Care Home: Queen Elizabeth's Foundation Brain Injury Centre

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What the care home does well The service operates a comprehensive pre admission procedure, which covers cognitive, communication, physical, emotional, social - behavioural and education needs. People their family members and relevant professionals are invited to attend for an informal visit. Following this people visit for two days to enable a preliminary assessment to be conducted which is carried out by the multi disciplinary team. People using the service are supported to access a range of vocational or educational studies. This includes entering or re entering college or work through vocational studies. People can study for accredited courses within the centre or at a local college. Internal and external work experience placements are also arranged and they are supported to attend job fairs, interview workshops and employment seminars. During this visit we visited a new wing , which has opened in the centre offering additional,educational, vocational, social and therapeutic opportunities for people. The views of clients using the service are promoted. Regular consultation meetings take place, the service holds regular student forum meetings and have student representatives in place and the centre has set up a recreational equality and diversity group. At the time of this visit a client told us about this group and showed us a suggestion box, which is available where client`s can post comments. Information supplied in the AQAA states that the centre offers a wide range of activities during the day, evening and at weekends. This includes accessing local amenities such as visiting the cinema, shops, library, visiting the local leisure centre. People receive supportto explore and plan specific activities of their choice. We were also informed that the Centre held a cultural diversity day. The centre have their own accessible vehicles and people receive support to develop their ability to access the local community using public transport and taxis. The Centre has their own radio station where clients have the opportunity to make broadcasts and they participate in producing the Centre`s news letter. During this visit people told us about some of the activities they attend including, attending education classes, swimming and music. A person surveyed said, "The centre is good at getting me ready for the outside world" and another person said, "The centre is good at helping you to become more independent". People are supported by a range of therapists who are available at the Centre including, psychology, occupational therapy, speech therapy and physiotherapy who support, advise and provide the rehabilitation staff team with advice and guidance for supporting people with moving and handling. People are registered with a local General practitioner , although we were informed that people are able to maintain links with their own family doctor if they wish. People are supported to attend other health appointments including dental, opticians and chiropody. Appointments attended were maintained in people`s care plan records. A number of positive comments were received from people during this visit and through surveys including, " "This is a very good place";" The staff look after us well"; " The staff provide good care" ;"They treat us well and the rehab is good in all areas" and "Everybody is really nice here". What the care home could do better: During this visit we sampled people`s medication administration records and observed that where medication instructions had been hand transcribed by staff these has not been checked and signed by two members of staff. Random inspection report Care homes for adults (18-65 years) Name: Address: Queen Elizabeths Foundation Brain Injury Centre Banstead Place Park Road Banstead Surrey SM7 3EE three star excellent service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Lisa Johnson Date: 2 6 0 4 2 0 1 0 Information about the care home Name of care home: Address: Queen Elizabeths Foundation Brain Injury Centre Banstead Place Park Road Banstead Surrey SM7 3EE 01737356222 01737359467 lynne.hensor@braininjurycentre.org.uk www.gefd.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Julie Anne Tugwell Type of registration: Number of places registered: Conditions of registration: Category(ies) : Queen Elizabeth`s Foundation care home 28 Number of places (if applicable): Under 65 Over 65 0 physical disability Conditions of registration: 28 The maximum number of service users who can be accommodated is: 28 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: Physical disability (PD) Date of last inspection Brief description of the care home Queen Elizabeths Foundation Brain Injury Centre is a residential and education facility in Banstead Surrey which offers rehabilitation and education for young adults who have acquired disabilities or associated learning difficulties as a result of brain injury. Care Homes for Adults (18-65 years) Page 2 of 10 Brief description of the care home Clients from all over the U.K access the service, and it is owned and run by the Queen Elizabeths Foundation, a registered charity. The maximum number of clients that the service is able to accommodate residentially is 28. The average length of stay is twelve to eighteen months, although each case is assessed individually. Most of the service users bedrooms are on the ground floor, with a few bedrooms situated on the first floor. All the bedrooms are for single occupancy. Some rooms and other accommodation are equipped for independent living. A multi-disciplinary team supports clients. The current weekly fee is £2,485 Care Homes for Adults (18-65 years) Page 3 of 10 What we found: This unannounced random inspection was undertaken as the Care Quality Commission has assessed the service, which continues to provide excellent outcomes for people using the service. The last key inspection was conducted 26th September 2007 and two annual service reviews have been carried out. Information was provided to us by the service prior to this visit in the Annual Quality Assurance Assessment (AQQA). This assessment identified areas that had improved in the last year and others where further developments were being planned. This visit was undertaken between 9.30am to 3.30pm. During this visit we met with the registered manager and six members of staff. We were able to speak to five people who use the service and six feedback surveys were returned to us. During this visit we sampled some peoples care plans, we looked at the services medication administration practises, sampled policies and procedures including complaints. We looked at the Centres quality assurance systems, staff recruitment procedures and staff training records. We observed the lunch time meal and looked at the menus. Each client has a care plan in place, which is compiled by the rehabilitation support team that is discussed in consultation with the client, which identifies their short and long term goals. Views of clients, their relatives or advocate are also taken into consideration. Each person has an allocated key worker who meets with them regularly. Review meetings are held every three months and action planning meetings take place. During this visit we sampled three clients care plans which confirmed that they are consulted about their care plans, which had been reviewed and they were up to date. Care plans and relevant documentation is also available electronically. Risk assessments are completed for people prior to admission and they are reviewed regularly to reflect any change in needs. Discussion takes place with clients about the risks of completing activities of daily living and they are supported to participate in activities that will promote their independence. During this visit we sampled some risk assessments, that had been completed, which were detailed and up to date. Clients care plans sampled detailed their individual routines, how their personal care needs are to be supported and how they are to be encouraged to make choices such as their preferred clothing and appearance. During this visit staff were observed to be attentive and spoke to clients in a friendly and respectful manner. During this visit we looked at the arrangements for meals and spoke with the Centres chef. There is a four weekly menu, which was varied and nutritious. The cultural and religious requirements of clients is supported and respected. We were informed that clients views and preferences have been considered with respect to the menu planning. There is a central dining room, although people can choose to eat in other areas if this if their wish. Referrals are made to dietitians and support is provided by the speech Care Homes for Adults (18-65 years) Page 4 of 10 therapist for people who have dysphagia. During this visit we observed the lunch time meal, which was well presented, balanced and choices were available . Staff were observed to provide good support to clients who required assistance with their meals. Four people told us that they enjoy their meals although two clients surveyed said, Provide a better diet for vegetarians and I would like to have breakfast in my room. During this visit we looked at the centres medication practises. Medication was stored safely and is dispensed by the chemist using the monitored dose system (MDS). Systems were in place for the receipt and disposal of medication. Medication administration records sampled were appropriately recorded and maintained. Senior rehabilitation staff are trained to administer medication. People are supported to self medicate, which would follow a risk assessment. The centre has a clear complaints procedure in place, which is provided to clients before their admission to the Centre in the introduction pack and during their induction. The Centre maintains written records of any complaints received with the outcomes of any investigations. Since the last annual service review two complaints were brought to the attention of the Commission that the Centre was requested to investigate, which they have completed. Five out of six people surveyed said that staff and managers listen to what they say. We looked at the Centres safeguarding vulnerable adults from abuse procedures and staff training records. The Centre has three managers who are appointed as safeguarding leads.The Centre has also revised their staff safeguarding training. Discussion with some members of staff confirmed that they had received this training and they were aware of their responsibilities should they ever witness or be made aware of any incident where the safety of people is compromised. Clients using the service are supported by sufficient numbers of staff that are trained to meet their specialist needs. We were told that the service had carried out a recruitment exercise, which was successful. Sixty one percent of rehabilitation support staff have attained National Vocational Qualifications (NVQ) (Level 2) or above. Seven other members of staff are also completing either NVQ 2 or 3. New staff receive Skills for Care induction and foundation training. Staff training plans and records sampled demonstrated that they receive training related to acquired brain injury and working with people with a disability to enable them to work with clients effectively. Staff also attend other training including, equal opportunities, equality and diversity, advocacy and clients rights and confidentiality. We were told that a new training schedule is being implemented, which will identify when staffs statutory training is due to be updated. A member of staff surveyed said that there is usually enough staff to meet the needs of people and three other members of staff said sometimes. Some staff identified that extra staff in the evening after therapies have finished would be beneficial to enable them to further support people with their rehabilitation. The service has a robust recruitment procedure. We sampled three members of staffs personal files, which contained the required information including a completed application Care Homes for Adults (18-65 years) Page 5 of 10 form, two written references and enhanced criminal records bureau check (CRB). The service continues to be run by an experienced registered manager who is a registered nurse and chartered psychologist. During this visit we had the opportunity to speak to the manager of the rehabilitation support team, who has applied to register with the Care Quality Commission. Discussion with staff indicated that the manager is very supportive , approachable and that they have an open door policy. Staff also told us that they receive regular formal supervision with their manager. The service has implemented a range of quality assurance systems which we sampled including, monthly quality monitoring visits, annual satisfaction feedback surveys to gain the views of clients, families and relevant professionals. Short satisfaction surveys are also carried out at three monthly intervals. Peoples health and safety is promoted and protected. Discussion with staff and training records sampled confirmed that they receive statutory training including, moving and handling, first aid, food hygiene and infection control. Accident and incident records are recorded, which we sampled. Records were maintained for water temperature monitoring and fire safety checks and evacuations. Information supplied in the AQAA indicated that all routine servicing and maintenance of equipment is up to date. What the care home does well: The service operates a comprehensive pre admission procedure, which covers cognitive, communication, physical, emotional, social - behavioural and education needs. People their family members and relevant professionals are invited to attend for an informal visit. Following this people visit for two days to enable a preliminary assessment to be conducted which is carried out by the multi disciplinary team. People using the service are supported to access a range of vocational or educational studies. This includes entering or re entering college or work through vocational studies. People can study for accredited courses within the centre or at a local college. Internal and external work experience placements are also arranged and they are supported to attend job fairs, interview workshops and employment seminars. During this visit we visited a new wing , which has opened in the centre offering additional,educational, vocational, social and therapeutic opportunities for people. The views of clients using the service are promoted. Regular consultation meetings take place, the service holds regular student forum meetings and have student representatives in place and the centre has set up a recreational equality and diversity group. At the time of this visit a client told us about this group and showed us a suggestion box, which is available where clients can post comments. Information supplied in the AQAA states that the centre offers a wide range of activities during the day, evening and at weekends. This includes accessing local amenities such as visiting the cinema, shops, library, visiting the local leisure centre. People receive support Care Homes for Adults (18-65 years) Page 6 of 10 to explore and plan specific activities of their choice. We were also informed that the Centre held a cultural diversity day. The centre have their own accessible vehicles and people receive support to develop their ability to access the local community using public transport and taxis. The Centre has their own radio station where clients have the opportunity to make broadcasts and they participate in producing the Centres news letter. During this visit people told us about some of the activities they attend including, attending education classes, swimming and music. A person surveyed said, The centre is good at getting me ready for the outside world and another person said, The centre is good at helping you to become more independent. People are supported by a range of therapists who are available at the Centre including, psychology, occupational therapy, speech therapy and physiotherapy who support, advise and provide the rehabilitation staff team with advice and guidance for supporting people with moving and handling. People are registered with a local General practitioner , although we were informed that people are able to maintain links with their own family doctor if they wish. People are supported to attend other health appointments including dental, opticians and chiropody. Appointments attended were maintained in peoples care plan records. A number of positive comments were received from people during this visit and through surveys including, This is a very good place; The staff look after us well; The staff provide good care ;They treat us well and the rehab is good in all areas and Everybody is really nice here. 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 2. Care Homes for Adults (18-65 years) Page 7 of 10 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 8 of 10 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, 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 20 It is reccomended that where medication is hand transcribed by staff on to the medication administration record this should be checked and signed by two members of staff. Care Homes for Adults (18-65 years) Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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