Care Home: Poppies

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What the care home does well The home has weekly resident meetings where people are encouraged to express their views about anything that impacts on their lifestyle. Care planning is person centred and service users are supported by designated key workers in the preparation of their six monthly reviews enabling them in voicing their wishes and aspirations. The service understands and actively promotes the importance of respecting the human rights of people using the service, with fairness, equality, dignity, respect and autonomy all being seen as central to the care and support being provided. What has improved since the last inspection? The home has provided a home entertainment gaming system for service users to interact with, both for pleasure and in promoting exercise. The homes manager has completed the Registered Managers Award and is now registered with the commission. A large garden shed has been provided to store items that are not used on a daily basis thus creating more room within the home for people living there. What the care home could do better: There are no requirements arising from this inspection. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Poppies The Ridgeway Southborough Tunbridge Wells Kent TN4 0AB     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Paul Stibbons     Date: 2 5 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Poppies Southborough The Ridgeway Tunbridge Wells Kent TN4 0AB 01892518208 01892518208 poppies@pepenbury.info Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Pepenbury Name of registered manager (if applicable) Mrs Kara Anne Thomas Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 6 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admisison to the home are within the following category : Learning disability( LD) Date of last inspection Brief description of the care home Poppies is a large detached house situated in a quiet road in Southborough and is opposite a large green with far reaching views over the rural area. The home provides care for up to six people with learning disability. There are six single bedrooms, two on the ground floor, three on the first floor and one to the top floor. All downstairs door widths meet standards for wheelchair access. All bedrooms have en-suite facilities. Care Homes for Adults (18-65 years) Page 4 of 28 care home 6 Over 65 0 6 Brief description of the care home There is ample shared day space and a kitchen that is accessible to people living in the home. The garden is wheelchair accessible via a ramp. Southborough has shops, church, pubs and public bus and train links. Fees are in the range of 1018.39 - 2252.63 pounds per week. Please contact the provider for current fees. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced inspection was conducted over a period of four hours from 12:00 until 16:00 and the registered manager was present. A completed AQAA (Annual Quality Assurance Assessment) was sent to the commission when we asked for it and prior to this visit. The AQAA contained excellent information that is fully supported by appropriate evidence. It includes a high level of understanding about the importance of equality and diversity and a wide range of evidence showing how they have listened to residents. Two service users were in the home during the visit along with three members of staff. Two service users were out at day centres and two were away on annual holidays. Care Homes for Adults (18-65 years) Page 6 of 28 A variety of records and documents were examined during the visit and included staff training records, personnel files, health and safety records, care plans, risk assessments and medication records. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 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. Prospective residents have sufficient information on which to make an informed decision as to whether the home can meet their needs. A trial period and full assessment of needs is conducted before a permanent placement and written contract of terms and conditions is offered to prospective residents. Evidence: There have been no new admissions since the home opened. Two care plans were viewed that evidenced that thorough assessment of need had been undertaken prior to the admission of current service users. The Statement of purpose and service user guide as well as a brochure give a clear understanding of the services and facilities available and are available in a picture format to aid understanding. The registered manager states that a trial period for potential service users is included Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: in the assessment process and contracts are between the company and local authorities. Care Homes for Adults (18-65 years) Page 11 of 28 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. People living in the home have an individual plan of care that sets out how their health, personal and social care needs will be fully met. People living in the home are protected by the homes policies and procedures for dealing with medication. Evidence: 3 Care plans viewed were person centred and are agreed with the individual. Plans are written in plain language, are easy to understand and look at all areas of the individuals life. They include reference to equality and diversity and address any needs identified in a person centred way. A key worker system allows staff to work on a one-to-one basis and contribute to the care plan for the individual. Each care plan includes a comprehensive risk assessment, which is reviewed regularly. The management of risk is positive in addressing safety issues while aiming for Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: improved outcomes for people. The home ensures that residents are consulted regularly to gather information about their satisfaction with the home. They are involved in both the development and review of the service. Separate medical information is accessible to staff should a service user require urgent medical treatment, for example hospitalisation. Confidential records are secure and observation of interactions demonstrated mutual respect and confidentiality of information. Care Homes for Adults (18-65 years) Page 13 of 28 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 living in the home have the opportunity to participate in a range of activities that meet their social, educational and recreational interests and needs. People living in the home enjoy a healthy and varied diet that is of their choosing. Evidence: Central to the homes aims and objectives is the promotion of the individuals right to live an ordinary and meaningful life, appropriate to their peer group, in both the home and the community, and to enjoy all the rights and responsibilities of citizenship. The home understands the importance of enabling younger adults to achieve their goals, follow their interests and be integrated into community life and leisure activities in a way that is directed by the person using the service. For example, service users are supported in going to local public houses, night clubs, annual holidays and other social Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: activities. The service understands and actively promotes the importance of respecting the human rights of people using the service, with fairness, equality, dignity, respect and autonomy all being seen as central to the care and support being provided. Staff members are aware of the Disability Discrimination Act to public facilities and will speak up for service users with communication difficulties. Residents are able to enjoy a full and stimulating lifestyle with a variety of options to choose from. The day services offered by the company locally include animal welfare, gardening, woodwork and arts and crafts. The home has sought the views of the service users with weekly meetings and considered their varied interests when planning the routines of daily living and arranging activities both in the home and the community. Routines are very flexible and service users can make choices in major areas of their life. Two service users were away on annual holidays at Coombe Haven at the time of the visit. There is evidence of innovative methods being used, and staff actively seeking information to enable people to access education and supported employment where they have the capacity. One service user attends an adult education centre and another West kent college with volunteer work at a stately park for one service user. The registered manager and staff say that visitors are always welcome and encouraged to comment on the service. Menus and records of service user meetings viewed demonstrate that service users play an active role in the choice of meals. For those individuals who need support during mealtimes, including those who have difficulty swallowing or chewing, staff give assistance. They were observed to be discrete and sensitive to the feelings of both the person they were helping and also to others present. Mealtimes are flexible and relaxed, staff are patient and helpful, and allow individuals the time they needed to finish their meal comfortably. Care Homes for Adults (18-65 years) Page 15 of 28 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 living in the home receive personal support in the way they prefer and require and their emotional and physical health needs are met. Evidence: Staff are highly aware that the way in which support is given is a key issue for people living in the home. Individual plans clearly record peoples personal and healthcare needs and detail how they will be delivered. These needs are recorded in a separate health action plan. Three care plans were viewed and peoples preferences were recorded, discussions with staff demonstrated expert knowledge about individual personal needs when providing support. The staff group is balanced to enable choice of male or female preferences when delivering personal care. Aids and equipment are provided to encourage maximum independence for people Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: using services, for example overhead hoists. Specialist advice is sought by the home to ensure effective use of equipment. Risk assessments and training records viewed evidenced the competency of staff and safety of service users when using equipment. Daily records viewed and notifications to the commission demonstrates that staff are very alert to changes in mood, behaviour and general wellbeing and fully understand how they should respond and take action. The home has an efficient medication policy supported by procedures and practice guidance, which staff understand and follow. Medication records are fully completed, contain required entries, and are signed by appropriate staff. Training records confirm that staff required to administer medication have the appropriate training in the safe handling and administration of medication. Care Homes for Adults (18-65 years) Page 17 of 28 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 living in the home can be confident that their views will be listened to, taken seriously and acted upon. People living in the home are protected from abuse. Evidence: The service has a complaints procedure that is clearly written and easy to understand. Observation of interactions during this visit indicated an open culture that allows residents to express their views and concerns in a safe and understanding environment. The AQAA states the home have not received any complaints in the last 12 months but would keep a full record of complaints including details of the investigation and any actions taken. Unless there are exceptional circumstances the service would always respond within the agreed timescale. The policies and procedures for safeguarding adults are available and give clear specific guidance to those using them. Discussions with 3 staff working at the service demonstrated that they know when incidents need external input and who to refer the incident to. Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: Training of staff in safeguarding is regularly arranged by the home and confirmed by induction and training records viewed. Care Homes for Adults (18-65 years) Page 19 of 28 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. Residents benefit from living in a safe, well-maintained environment with ample personal and communal space to meet their needs. Residents have the specialised equipment they require to maximise their independence. Evidence: The provider and manager have ensured that the physical environment of the home provides for the individual requirements of the people who use the service and live there. There are six single bedrooms all with en-suite facilities and all doorways on the ground floor are wheelchair accessible. Wheelchair users benefit from being able to access the kitchen area and rear gardens. The living environment is appropriate for the particular lifestyle and needs of the residents and is homely, clean, safe and comfortable, well maintained and reflects the individuality of the people using the service. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: People living in the home have the specialist equipment such as hoists and handrails that they require to maximise their independence installed. Service users have a House day where they are supported in cleaning and maintaining their own rooms. Two bedrooms were seen and both had personal possessions on display that reflected the lifestyles and interests of the occupants. Observations demonstrated that people living in the home moved around the house freely and were familiar with their surroundings. Maintenance records viewed include a monthly environmental checklist and the service have their own maintenance team. The AQAA states that the home plans to ensure that maintenance issues are addressed more speedily than they are at present. A large shed has been erected in the rear garden to store equipment that is not used on a daily basis allowing more space for people within the home. Care Homes for Adults (18-65 years) Page 21 of 28 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 living in the home are supported by a competent staff team and they are protected by the homes robust recruitment practices. Evidence: All staff receive relevant training that is focused on delivering improved outcomes for residents. The AQAA states that all staff complete an induction and core training during a six month probationary period, this was confirmed by training records viewed and discussions with staff members. The home puts a high level of importance on training and staff report that they are supported through training to meet the individual needs of people in a person centred way. The AQAA states that 63 of staff have achieved an NVQ qualification in care and the manager has the Registered Managers Award. There is a good recruitment procedure that clearly defines the process to be followed. This procedure is followed in practice with the home recognising the importance of effective recruitment procedures in the delivery of good quality services and for the protection of individuals. Staff files viewed and staff feedback confirms appropriate checks including CRB, POVA and satisfactory references are obtained prior to Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: employment. Staff meetings and supervision sessions are regular and staff find them helpful with a focus on improving outcomes for people using the service. Notes and action points are taken of meetings and sessions. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from living in a home that is run by a competent manager and the ethos, leadership and management approach of the home. The home is run in the best interests of the residents and their health, safety and welfare is promoted and protected. Evidence: The registration certificate is correct and displayed as required. The registered manager has the required qualification and experience, is highly competent to run the home and meets its stated aims and objectives. The manager communicates a clear sense of direction, and through the AQAA evidences a sound understanding and application of best practice operational systems, particularly in relation to continuous improvement, customer satisfaction, and quality assurance. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: Equality and diversity, human rights and person centred thinking are given priority by the manager who is able to demonstrate a high level of understanding and demonstrate best practice in these areas. The AQAA contains excellent information that is fully supported by appropriate evidence. It includes a high level of understanding about the importance of equality and diversity and a wide range of evidence showing how they have listened to residents. The home demonstrates a high level of self-awareness and recognises the areas that it still needs to improve. The home fully recognises the importance of the annual quality assurance assessment and has used the content to inform its own quality assurance. The data section of the AQAA is accurately and fully completed and supports evidence in the self-assessment section. There is full and clearly written recording of all safety checks and accidents, including analysis, and there is no evidence of a failure to comply with statutory reporting requirements and other relevant legislation. The home proactively monitors its health and safety performance and consults other experts and specialist agencies about health and safety issues as required. There is evidence of organisational monitoring by the companys board of governors. Care Homes for Adults (18-65 years) Page 25 of 28 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 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 27 of 28 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. 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