Care Home: Queen`s Retreat

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What the care home does well The service has an experienced and motivated staff team who have developed positive relationships with the people living in the home. The home has implemented an effective form of person centred planning. Staff receive good levels of support and supervision and are supported to complete training and to develop their professional skills. The manager provides good leadership, direction and support to the staff team. The home provides a comfortable and homely environment that is well situated to access the local community and the surrounding area. What has improved since the last inspection? No specific areas of improvement were identified. The home has maintained the high standards of care and support that were reported at the previous inspection visit. What the care home could do better: The home needs to ensure that it supports the people living in the home to have access and choice for appropriate day time and vocational activities to replace the routines and activities that have stopped over recent months. Key inspection report Care homes for adults (18-65 years) Name: Address: Queen`s Retreat 7 Russett Road Cheltenham Glos GL51 7LN     The quality rating for this care home is:   three star excellent 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: Simon Massey     Date: 1 5 0 4 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 20 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 20 Information about the care home Name of care home: Address: Queen`s Retreat 7 Russett Road Cheltenham Glos GL51 7LN 01242703100 01242706080 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Chances Gloucestershire Community Child Care & Family Support Services Name of registered manager (if applicable) Mrs Beverley Anne Morgan Type of registration: Number of places registered: care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Queens Retreat is an older style detached property, set in private grounds on the edge of Cheltenham. The house is part of the Chances organisation, which has other homes in Gloucestershire. The home offers individually tailored packages of care and education to adults with disabilities. There is a strong emphasis on helping residents achieve a level of independence. The home also provides and supports education packages, both from its own education facility through to college and work placements. The current fee range for the home begins at #1200 to #1600 per week. 3 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 20 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 inspection was undertaken over one day and lasted approximately six hours. The Inspector looked at records relating to care planning, staff recruitment and training, medication, health and safety and maintenance. An inspection of the environment was also carried out. The Inspector met with staff, the Registered Manager and all of the people living in the home. The Commission also received a number of completed surveys in relation to the service and also received a detailed and comprehensive Annual Quality Assurance Assessment from the Provider. Care Homes for Adults (18-65 years) Page 5 of 20 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 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 6 of 20 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 7 of 20 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. The needs and aspirations of people moving to the service would be properly assessed prior to admission to ensure the service was the correct placement for the individual concerned. Appropriate information is provided for users of the service and their families. Evidence: The home has admitted no new service user since the previous inspection so has not had to complete any new assessments. The service has a detailed admissions process and the ongoing needs of people living in the home are regularly monitored and reviewed. This is done with the involvement of the people concerned. The service has recently reviewed and updated its Statement of Purpose and Service User Guide and these documents provide detailed information about the services that are offered. Care Homes for Adults (18-65 years) Page 8 of 20 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. An effective and detailed care planning system ensures that support and care needs are routinely monitored and reviewed with the full involvement of people concerned. People are consulted about the running of the home and are supported to make decisions about their lives. Evidence: There are detailed care plans in place that cover all aspects of care and support for the individual living in the home. People confirmed they are involved reviewing their plans and demonstrated their understanding of the relevance and application of the care planning process. People explained how they are supported to make decisions about all aspects of daily living and also in relation to longer term goals and objectives. A sample of risk assessments were seen and some of these were overdue reviews, though others were up to date and had been reviewed at the appropriate intervals. People living in the home also explained how they were able to raise any issues about daily living in the service through a discussion book which recorded their views about Care Homes for Adults (18-65 years) Page 9 of 20 Evidence: a variety of issues. They considered that this had worked well in preference to having to having house meetings. Care Homes for Adults (18-65 years) Page 10 of 20 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 living in the home are supported to develop their skills and self confidence, plan for greater independence and enjoy the leisure activities of their choice. Evidence: At the time of this inspection visit the the people living in the home were all without a regular weekly day care or weekly routine. This was due to a number of differing reasons, including the closure of the educational day care unit run by the Provider and also some reductions that had been made in funding. The manager and the people living in the home explained how they were looking for alternative options and how they had increased their time spent on developing independence skills. People said they were happy with the leisure and social activities they were being supported to undertake, and gave examples of the variety of trips out and activities they had done. People explained how they are involved in the daily chores and routines in the house Care Homes for Adults (18-65 years) Page 11 of 20 Evidence: and being supported to develop their skills in cooking, budget planning, shopping and using public transport. People were very positive about the quality of food and explained how they were encouraged to eat a healthy diet but that their choice was respected by the staff team. Care Homes for Adults (18-65 years) Page 12 of 20 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. Peoples personal and healthcare needs are met, promoting their dignity and wellbeing Satisfactory arrangements are in place for the handling of medication, promoting service users wellbeing and, where appropriate, their independence. Evidence: People confirmed they received the personal care support they require. People living in the service described how they had been supported through health care issues, including hospital stays, and explained how they have developed their understanding of health care issues. People are supported to attend appointments and access any specialist input they require. People have Health Action Plans and also are supported to have annual health checks. Clear records are kept of appointments and all medication was correctly stored and recorded. Staff must undertake training before they are able to administer medication. Care Homes for Adults (18-65 years) Page 13 of 20 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a safe environment for service users in which they are respected and treated with dignity. Evidence: People living in the home confirmed they were aware of how to raise concerns or make a complaint about aspects of their care and support and said they felt confident about approaching staff or management about anything that concerned them. People said they felt safe in the home. All staff have completed training safeguarding and the home has comprehensive policies and procedures on protection practice. The service has a policy of not using restraint and staff are aware of the practices required to manage challenging behaviors. Care Homes for Adults (18-65 years) Page 14 of 20 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from a home that is well maintained and decorated throughout and provides a comfortable homely environment. Service users are supported and encouraged to personalize their living space and are involved in all decisions relating to redecoration of the home. Evidence: The home is well maintained throughout and provides a homely and comfortable environment for the people living there. There is sufficient communal space and a good sized garden, and the home is well situated to access local facilities and amenities. The bedrooms are personalized and people confirmed that their privacy was respected. The home was clean and hygienic throughout at the time of this inspection. Care Homes for Adults (18-65 years) Page 15 of 20 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. Service user needs are met by a motivated and effective staff team. Evidence: All the people living in the home spoke very positively about the staff team and the support they receive. They stated that they were treated with respect and that they were able to discuss issues or concerns if they wished to. They also commented on various activities they undertook with staff, which they said they all enjoyed. The majority of staff have completed NVQ training and the latest AQAA states that the figure is currently 80 per cent of the team. Records examined showed that people were up to date with statutory training as well as having undertaken training on managing challenging behaviors and adult protection. The Registered Manager has recently qualified as a trainer in life long learning, which will enable them to provide additional input and support to the staff. All staff have received regular supervision and were positive about the support they receive from the management and the Provider. A sample of recruitment records were examined and these showed that all required pre employment checks were being completed and that the necessary records were in place. Care Homes for Adults (18-65 years) Page 16 of 20 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. Service users benefit from a home that is well managed and organized and committed to providing high quality care and support. Evidence: The service has an experienced and qualified manager and it was evident from feedback from staff and service users, both in interviews and from surveys, that they are provided with leadership and direction. The Manager has regular contact with the Provider and several staff stated that they were clear about the ethos of the service and the commitment to provide a high quality level of care and support. The management take a proactive role in the implementing and developing of the care planning process and also undertake direct support work with the people living in the home. The home has systems in place to review the quality and performance of the service and a number of policies have been recently reviewed and updated were appropriate. All health and safety checks have been completed and the home has a current fire assessment in place. All fire safety checks have been recorded and staff have received training in fire safety. Care Homes for Adults (18-65 years) Page 17 of 20 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 18 of 20 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 19 of 20 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. Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 20 of 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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