Care Home: Park Croft

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Park Croft Park Place Winchester Road Wickham Fareham Hampshire PO17 5EZ two star good 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: Tracey Horne Date: 2 3 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. 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.cqc.org.uk Information about the care home Name of care home: Address: Park Croft Park Place Winchester Road Wickham Fareham Hampshire PO17 5EZ 01329833994 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) : andy.harris@unitedresponse.org.uk United Response care home 10 Number of places (if applicable): Under 65 Over 65 10 0 learning disability Additional conditions: The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). The maximum number of service users to be accommodated is 10. Date of last inspection A bit about the care home Park Croft is a registered care home owned by United Response. The home is registered to provide care and accommodation for ten adults with learning disabilities. It is located in woodland just outside a village called Wickam and is near to the Town of Fareham. Nine people live at the home when we visited. The home has ten bedrooms, a lounge, kitchen, dining area and outbuildings which are used for a visitors lounge, craft and activity area, and office for the staff. The fees for the home range from # 698.49 to #1519.77 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: 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 How we did our inspection: This is what the inspector did when they were at the care home We visited the home on 23 April 2009. We spoke with one service user and three staff. We talked to the manager and looked at how staff supported the people who live at the home. We received surveys from one person who live in the home, three staff and one health care professional. We looked at all the information we have received about the home since our last visit. We looked at some of the paperwork the home has to keep. This included care plans, medication charts, menus, staff training, and various certificates. What the care home does well People living in the home have a care plan which is individual and detailed. People are involved in making decisions about their lives and the plans help staff provide the support that people need. People are supported to take part in a range of activities they enjoy and to keep in contact with family and friends. The home is well maintained and provides a clean, comfortable and safe environment to live in. Staff are well trained and there are good systems to check them before they work in the home. This helps to keep people safe and ensure staff can meet their needs What has got better from the last inspection People are involved in reviewing their care plans. Risk assessments have been updated. Systems are in place to make sure staff records are available at all times. 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 Tracey Horne The Oast Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT Telephone: 01622 724 950 Fax: 01622 724980 www.cqc.org.uk 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 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 are good systems to assess peoples needs before they move into the home. This reassures people that the home will be able to meet their needs. Evidence: The AQAA states that no-one has moved into the service in the past twelve months One person the home support responded to our survey. They were not asked if they wanted to move to the home. They did not get enough information about the home before moving in to help decide if they wanted to live there. We spoke with the manager who said that this person moved in some time ago when there wasnt a pre admission procedure as there is now. Although no one has moved in recently, there is one bedroom available and people who live at the home and staff would be fully involved in this process. One person the home supports said they would like to show people around and get to know them before they moved in. The manager said the home would actively encourage this along with short stays, to ensure everyone meets and the prospective person the home supports gets a feel of what life will be like living at the home. 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 . Support plans are in place for people so that staff can support them consistently. People living at the home make choices on a regular basis. Evidence: The AQAA states Care plans and Agreed Working Practices, known as AWPs are regularly updated to make sure that support is consistent and meets the preferences of the individual. The views of family and any other key person in the persons life are sought. Reviews take place regularly with care managers with input from the community team specialists and advocacy where required. The home have improved and updated all risk assessments. Record of health needs and appointments are kept. The home have introduced new monthly reviews for each person they support. We inspected the records of three people who live in the home during the visit. Each person had a person centered support plan, which set out how their assessed needs should be met and records were seen relating to health issues, such as doctors appointments, hospital appointments and chiropodist visits. The plans seen contained detailed information about how staff should provide support to meet peoples needs and aspirations. They contained specific information about what is important to the individual and how they would like to be supported, for example for one person it is important to them to follow a specific relaxation routine which in turn means they are able to sleep better at night. Plans are regularly reviewed and updated where peoples needs have changed for example one person decided not to go to a day centre anymore. One persons plan had not been completed fully, staff were aware of the individuals needs and how they like to be supported. The manager said that the person has complex needs and the staff have been working together and with the person to Evidence: gather information which will form the care plan. The manager confirmed the care plan will be complete within two weeks. Details of how people should be supported to make decisions are set out in the support plans. Staff demonstrated a good understanding of peoples needs and the importance of supporting people to make decisions about their lives. One person the home support responded to our survey and agreed they can do what they want during the day, night and at the weekend. We spoke with this person who agreed they can make decisions about most things and are happy with this. People were seen to make decisions about things during our visit, for example what to eat for lunch and what activities to do during the day. We received one healthcare professional survey, which stated that dignity and respect are at the forefront of all aspects of care. Risk assessments have been completed for people who live in the home and contain clear information about how to manage the identified hazards, for example how to reduce the risk of choking. The assessments seen had been regularly reviewed relevant to individuals needs. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People the home support take part in activities of their choice. Relationships are supported and promoted. Daily routines are flexible and a people enjoy their meals which they choose Evidence: One person the home support responded to our survey, they felt they could Sometimes make decisions about what to do each day. We spoke with this person who agreed they can make decisions about most things and are happy with this. People were seen to make decisions about things during our visit, for example what to eat for lunch and what activities to do during the day. 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 . Individuals health and personal care needs are met and there good systems to safely store and administer peoples medication. Evidence: The AQAA states the home provides personal care in a way preferred by the individual and in a manner that provides continuity of care. There is always a female on duty to provide personal care to female people who live there. Going to appointment forms have been introduced. These are for people we support to take to appointment e.g. GP, nurse. Medication amendment forms allow staff to record any medication changes. The plans seen clearly showed that individuals needs were met in ways they preferred. Health care plans showed evidence of involvement from professionals such as dentists, chiropodists, and opticians. Records showed that service users see their GP. Weight is monitored on a regular basis. There were thorough instructions in the plans regarding the use of special equipment. One healthcare professional who responded to our survey stated that the service has an excellent record with regard to the health care of the people they support. Medication is audited regularly. We looked at the records of medication administration and there were no gaps. 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 the home support feel that complaints made will be taken seriously and responded to. Policies are in place to protect them Evidence: The AQAA states that three complaints have been received in the last twelve months, all were resolved within twenty eight days. No incidents of restraint, safeguarding referrals or safeguarding investigations have been carried out. Mandatory checks of peoples finances are made each day to protect them. CRB and POVA checks are carried out for all staff. Satisfactory references taken before commencing employment. All staff have attend Safegaurding, prevention of harm and challenging behavior training which is refreshed. Three staff responded to our survey and stated they were aware of what to do if someone had any concerns. One person the home support responded to our survey and knows who to speak to if not happy, and wrote management, staff and agency staff if working at the time. We looked at the complaints log and saw that complaints had been actioned according to the homes procedure but not all records of outcomes were held at the home. The manager confirmed they would get them from head office and make sure all paperwork regarding complaints is available in the home from now on. 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 . People live in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. Evidence: The AQAA states the home wish to develop the downstairs bathroom into a level access shower room, the kitchen, laundry room, develop the garden and the home needs redecorating. The lounge has recently been decorated. One person the home support responded to our survey. The home is always and fresh and clean and wrote their room needs to be cleaner. We spoke to this person who confirmed they are responsible for cleaning their room with staff support, as stated in their care plan, but agreed they sometimes do not like to do it. The care plan has clear guidelines of how staff provide support when this occurs. Some areas of the home would benefit from redecoration, the manager explained there are plans to address this, as the provider is hoping to redevelop the home to provide a home specific to the needs of the people who live there. 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 and there are good systems to check staff before they work in the home. This helps to keep people safe and ensure staff can meet their needs Evidence: The AQAA stated the home try to ensure that the staffing ratio reflects the needs of the people they support and that a keyworker system is in place. Staff are confident and competent in their job roles, are aware of their responsibilities and duty of care to the people they support. People the home support are included in the recruitment process, matching staff skills and the short listing and interviewing process. All staff have attended equality and diversity training as part of the core training. Challenging behavior training has become more person centered and service specific. Two agreed they always have the right support, experience and knowledge to meet individuals needs. Comments made included We have minuted weekly meetings, appraisals are held periodically and their manager meets regularly for supervision. One ticked always, one usually and one sometimes to there being enough staff to meet individuals needs. One comment made was more staff would enable people we support to access community more often. One health care professional who responded to our survey stated that the staff receive all appropriate training required to meet individuals needs. Staff training is very good. The manager said that the a recruitment drive at the beginning of the year was successful and three new relief staff were employed. One person the home support said they were involved in this process and asked the candidates questions at interview and showed them around the home. Three staff responded to our survey. All agreed that CRB and references had been carried out before they started work. The recruitment files of three newly appointed staff were seen and these were found to hold all the specified documents required when employing staff to work with vulnerable Evidence: people. Evidence of an application form, two references, CRB disclosure and POVA checks were in place for each. All ticked very well to induction covering everything they needed to know and to being given enough training which is relevant to their role, up to date with new ways of working and helps them to understand individuals needs. New staff undertake a two week training programme and the manager told us that they also complete two weeks of shadowing as part of their induction. We looked at training records which are audited monthly. The mandatory training programme includes fire safety, first aid, infection control and moving and handling. Other training includes areas such as challenging behavior, working in an empowering way and specialist subjects which reflect the individual needs of the people the home support. Staff spoken with agreed the training was very good and very specific to the needs of the people they support. 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 has a qualified and skilled manager in post who supports staff to do their jobs effectively. There are some quality assurance systems in place and a strong emphasis on gaining the views of people who use the service Evidence: The AQAA stated that monthly meetings and reviews are held for the people the home support. The support given to people who live at the home is very person centred and the organisation is developing the Way We Work (WWW) approach to support staff. One of the tools that the home use is what works, what doesnt work. This is very useful when supporting people with limited communication and is employed during handovers, team meetings and during supervisions. The manager has been in post for a number of years and has completed the Registered Managers Award. Staff spoken with said they thought the manager was supportive and said they receive regular supervisions. Records of these were seen, but not all records were not easy to find, so the manager confirmed they would ensure this is improved. The manager confirmed that a system is in place to ensure staff records are available when the manager is not on the premises. The manager demonstrated that she has an understanding of the needs of people who need nursing care, who have physical disabilities, and of her roles and responsibilities in ensuring their needs are met. The home liaised with Adult Services to agree a way of responding to the needs of one person who displays the most challenges to the service. Organised bimonthly meetings with Care Manager to discuss and plan for the behaviors of one person the home support. The home consult the people who live there on a daily basis about the way it is run Evidence: and have regular meetings to talk about things happening at the home. The home undergoes a monthly audit by a representative of the organisation and copies of the report are sent to the manager. The home has maintenance contracts in place and we saw up to date certificates for equipment such as the hoists. The manager said all staff and people who live in the home receive fire evacuation training. Potentially hazardous substances were stored in a locked cupboard Are there any outstanding requirements from the last inspection? Yes No X 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 Refer to Standard Good Practice Recommendations 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). 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. Re-publishing this information is in breach of the terms of use of that website. 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