Care Home: Pennine Centre

What the care home does well People who use this service have their needs fully assessed and usually have the opportunity to visit the home before they decide to move in, this means choice is promoted and people can make an informed decision about whether to move into the home. The home continues to offer a varied menu and excellent standard of food, from speaking to people living in the home it was clear that they enjoyed their mealtime experience. People told us that they receive their personal support and care the way they prefer and require. People told us that staff assist them in a way that promotes their independence, maintains their dignity and privacy. Comments from people living in the home included, "I talk to the staff and they listen, some people cannot speak, but the staff find a way to communicate","the staff are fantastic". Surveys received from people using the service commented, "the personal care and knowledge of peoples` particular needs and care is excellent", "the Pennine Centre is unique in the service it offers", "they are so caring and your health and happiness is paramount", "I enjoy myself when I come here", "staff treat me with respect and as an individual". People who use the service are informed about the complaints procedure and are able to express their concerns in an open culture. People are protected from possible harm or abuse. The home has a policy and procedure for dealing with peoples monies and financial affairs. The home is maintained to an excellent standard and the environment is clean, hygienic, comfortable, homely and meets the general needs of people living there. Training in relation to meeting more diverse needs is offered to staff and from speaking to people using the service it was clear that the staff have the skills to offer support that would meet their needs. Some training courses offered include transgender awareness, eating and drinking difficulties, learning disability awareness, mental health first aid, stroke awareness. What has improved since the last inspection? Improvements have been made to individual care and risk management plans that makes them more person centred. Each person receiving a service has a one page profile that identifies what is important to them. A training plan has been agreed to deliver in-house person centred thinking and person centred risk training to all staff. The level of activities has increased and people told us that they have been on outings to various places in both group settings and on an individual basis. The manager told us that an activity plan for each person has been developed that takes into account their hobbies and interests and this will form part of their care plan.Daily routines are promoted within the home and people confirmed this when they were spoken to. Staff told us how they would assist people in a way that promoted their independence and encourage people to do things for themselves. The medication system has been improved and was of a good standard. The manager told us there is a new system when booking in medication, all staff have undertaken further medication training, including shadowing and learning from other establishments. The improvement plan received following the previous inspection told us that monthly observation and checking of records would take place. The improvement plan received stated that all staff were to undertake the safeguarding adults training update and the reporting procedure was to be reviewed. The manager told us that every staff member has attended in-house safeguarding training and in supervision staff are discussing their roles and responsibilities in passing on information and making referrals appropriately and in a timely fashion. People are supported by staff who have been recruited safely and the staffing levels are sufficient to meet their needs. The home seeks the views of people using the service, the maintenance of the building is maintained to an excellent standard and improvements have been made to the management systems, therefore peoples health and safety is promoted. What the care home could do better: The home needs to maintain the good progress made with regard to further developing individual plans of care and complete a person centred plan for every person using the service. Supervision is offered to all staff and from looking at written evidence it was confirmed that this is not as regular as it should be and in particular for night and casual staff. During this visit it was identified that staff are offered essential training, however, this is not always updated as regular as it needs to be. Key inspection report Care homes for adults (18-65 years) Name: Address: Pennine Centre Pennine Way North Bransholme Kingston upon Hull East Yorkshire HU7 5EH     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Angela Tew     Date: 2 2 0 6 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 31 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Pennine Centre Pennine Way North Bransholme Kingston upon Hull East Yorkshire HU7 5EH 01482839311 01482839021 pat.walker@hullcc.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Kingston upon Hull City Council Name of registered manager (if applicable) Mrs Patricia Mary Walker Type of registration: Number of places registered: care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 physical disability Additional conditions: That the intended work as stated in the action plan in regard to the premises is carried out. To provide personal care and accommodation for three service users with physical disability who have reached 65 years of age. Date of last inspection Brief description of the care home The Pennine Centre is a modern purpose built care home situated on a large housing estate on the outskirts of the city of Hull. It is owned and run by Kingston Upon Hull City Council. There is an adjacent day centre, which people staying in the home can use if they wish to. The Pennine Centre has been subject to extensive refurbishment and is registered for up to 12 younger adults who have a physical disability. The home offers care and accommodation mainly on a short term and respite basis. The statement of purpose and service user guide has been amended and clearly states how Care Homes for Adults (18-65 years) Page 4 of 31 Over 65 1 12 2 7 0 1 2 0 0 9 Brief description of the care home the needs of people staying there will be met. The home is secure and has its own well tended grounds. Public transport is accessible adjacent to the home and there are some local facilities nearby. The home has a ground and first floor with a passenger lift connecting the two. There is ample communal space for people, including three lounges, a visitors room and a large dining area. The home offers eleven respite and one long term placement. On the first floor there are two rehabilitation bedrooms. People are given a service user guide explaining what the home will provide. Care Homes for Adults (18-65 years) Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. This site visit took place over one day and took a total of 8 hours. A regulation inspector visited the home as part of the process. Prior to the visit surveys were posted out to people living in the home, staff members and health and social care professionals, information was gained from these and this has formed part of the evidence. The Annual Quality Assurance Assessment was returned to the CQC prior to the visit taking place. It had been completed to an adequate standard. Several of the people living in the home were spoken to throughout the day about the care they receive and what it is like to live in the home, some of their comments have been included in this report. Three files of people living in the home and four staff personnel files were looked at during the site visit. Two staff members were spoken to, this was to find out what it was like working in the home and what training support and Care Homes for Adults (18-65 years) Page 6 of 31 supervision was offered to them. A tour of the premises was undertaken and a number of records were looked at to ensure that the correct maintenance has been undertaken. The medication procedure and the way that incidents are reported was looked at and the manager was given feedback at the end of the visit. The manager told us that the current fees charged range between £49.00 and £84.77. Additional charges are made for the following, newspapers, magazines and sweets, hairdressing. We also checked how privacy and dignity was maintained. We also wanted to be sure that people could make choices about aspects of their lives and that the home ensured they were protected and safe in a clean environment. We observed the way staff spoke to people and supported them. We would like to thank the people that stay at Pennine, staff and management for their hospitality during the visit, and also thank the people who had discussions with us. We have reviewed our practice 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 the 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 7 of 31 What the care home does well: What has improved since the last inspection? Improvements have been made to individual care and risk management plans that makes them more person centred. Each person receiving a service has a one page profile that identifies what is important to them. A training plan has been agreed to deliver in-house person centred thinking and person centred risk training to all staff. The level of activities has increased and people told us that they have been on outings to various places in both group settings and on an individual basis. The manager told us that an activity plan for each person has been developed that takes into account their hobbies and interests and this will form part of their care plan. Care Homes for Adults (18-65 years) Page 8 of 31 Daily routines are promoted within the home and people confirmed this when they were spoken to. Staff told us how they would assist people in a way that promoted their independence and encourage people to do things for themselves. The medication system has been improved and was of a good standard. The manager told us there is a new system when booking in medication, all staff have undertaken further medication training, including shadowing and learning from other establishments. The improvement plan received following the previous inspection told us that monthly observation and checking of records would take place. The improvement plan received stated that all staff were to undertake the safeguarding adults training update and the reporting procedure was to be reviewed. The manager told us that every staff member has attended in-house safeguarding training and in supervision staff are discussing their roles and responsibilities in passing on information and making referrals appropriately and in a timely fashion. People are supported by staff who have been recruited safely and the staffing levels are sufficient to meet their needs. The home seeks the views of people using the service, the maintenance of the building is maintained to an excellent standard and improvements have been made to the management systems, therefore peoples health and safety is promoted. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 31 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 10 of 31 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 who use this service have their needs fully assessed and usually have the opportunity to visit the home before they decide to move in, this means choice is promoted and people can make an informed decision about whether to move into the home. Evidence: Since the previous inspection the home has not taken any new referrals for respite care. This is because the Local Authority made the decision not to offer placements to people due to the poor quality rating received, this will be reviewed following this inspection. The manager told us that people have their needs assessed prior to and following admission. We received an annual quality assurance assessment (AQAA) that the home had completed and this gave information about the support and care offered to people. We looked at four files of people staying at the home confirming that people have their needs assessed before they move in and from speaking to people during the visit it was clear that this is done in consultation with them. Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: People told us, respite make life so much easier, the personal care and knowledge is excellent, I enjoy myself when I come here and all of the staff are friendly and caring. Care Homes for Adults (18-65 years) Page 12 of 31 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 have care plans and risk management plans that describe their needs in full and they include specific direction to staff about what they need to do to. Some of the care plans need further development to ensure that these include the persons wishes and any preferences, this would make them more person centred. Evidence: The manager gave us an update with regard to the progress made since the last inspection visit in January 2010. Since that time several meetings have been held to look at the improvement plan for the home and progress reports have been submitted to CQC. Improvements have been made to individual care and risk management plans, each person receiving a service has a one page profile that identifies what is important to them. A training plan has been agreed to deliver in-house person centred thinking and person centred risk training to all staff. Each care plan has been evaluated and key workers are beginning to introduce person Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: centred documents. The manager said, when a person is coming to stay for respite their care plan is being evaluated and updated to include the persons view, feelings and preferences. We are well on with this, but there are a few that need further work. People told us that they had been involved in developing their own plan and were happy that they were part of that process. One person said, I have spoken to the staff about what I used to do and what I like doing. We looked at four care files of people staying in the home and these now give the reader information about the needs of the person, they identify short and long term objectives for that person. They describe in detail how staff should undertake care and support. We saw that risk is managed effectively and since the previous inspection visit, it was clear that a lot of work had been undertaken in ensuring that all risks have been assessed and there is a plan in place that describes those risks in detail and give clear direction to staff. The manager told us, since the last visit we have four new senior carers at Pennine and they have been developing the existing risk management plans and as part of the improvement plan all staff are to complete the person centred risk training. People told us that choice, participation and independence are all promoted and that they are able to make decisions about everyday life, such as when to have a shower or get up. Care Homes for Adults (18-65 years) Page 14 of 31 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 are encouraged to maintain outside links with family and friends and the menu offered is of an excellent standard, daily routines promote independence. Evidence: People told us that they are encouraged to take part in activities both inside and outside of the home. Some people also attend day centres or community groups. The home has a computer and people have access to this. Surveys we received from people receiving a service told us that visitors are made welcome at any time. People told us, my family come and visit me when they want to and they are always made welcome, the staff are fantastic, you couldnt ask for better. People told us that they can receive visitors at any time, my family come and visit me all of the time and are always made welcome, yes I can have visitors when I want and there are plenty of rooms to go to. Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: The activities have improved since the last inspection and it was clear from speaking to people and looking at written records that both individual and group activities are taking place on a regular basis. People told us, I do crosswords with the staff and enjoy that very much, yes I feel the activities have increase and we have been out on trips, I play scrabble and go out to the pub sometimes. Staff told us that a cookery and gardening group had been set up to encourage people to maintain daily living skills. Daily routines are promoted within the home and people confirmed this when they were spoken to. Staff told us how they would assist people in a way that promoted their independence and encourage people to do things for themselves. The manager told us that an activity plan for each person has been developed that takes into account their hobbies and interests and this will form part of their care plan. The home continues to offer a varied menu and from speaking to people living in the home, it was clear that choice is offered. People said, the food is very good, we always get a choice and plenty, the staff are very good and ask what we would like to eat. The home received a score of A with the Environmental Health Department, this means the hygiene in the kitchen was of an excellent standard. The home has also maintained the Healthy Option Award. The dining room is well laid out with plenty of space for wheelchair users, this enables all people using the service to take part in the mealtime experience. Staff were observed during lunch and carried out their duties in a caring and empathic way, showing respect to the person at all times. Care Homes for Adults (18-65 years) Page 16 of 31 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. People who use the service receive a good level of personal and healthcare support and their medication is administered correctly. This means that people receive their support in a safe way. Evidence: People told us that they receive their personal support and care the way they prefer and require. Since the last inspection each person using the service has had a one page profile developed and some care plans have been further developed to include peoples preferences, choice, likes and dislikes. These give a lot of information with regard to what support is required and how to ensure the persons dignity, independence are maintained. The improvement plan received stated that the home will identify a minimum of ten dignity in care champions who will raise the profile and ensure dignity is maintained. Four files of people who live or stay on respite in the home were looked at, written evidence was in place confirming that healthcare checks are undertaken. People told us that they are supported to attend hospital, GP and other healthcare appointments. Aids and adaptations are sought to assist people with their mobility and independence. Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: People told us that staff assist them in a way that promotes their independence, maintains their dignity and privacy. Comments from people living in the home included, I talk to the staff and they listen, some people cannot speak, but the staff find a way to communicate,the staff are fantastic. Surveys received from people using the service commented, the personal care and knowledge of peoples particular needs and care is excellent, the Pennine Centre is unique in the service it offers, they are so caring and your health and happiness is paramount, I enjoy myself when I come here, staff treat me with respect and as an individual. Surveys received from other social and healthcare professionals told us that the home communicates well with other agencies and seeks advice when necessary. Some comments received included; the service appropriately liaised with other agencies, ensured regular reviews took place, negotiated well around tensions with other agencies and families, the Pennine Centre is an exemplary service of a respite centre, attitude and consideration given to patients are excellent, provides a valuable service for people with differing needs. Since the previous inspection the medication procedure has been reviewed and improved. The manager told us, we have had no further medication errors since February 2010, the new system is working well and the new seniors have developed new ways of working. The manager told us there is a new system when booking in medication, all staff have undertaken further medication training, including shadowing and learning from other establishments. The improvement plan received following the previous inspection told us that monthly observation and checking of records would take place, evidence to confirm this was seen. From looking at several medication administration records (MAR) it was clear that the recording was of a good standard, there were no gaps and the medication stock tallied with the written records. Each person has a medication file that has a photograph and a list of the medication they are currently taking. There is also a risk assessment in place that details whether it is safe for the individual to self-medicate and some people do look after their own medication whilst staying at the Pennine Centre. The home has a returns procedure, which detailed the name of the person the medication was for, the medication prescribed and dosage. The medication is stored in a locked medication room and within that room there are several locked cabinets and a controlled drugs cabinet. There is also a medication trolley. The home has a refrigerator to store medication and evidence was seen confirming that the temperature is taken on a daily basis. Controlled drugs are stored securely and Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: records show that two staff always sign when given. Care Homes for Adults (18-65 years) Page 19 of 31 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are informed about the complaints procedure and are able to express their concerns in an open culture. People are protected from possible harm or abuse. Evidence: The home has a complaints procedure and it was confirmed from speaking to people living in the home and from surveys received that complaints are listened to and acted upon. People told us that, yes complaints are listened to, they always listen to me, I would tell the staff if I had a problem. Since the previous inspection there have been two complaints and written records showed us that these were dealt with and responded to. A written outcome letter was also forwarded to the complainant. The home has a multi agency policy and procedure for the prevention of abuse. Since the last inspection there have been seven safeguarding referrals made to the Local Authority Safeguarding team. One incident had occurred whilst the individual was not in the home, the referrals included financial irregularities and medication received incorrectly. The manager showed us that safeguarding referrals had been forwarded immediately to the Hull Safeguarding Team and CQC had been notified too. Six of the safeguarding referrals have been concluded and one remains outstanding as this is currently being investigated, this involves a staff member giving medication incorrectly. The outcome was for this to be dealt with via the Local Authoritys disciplinary procedure. Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: There was a safeguarding referral that was mentioned in the last report that had not been concluded, this involved an allegation that two staff members physically and emotionally abused a person living in the home. This was investigated by Hull Social Services and the Police and the outcome was that there was no malicious intent on the carers behalf and was a misunderstanding. The complainant was satisfied with the outcome and a letter of apology was subsequently sent to the complainant. The improvement plan received stated that all staff were to undertake the safeguarding adults training update and the reporting procedure was to be reviewed. The manager told us that every staff member has attended in-house safeguarding training and in supervision staff are discussing their roles and responsibilities in passing on information and making referrals appropriately and in a timely fashion. From speaking to two staff members it was clear that the reporting of incidents had improved and they could clearly describe the procedure. The home has a policy and procedure for dealing with peoples monies and financial affairs. Records for maintaining the personal finances were looked at were up to date and in order. People living in the home told us that they were able to gain access to their money when they wanted to. There is also a lockable facility in each of the bedrooms. Care Homes for Adults (18-65 years) Page 21 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is maintained to an excellent standard and the environment is clean, hygienic, comfortable, homely and meets the general needs of people living there. Evidence: During the visit a tour of the building was undertaken and the standard of accommodation and cleanliness was as always excellent. The health and safety of people living in the Pennine Centre is maintained and promoted. People are allocated a bedroom for their stay in the home and individual rooms were nicely furnished and decorated. There were pictures, posters, dvds and belongings and people living in the home told us that the home was very comfortable. People said, the bed linen is washed everyday and rooms are cleaned to a good standard, bedrooms are clean. Staff told us, the home is maintained to a high standard and the environment is clean, comfortable and welcoming. The home was clean, hygienic and had no offensive smells present. Staff receive training in relation to infection control and there are clear guidelines set down to staff to follow if there are any infectious diseases. The home has a laundry with two industrial washing machines and two industrial dryers, there is a sluice facility and sterilising unit. Care Homes for Adults (18-65 years) Page 22 of 31 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. People are supported by staff who have been recruited safely and the staffing levels are sufficient to meet their needs. However, training and supervision are not undertaken as regular as they should be. Evidence: An improvement plan was received by CQC and it stated that changes were to be made with regard to the senior staff group. Four senior care staff have been brought into Pennine Centre to assist with the implementation of the person centred thinking programme and part of their role is to support staff with personal care and activities. Five of the senior staff have completed NVQ level 3 in care, one is working towards achieving NVQ level 3 and one is working towards achieving NVQ level 2 in care. All care staff have either achieved or are working towards NVQ level 2 in care. During the inspection visit three staff files were looked at confirming that the recruitment procedure is followed. The recruitment documentation including criminal records bureau check, references and an application form are held at the Personnel Section. All staff undertake an in-house induction and a more thorough corporate induction Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: that meets the skills for care specification. Supervision is offered to all staff and from looking at written evidence it was confirmed that this is not as regular as it should be and in particular for night and casual staff. CQC recommend a minimum is six per year as this would ensure good practice is being followed and staff receive sufficient support, supervision and guidance, however the local authority have their own policy which states supervision must be offered on a monthly basis. During this visit it was identified that staff are offered essential training, however, this is not always updated as regular as it needs to be. The manager showed us a new system for auditing the training of the full staff team and when this has been undertaken it will give a clearer idea of who needs what training. At the moment it is not a clear system and from looking at three files it was clear that some training has not been updated or undertaken for some time. Staff are offered induction training that meets the common induction standards and 90 of staff including any casual staff have achieved NVQ level 2. Training in relation to meeting more diverse needs is offered to staff and from speaking to people using the service it was clear that the staff have the skills to offer support that would meet their needs. Some training courses offered include transgender awareness, eating and drinking difficulties, learning disability awareness, mental health first aid, stroke awareness. The manager told us that since the last inspection she has looked at specialist training around neurological conditions and a request sent to the training section to provide this. From speaking to two of the new senior care staff it was clear that they had a very good understanding of the needs of the people who use the service and had commenced implementing the person centred plans. The staff told us, the seniors are sharing their knowledge and we are working as a team, the environment is fantastic, the care staff are willing and friendly, its good to see the care staff flourish. During the inspection visit it was clear that the staff team are working together and the home has a warm and welcoming atmosphere. People staying at the home spoke highly of the care staff and manager and said, there are big differences since the last inspection, always enough staff, two to help me, I can have a shower when I want one now. The staffing levels were looked at for this week and taking into account the level of Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: need and number of people in the home at this time, it would appear that they are sufficient to meet the needs of individuals. People confirmed that the care staff are very helpful, professional and polite when offering personal care. Care Homes for Adults (18-65 years) Page 25 of 31 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 seeks the views of people using the service, the maintenance of the building is maintained to an excellent standard and improvements have been made to the management systems, therefore peoples health and safety is promoted. Evidence: Since the previous inspection an improvement plan has been submitted to CQC stating what changes would be made to ensure that the home is run to an adequate standard and to ensure that peoples health and safety are maintained. The Local Authority stated that the management competencies of the management team within the home would be monitored and each would have an individual development plan. The registered managers office to be relocated to downstairs in the building, to ensure the manager is accessible to all services users and staff. The registered manager was to work with a mentor on progressing the improvement plan. During this visit the manager told us that the improvement plan had been complied with and she feels that the home is running much more effectively. The manager said, the staff are working together as a team, the new seniors are fantastic, everyone is Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: very enthusiastic and real progress is being made. Training has taken place for safeguarding adults and medication updates, person centred thinking is well underway and the care staff have embraced this way of working and thinking. The manager also told us that she receives support and supervision on a regular basis and has been meeting with a mentor on a weekly basis and said, this has been very beneficial and I have moved my office downstairs and now feel part of the team. We saw that the improvement plan had been fully implemented and the health and safety of people using the service is being promoted and maintained. The manager has obtained NVQ 4 in Care and the Registered Managers Award. She told us that she has kept her knowledge up to date by attending training in interpersonal aspects of management and leadership, deprivation of liberty, employment law essentials, mental health first aid and person centred thinking. Staff told us, the manager has been very supportive, her office is always open, she is open and approachable. The quality assurance system was looked at and surveys are sent to people using the service, their relatives, health and social care workers, GPs and. The results are gathered and analysed and presented in a report format this is shared with the people living in the home. The home has also developed a newsletter that incorporates the views and stories of people living in the home and staff also contribute. All compliments and complaints are recorded. Written records were seen that confirmed that the home listens to people and changes had been made to the dining times, a variety of drinks had been made available for people to access for themselves. The building is well-maintained by having all of the appropriate maintenance certificates in place, regular checks on these take place and evidence was seen confirming this. Staff undertake all health and safety courses within the first 6 months of employment ensuring that the staff are knowledgeable and have the necessary skills to deal with emergencies. However, some of the essential training requires updating, in particular for casual and night care staff. Incidents and accidents are reported in accordance with procedure and in a timely fashion. Equality and diversity is promoted. The majority of staff have attended training in relation to values and attitudes, alcohol, physical and learning disability awareness and equality and diversity. The Local Authority offer understanding a physical disability and some staff have undertaken this. The manager told us since the last inspection a request has been made to the training department for them to provide specific training for neurological conditions and person centre thinking. She said, we have an Care Homes for Adults (18-65 years) Page 27 of 31 Evidence: awareness training session this week for Huntingtons disease and other specific training is planned and the majority of staff have completed the person centred thinking training. Care Homes for Adults (18-65 years) Page 28 of 31 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 29 of 31 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 6 Care plans should involve the person receiving the support and describe their needs, preferences and choice. This would make them more person centred. Training and regular updates should be offered to all staff including casual and night carers. This would make sure that staff have the necessary skills to do their job. Supervision should be offered to staff on a monthly basis in line with the organisations policy. This would ensure that staff receive the support and guidance they need to carry out their responsibilities and good practice is promoted. 2 35 3 36 Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Adults (18-65 years) Page 31 of 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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