Care Home: Northcroft

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Northcroft Barrows Road Cheddar Somerset BS27 3BD three star excellent service The quality rating for this care home is: 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: Barbara Ludlow Date: 0 5 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: 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. 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. Internet address www.csci.org.uk Information about the care home Name of care home: Address: Northcroft Barrows Road Cheddar Somerset BS27 3BD 01934744734 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : northcroft@orchardvaletrust.org.uk The Orchard Vale Trust care home 8 Number of places (if applicable): Under 65 Over 65 8 0 learning disability Additional conditions: Date of last inspection 1 7 1 0 2 0 0 6 A bit about the care home Northcroft is a large house close to the shops in Cheddar. Eight people with a learning disability live at the home. Everyone has their own bedroom. The house has been nicely decorated and there is a garden. The Manager is Miss Christine Kingham. Home is owned by Orchard Vale Trust. The weekly fees are between 600 pounds to 860 pounds per week. 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 How we did our inspection: This is what the inspector did when they were at the care home We made two visits to the house to meet the people living at the home, the staff and the management. There were seven people at home and we talked to them. We talked to the staff on duty. Records were examined these included care plans and maintenance records. The staff recruitment files were sampled. A tour of the house was made with the Deputy Manager. People were spoken with in private in their rooms. Feedback was given. What the care home does well Northcroft has a dedicated staff team. People are treated with respect and dignity. People can take part in a wide range of activities. People shop, cook and clean the home They go out socially with staff to clubs, leisure facilities in the homes car. Families visit and join in the social events at the home. What has got better from the last inspection The staff meet with the managers to discuss working at the home. What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Barbara Ludlow 33 Greycoat Street London SW1P 2QF 02079792000 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 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 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 have been no new admissions to the home for four years. The home has an admissions policy to guide the process. Pre admission assessment and the involvement of the person and their significant others would be an important part of the pre admission planning. Contracts are issued on admission. Evidence: There have been no new admissions to the service for some time. The AQAA stated that there have been no new admissions for over three years and most residents have lived here happily for a period of 13 to 16 years. The comment card feedback from four people living at the service indicated that they all had been asked if they wanted to live at Northcroft. Comment included Northcrofts a great house because I am near my family, Yes I was asked and I was very happy to say yes and My Mum and Dad were happy for me to be at Northcroft. All said they had enough information before moving here to help them decide it was the right place for them. Comment included information was very useful and I decided myself and I came to look around first. At previous inspections the pre admission assessments have been sampled and found to be sufficiently detailed and well considered by those involved. Opportunities are made for people to come and stay and get to know the home and Evidence: the other people before a mutual decision is made about a place being allocated. The contract states that the first three months is a trial period. Contracts are issued on admission. The AQAA indicated that all people coming for a trial or settling in period have chosen to stay. All have stated that they would like to stay when they had their three month review. 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 . Each person has a care plan that is kept in their room. Care is individually planned, developed and is regularly reviewed. People make their own informed decisions about their lives and daily living at the home. Staff are fully committed to supporting the people in their care to lead full and rewarding lives. Evidence: Everyone has a care plan that they keep in their room. A sample of these were seen with the permission of the individual. The care plans are regularly reviewed and covered all aspects of daily life. The care plans are agreed with the individual. They form a support to daily living and acknowledgement of the individuals preferences. More detailed records such as for health and professional contacts are stored securely in a locked cupboard, these can be accessed, if desired, by the individual. People make decisions in their daily lives and for the day to day events at the home. The people living at the home were joined after tea as they sat around the table and discussed the forthcoming parents visiting day and other day to day matters. Decisions were made following negotiation in the group and plans were confirmed for the coming weekend. It was very useful to the inspector to have been included in this informal meeting, which helped to demonstrate the way in which people are empowered at Northcroft by the staff and the ethos of the service. 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 live interesting and meaningful lives. People have regular access to a range of activities and community events with their peers. Family relationships are encouraged and supported. Evidence: People at Northcroft have access to opportunities to learn crafts and skills at the sister home, East Court. The facilities at East Court include a bakery, weavery, pottery, vegetable gardens and craft workshops. People can attend local sports and recreational facilities and further education courses at adult community and learning centres. Community outings to the cinema and bowling or for meals are organised for the individuals to enjoy if they wish. Any activity is a as a result of a positive choice being made by the individual. Holidays or day trips away from the home are organised and supported by staff. Some people visit family regularly and are assisted to do this safely and with the support required. One person was away at the time of the visit. 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 . People are well groomed and receive the support they need with their personal care. Health care is appropriately accessed from the local health care services. Medication is safely managed. Staff treat people as individuals and with dignity and respect at all times. Evidence: All people seen were well groomed and smartly dressed reflecting their individual tastes in fashion and accessories. Good health is promoted with access to dental and chiropody care. Access to influenza vaccination is supported. Individual Support and care plans are kept up to date and detail these matters and other health related issues such as continence management and relevant sexual health related issues. Health care is appropriately accessed from the local health care services in Cheddar. Medication is safely managed and staff receive medication administration training. Staff are well trained and aware of the need to observe for any changes that are age or ill health related. Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home has policies and procedures in place to safeguard the people in their care from the risk of harm. There have been no complaints made to the service or to CSCI since the last inspection. Evidence: There are policies and procedures in place to protect people from harm. Recruitment practice was found to be thorough and Criminal Record Bureau checks are made and two references are taken up and are confirmed as satisfactory before people commence working at the home. The home reported in the AQAA that it has not received any complaints in the last twelve months. The commission has not received any complaints or concerns about this service. Three staff were asked about the protection of people in their care. All confirmed having received protection of vulnerable adults (POVA) training, one person said this was recent, about three months ago. People living at the home said they would speak to staff if they had any concerns and were happy to approach them. 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 provides a comfortable homely place for people to live. The home has been suitably adapted to meet the needs of the client group, it is well maintained and hygienic. Evidence: The home has parking spaces at the front of the house. On arrival at the home the door was answered by a person in residence. They had been watching television in the large lounge at the front of the house. The inspector was invited to sign in as a visitor to the home. The home has a pleasant homely ambiance and was clean and fresh smelling. The communal areas were seen, the lounge is spacious and a good level of communal space is available. The home is well decorated and comfortably furnished. A tour of the premises was made. After consulting with the people living at the home a small number of bedrooms were sampled. These had been personalised and were very pleasant and comfortable. Personal private space is respected by staff who were observed to knock before entering a persons bedroom. People told the inspector that they keep their own rooms clean and tidy. One person did not have a risk assessment for the high cleaning of windows and although undertaken with one to one supervision this should be risk assessed, a recommendation is made for this. There are sufficient toilets and bathing / shower facilities. One shower which is monitored was recorded to be running at a higher than recommended temperature. This should be addressed by fail safe temperature control to reduce the risk of accidental scalding. This is recommended at this inspection ( see management Evidence: section). There are sufficient hand washing facilities for staff to access. 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 an experienced and dedicated staff team. Staff know the people they care for well and understand their individual and particular needs. New staff are safely recruited and receive induction, training and supervision. Evidence: The home has an experienced and stable staff team. Staff are encouraged to undertake National Vocational Qualification (NVQ) training and of the twelve staff in the team there are three who have achieved an NVQ. The manager of the home is an NVQ Assessor and five staff are currently undertaking an NVQ. One staff member is studying at level 2, three staff at level 3 and the deputy is undertaking NVQ level 4 in management. On completion the training the number of staff will be above the National Minimum Standard of fifty per cent of staff. The AQAA indicates that the plan for the next twelve months is to ensure that these staff achieve their awards. Staff were seen on duty at each visit. Three support staff and the deputy were spoken with about their recruitment, training and experience. Staff expressed their dedication to their roles at the home, their commitment to providing a person centred support service and their enjoyment of the work role they have. All interactions between staff and people living at the home were friendly, caring and appropriate. There was a sufficient staff number on duty. The AQAA indicated that the number of staff on duty fluctuates according to the number of people, their needs and the planned activities. The inspector heard that there is usually a ratio of one staff to four people at the home. The AQAA says that more staff are deployed at Bank Holidays to increase the level of activities available for those people not away with their families. Two sleep over staff provide the night support at the house. Evidence: Staff confirmed having undertaken training in the protection of vulnerable adults and had an understanding of what constitutes abuse. Other training identified by speaking with staff included fire safety, fire drills, health and safety, infection control, first aid and medication administration. The deputy has the role of supervisor for staff and has undertaken supervision with all staff. The frequency of supervision needs to be every two months to comply with the National Minimum Standard. Staff recruitment records were sampled for five staff. Only one person was identified as having been employed in the last twelve months. There was evidence of a thorough recruitment procedure being followed. CRB checks are shredded by head office in line with data protection. The staff files were made available by the Registered manager on the second inspection visit. The application form includes a health declaration and the inspector heard that information is gathered at the application stage for equal opportunities in recruitment monitoring. People who live at the service have an opportunity to meet prospective employees when they come for an informal visit at the start of the recruitment process. The opinions of the people living at the home are sought and the inspector was informed that this has influence with the recruitment process. 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 effectively managed and is well supported with by the Orchard Vale Trust. The home has a relaxed and calm atmosphere and the people living here come first. Records are safely and securely stored. The home is safely maintained. Evidence: The Registered Manager Ms Christine Kingham is an experienced care home manager and holds the Registered Managers Award. Ms Kingham has a Deputy Manager, appointed during mid 2008. The Deputy Manager was on duty on day one of this inspection which commenced at 5 pm and he stayed on duty to assist with the inspection process until the visit concluded at 11pm. The Orchard Vale Trust provides management input with staff recruitment and administration processes. Finances are managed at the Trusts head office. The Registered Manager was seen on the second day of this key inspection by appointment, the Chief Executive Officer for the Orchard Vale Trust kindly came along on the second day to support the inspection process. Management meetings are held each month. During the tour of the premises it was noted that the water at a shower outlet was Evidence: very hot. This should be restricted to run within a safe temperture range by fail safe device. This would reduce the risk of accidental scalding when someone uses the shower. Records for the servicing and maintenance of equipment were sampled, these records included, the fire alarm and emergency lighting which are checked each week. Fire safety equipment such as the fire door guards and the front door alarm are checked each week. Staff confirmed receiving fire training and regular drills. People living at the home are included in the fire safety training and take part in the fire drills. The homes electrical installation had been checked on 1/5/08 and the portable appliance testing for the home had been carried out on 18/09/08. The homes gas and Aga servicing had been undertaken in May and September respectively. It was noted that the employers liability certificate was out of date, the current certificate should be displayed. All records were stored securely and safely, with access appropriately restricted. All records relating to people living at the home were stored in line with Data Protection Act 1998. Are there any outstanding requirements from the last inspection? Yes  No  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 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 Description 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 Description 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 1 2 3 Refer to Standard 24 36 42 Good Practice Recommendations Any high cleaning and especially of windows must be risk assessed. Staff should have regular recorded supervision sessions at least six times per year. The water temperature at the shower outlet that was excessive at the inspection should be restricted by a fail safe device to run within safe temperature limits. The employers liability insurance certificate displayed should be up to date. 4 43 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web:www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (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. - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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