged to enjoy an individual lifestyle pursuing their own interests and encourage to try new activities with good support from staff. Staff explained that they supported everyone in what they wanted to achieve including Care Homes for Adults (18-65 years) Page 13 of 24 Evidence: one individual who wanted to go horse riding. This had meant a change in life style and healthy eating. The staff have done this positively and the household has a healthier day to day menu which benefits everyone. The individual is now able to go horse riding. People are also encouraged to go on annual holidays and have gone to interesting locations such as Lanzarote and Tenerife. Individuals enjoy other activities such as Swimming, Bowling, The Railway club, trips to the theatre, Butlins 60s weekend and many visits to places of local interest. The staff continue to think and put into practice innovative ideas, they have a garden plot with green house and individuals are growing their own vegetables. Individuals are encouraged to keep in contact with families and friends. The staff also support people to visit other homes within the St Annes group where friendships have been made. Staff have supported people in a healthy lifestyle which has meant some adjustments to menu planning and also encouraging more physical activity. Staff have supported everyones participation in the local Nidderdale walk. Care Homes for Adults (18-65 years) Page 14 of 24 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal and health care needs are met. Evidence: People have good support with their health care and staff encourage a healthy style of living. Staff say that everyone has regular health checks and their medication has been reviewed. The gentlemen have attended the well man clinics run at the local surgery. The care plans are then updated when appointments are made. Any recommendation made by Health Care Professionals are included in the care plans. Medication was reviewed and found to be held responsibly. The home uses a monitored dosage system, but concerns were raised regarding hand written records. The manager must follow The Royal Pharmaceutical Guidelines and ensure the medication records are not hand written, this is to minimise mistakes. Care Homes for Adults (18-65 years) Page 15 of 24 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. Clear complaints policies and procedures are in place to address peoples concerns. Evidence: The home has a complaints procedure. This details how someone can make a complaint and the actions that will follow on from this. There have been no complaints made to the home or received by the CQC about this service. A comprehensive complaints procedure is followed and is made available to individuals in an easy read style with pictures and graphics. People at the home have differing ways that they communicate. Staff say they are able to tell if people are unhappy through watching their behaviour and body language. Staff work hard to understand different ways of communicating and have completed additional training to help them communicate better. Care Homes for Adults (18-65 years) Page 16 of 24 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 home is well decorated clean and comfortable to live in. Evidence: The home was welcoming and well maintained. The redecoration of the lounge is complete and other areas of the home have been improved including bedrooms. The kitchen and bathroom areas were clean and also well maintained. Bedrooms were individually decorated and held many personal possessions and items reflecting their individuality and personalities. Staff tell us that individuals decide how they will have their rooms decorated, what their carpet will be like and what they want in their rooms. The home had an Environmental Health inspection last year which confirmed they were happy with the standard of food hygiene in the home. The gardens are well maintained, with garden furniture including a swinging hammock and tables and chairs. Staff encourage people to spend time outdoors maintaining and enjoying the garden. Care Homes for Adults (18-65 years) Page 17 of 24 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. Staff are well trained to support people living at the home. Evidence: No new staff have been recruited to the home since the last inspection so the recruitment records were not looked at on this occassion. On the day of the inspection there were two staff on duty, supporting three people in the home whilst another individual was attending an activity. The duty rotas show that there are at least two staff members on duty at all times through the day. Staff say that new staff complete induction training and the LDAF (Learning Disability Award Framework) and then onto NVQ (National Vocational Qualification) awards. All staff at the home now have NVQ level 3. The manager audits other staff training to make sure that training needs are up to date in areas such as manual handling, health and safety and first aid. Staff also have access to other training within the organisation if they wish to develop their skills Care Homes for Adults (18-65 years) Page 18 of 24 Evidence: further. This is good practice and shows that the service sees training as important, making sure that people are cared for by a skilled staff team. Staff confirmed that they have regular staff meetings and supervision. Care Homes for Adults (18-65 years) Page 19 of 24 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 home is well managed. Evidence: The new manager is now registered with the Care Quality Commission and is undertaking the Registered Managers Award. The manager has many years experience of working with people with Learning Disabilities. The manager divides her time between the this home and Leeds Road, which she also manages. Regular house meetings do not appear to be held. Some discussion was held with the manager about re-introducing meetings to hold something more informal to suit the needs of the people living at the home. Health and safety checks were undertaken and records were kept up to date with the exception of the Electrical Safety Certificate, this document was not avilable. This Care Homes for Adults (18-65 years) Page 20 of 24 Evidence: check is important as it confirms that the wiring in the home is safe. The manager was able to confirm the date this had been completed. The manager has carried out a fire risk assessment of the premises and fire safety checks and training are regularly undertaken to maintain fire safety. Systems are in place for monitoring and recording hot water temperatures throughout the home. Staff say that they have regular Health and Safety training and this is regularly updated so that staff are aware of up to date safe working practices. Some questionnaires commented that the budget for running day to day expenses was limited and during the inspection staff were concerned that available food money may not be enough. The manager said that she was aware of this and it is presently being reviewed and hopefully increased. The budget allowed for the home for food and cleaning products has not been increased for some time. The staff confirmed that staff meetings are held regularly. They also confirmed that they have regular supervision and appraisals. When we looked at the supervision records all but one member of staff had up to date supervision. Some questionnaires returned from staff felt that the manager working between the two homes meant that at times they were not well supported. They also say that the manager worked on shift at times. The manager said that she has only worked the shift at either home in an emergency. The recruitment of a second deputy would hopefully resolve support issues for staff. It is essential that the manager hours are supernumerary in both homes if the manager is to effectively manage. Care Homes for Adults (18-65 years) Page 21 of 24 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 22 of 24 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 manager must make sure the home follow the Royal Pharmaceutical Guidelines on the Administration of medicines in Care Homes. This is to make sure that people are safe from harm and mistakes are minimised. 29/05/2009 2 37 12 The service must ensure that there is adequate support given to the home and that someone is in day to day charge at all times. To protect the health and welfare of people living at the home. 29/05/2009 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 Care Homes for Adults (18-65 years) Page 23 of 24 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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