Care Home: Red Admiral Court (3)

Similar services:

• 22 Sandown Road
• The Highlands
• Dilston College Of Further Education
• West View House
• Blenheim House
• Prince Bishop Court
• Park View (15)
• Craigmore House

What the care home does well The manager and her staff team engaged with the inspection process in a very positive manner. Staff have developed warm and affectionate relationships with the people they care for. They are positive and show a genuine interest in people’s needs. The home has a warm and friendly atmosphere. Staff are polite, courteous and respectful. Red Admiral Court (3) DS0000066171.V374790.R01.S.doc Version 5.2 The home has been adapted to meet the needs of people with visual impairments and physical disabilities. This helps to promote people’s independence. The home is domestic in appearance, fits in well with the local community and is nicely furnished. The people living at Red Admiral Court said that they are happy living at the home and feel well looked after. Equality and diversity issues are taken seriously within the home. For example, the rota is organised to ensure that people are cared for by someone of the same sex where this is important to them. People using the service are involved in the staff recruitment process. People living at the home are able to access the provider’s specialist rehabilitation services. People receive support with planning mobility routes, accessing leisure activities and participating in household tasks. Staff receive training that is specific to the needs of people with visual impairment. The relatives of people living at the home who returned surveys said that: • ‘They have a varied range of activities to participate in on a regular basis. We receive regular progress updates. We are constantly kept up to date regarding medical concerns and are always made to feel welcome when visiting. The staff team is friendly and we have been supported through recent problems;’ ‘Staff care for our daughter very well. She is in a safe and happy house.’•A healthcare professional who returned a survey said ‘…I am no longer the coordinator for my service user. However, whilst I was involved I always felt staff communicated well with me ensuring that I was kept informed of any changes in my service user’s needs.’ A member of staff who returned a survey said ‘…there is an excellent atmosphere in the house. All the staff and service users get on with each other very well and staff have good relationships with them. The service users are always out and about and staff are very supportive of each other. I love my job, all the service users and the staff are great. I enjoy coming to work.’ Another member of staff said ‘…the home has a strong staff team. We all work well very hard to ensure that service users have excellent care. Above all, we strive to promote independence. In my opinion, the service users are very happy here.’Red Admiral Court (3)DS0000066171.V374790.R01.S.docVersion 5.2Page 7 What has improved since the last inspection? Service users have been provided with opportunities to access a wider range of activities. Staff have supported people to make choices about the type of day service provision they wish to participate in. Service users have been provided with discrimination awareness training. Role play and ‘Stranger Danger’ awareness training are being used to help people stay safe. Service users have been consulted about the development of the home’s large garden area. Their views have been incorporated into the development plan for improving the garden. Service users have more involvement in devising their individual support plans. Each service user has a named social worker and has had an annual review. Service users have been supported to apply for grants to enable them to access holidays of their choice. Following successful applications, some people have made a decision to visit the Calvert Trust in Keilder. This is a specialist facility for people with learning and physical disabilities. All staff have completed an accredited medication award. Most staff have completed a recognised qualification in social care. Staff are receiving regular supervision. Communal areas have been re-decorated during the previous 12 months. Vibrant wall coverings have been used to make it easier for people with visual disabilities to use the building safely. Following concerns identified in the last inspection, the manager has improved the home’s day to day medication practices. What the care home could do better: Ensure that criminal Records Bureau disclosure certificates are held until they can be checked by a CQC inspector during their next visit to the service. The provider must obtain a recent identity photograph for each member of staff. This will help people using the service to be confident that they are in safe hands at all times.Red Admiral Court (3)DS0000066171.V374790.R01.S.docVersion 5.2 Key inspection report CARE HOME ADULTS 18-65 Red Admiral Court (3) 3 Red Admiral Court Gateshead Tyne and Wear NE11 9TW Lead Inspector Glynis Gaffney Key Unannounced Inspection 12 and 13th May 2009 10:00 th Red Admiral Court (3) DS0000066171.V374790.R01.S.doc Version 5.2 Page 1 This report is a review of the 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. 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 home adults 18-65 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. Red Admiral Court (3) DS0000066171.V374790.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) 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. www.cqc.org.uk Internet address Red Admiral Court (3) DS0000066171.V374790.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Red Admiral Court (3) Address 3 Red Admiral Court Gateshead Tyne and Wear NE11 9TW 0191 4611469 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Henshaws Society for Blind People Alison Thornton Care Home 6 Category(ies) of Learning disability (6), Physical disability (3), registration, with number Sensory impairment (6) of places Red Admiral Court (3) DS0000066171.V374790.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th May 2008 Brief Description of the Service: 3 Red Admiral Court is a large, family house in a modern housing estate that was built in 1990. It has been extended to provide six bedrooms that meet the National Minimum Standards for Younger Adults. The home provides six places for younger adults with visual impairments, who may also have learning and physical disabilities. Three bedrooms on the ground floor are suitable for people who use a wheelchair. The remaining three bedrooms are on the first floor, one of which has an en-suite bathroom. There is a communal bathroom on the ground floor and another on the first floor. There is also a kitchen/dining room, a lounge and a small quiet room on the first floor. The building has been assessed by a mobility officer to ensure that the facilities provided meet the needs of people with a visual impairment and a physical disability. There is a large staff office on the second floor. The house is a short walk from the local shops and transport routes. The current residential fee ranges from £1138.63 to £1,165.96 per week. Copies of Care Quality Commission reports are available in the main reception area. Red Admiral Court (3) DS0000066171.V374790.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is two star – good service. This means the people who use this service experience good quality outcomes. How the inspection was carried out: Before the visit: We looked at: • • • • • Information we have received since the last key inspection visit on the 29 May 2008; How the service dealt with any complaints and concerns since the last visit; Any changes to how the home is run; The manager’s view of how well they care for people. We also interviewed three people who use the service and three staff; The views of relatives, other professionals and staff. The Visit: An unannounced visit was made on the 12 May 2009. During the inspection we: • • • • • • Talked with the manager; Looked at information about the people who use the service and how well their needs are met; Looked at other records which must be kept; Checked that staff have the knowledge, skills and training to meet the needs of the people they care for; Looked around the building to make sure it is clean, safe and comfortable; Checked what improvements had been made since the last visit. What the service does well: The manager and her staff team engaged with the inspection process in a very positive manner. Staff have developed warm and affectionate relationships with the people they care for. They are positive and show a genuine interest in people’s needs. The home has a warm and friendly atmosphere. Staff are polite, courteous and respectful. Red Admiral Court (3) DS0000066171.V374790.R01.S.doc Version 5.2 Page 6 The home has been adapted to meet the needs of people with visual impairments and physical disabilities. This helps to promote people’s independence. The home is domestic in appearance, fits in well with the local community and is nicely furnished. The people living at Red Admiral Court said that they are happy living at the home and feel well looked after. Equality and diversity issues are taken seriously within the home. For example, the rota is organised to ensure that people are cared for by someone of the same sex where this is important to them. People using the service are involved in the staff recruitment process. People living at the home are able to access the provider’s specialist rehabilitation services. People receive support with planning mobility routes, accessing leisure activities and participating in household tasks. Staff receive training that is specific to the needs of people with visual impairment. The relatives of people living at the home who returned surveys said that: • ‘They have a varied range of activities to participate in on a regular basis. We receive regular progress updates. We are constantly kept up to date regarding medical concerns and are always made to feel welcome when visiting. The staff team is friendly and we have been supported through recent problems;’ ‘Staff care for our daughter very well. She is in a safe and happy house.’ • A healthcare professional who returned a survey said ‘…I am no longer the coordinator for my service user. However, whilst I was involved I always felt staff communicated well with me ensuring that I was kept informed of any changes in my service user’s needs.’ A member of staff who returned a survey said ‘…there is an excellent atmosphere in the house. All the staff and service users get on with each other very well and staff have good relationships with them. The service users are always out and about and staff are very supportive of each other. I love my job, all the service users and the staff are great. I enjoy coming to work.’ Another member of staff said ‘…the home has a strong staff team. We all work well very hard to ensure that service users have excellent care. Above all, we strive to promote independence. In my opinion, the service users are very happy here.’ Red Admiral Court (3) DS0000066171.V374790.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? What they could do better: Ensure that criminal Records Bureau disclosure certificates are held until they can be checked by a CQC inspector during their next visit to the service. The provider must obtain a recent identity photograph for each member of staff. This will help people using the service to be confident that they are in safe hands at all times. Red Admiral Court (3) DS0000066171.V374790.R01.S.doc Version 5.2 Page 8 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. Red Admiral Court (3) DS0000066171.V374790.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Red Admiral Court (3) DS0000066171.V374790.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 2. People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are suitable arrangements for making sure that people’s needs are assessed before they are admitted into the home. This helps to ensure that staff will be able to meet people’s needs on admission into Red Admiral Court. EVIDENCE: People admitted into the home are former students of a specialist further education college run by the provider. People’s needs are assessed before admission to ensure that the placement offered at Red Admiral Court is suitable. This helps the provider to set up independence programmes for people using the service. Relevant professionals are involved in the preadmission assessment process. All of the records checked contain a social services assessment and relevant information from their previous residential college placement. There have no new admissions into the home within the last three years. Red Admiral Court (3) DS0000066171.V374790.R01.S.doc Version 5.2 Page 11 Red Admiral Court (3) DS0000066171.V374790.R01.S.doc Version 5.2 Page 12 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. People using the 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 arrangements for ensuring that people’s individual needs are met, and their choices respected, are good. This means that people are able to benefit from being cared for by staff who know what their needs are and how to meet them. EVIDENCE: There are good arrangements for ensuring that people’s individual needs are met. A sample of people’s care records was looked at as part of the inspection. These included: • ‘All About Me’ information. This provides staff with important information about people’s lives before coming to live at the home; DS0000066171.V374790.R01.S.doc Version 5.2 Page 13 Red Admiral Court (3) • An ‘Individual Service Plan’ (ISP) and objectives addressing their needs in a range of areas. Following a requirement set in the last inspection, the manager and her team have put a lot of effort into ensuring that people’s ISPs and individual objectives relate specifically to their needs and aspirations. Following the last inspection, the provider’s rehabilitation team visited the home and reviewed people’s ISPs, individual objectives and ‘Living Skills’ checklists. Service users now work towards achieving a maximum of two objectives at any one time to ensure they remain obtainable. Staff are now much clearer about the action they must take to meet people’s needs. People’s placements are reviewed regularly. In the last 12 months each person has had a social services review. One person’s review took place during the inspection. The review was attended by social services, staff from the home, the service user and their family. People living at the service said that they are always invited to their review meetings. They also said that they had been offered the opportunity to contribute to their ISP and individual objectives. Key Worker meetings now take place every month and review people’s progress in relation to their ISPs and individual objectives. This is useful as it records what events have taken place in the person’s life during the previous month. The meetings also measure the effectiveness of people’s ISPs and objectives. People’s care records contain information about their preferred routines, likes and dislikes. The manager and her staff team are in the process of carrying out Mental Capacity Act assessments for each person using recommended tools to do this. People said that they are supported to make all their own decisions. One person said ‘…I choose when I get up, what I have for breakfast and what I wear. Staff don’t make decisions for me. They listen to what I have to say. Sometimes they advise me. But, I make my own decisions. That is the way it should be.’ People are supported to take appropriate risks. Risk assessment policies and procedures are in place. The manager emphasised that people’s safety is taken seriously and risk assessments are carried out wherever staff identify potential areas of concern. For example, in one person’s care records, risk assessments have been devised covering the support they need to use the home’s kitchen, go swimming and using a trampoline. Another person’s care records contain a complex risk assessment providing staff with guidance about how to manage this individual’s challenging behaviours. Staff have signed completed risk assessments to confirm that they have read them. However, it was identified that some risk assessments have not been updated during the previous 12 months. Most of the staff who returned surveys said they are given up to date information about people’s needs and the ways of sharing information between shifts works well. Red Admiral Court (3) DS0000066171.V374790.R01.S.doc Version 5.2 Page 14 Red Admiral Court (3) DS0000066171.V374790.R01.S.doc Version 5.2 Page 15 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): This is what people staying in this care home experience: 12, 13, 15, 16 and 17. People using the 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 able to choose how they want to live their lives, and they receive the level of staff support that suits them. This means that people are able to benefit from living in a home where staff support them to engage in their community, be more independent and live a healthy lifestyle. EVIDENCE: People are supported to take part in culturally age appropriate activities and to make use of community based facilities. For example: • Five of the people living at the home attend college courses of their own DS0000066171.V374790.R01.S.doc Version 5.2 Page 16 Red Admiral Court (3) • • • • • choosing. Two people have recently completed a college IT course which they commenced in September 2008; With the support of RNIB, staff are supporting one person to move into supported employment; Service users take part in the ‘Sounds Good to Me’ choir which they attend on a weekly basis at the Sage Gateshead; Two service users are members of ‘Friends Action North East.’ They meet every fortnight at their local pub and attend other arranged events such as Steak and Curry Nights; People attend local groups such as Gateway Wheelers which provides people with opportunities to socialise with their friends; Service users are consulted about what day trips they would like to participate in. Trips to Alnwick gardens and Seahouses are planned for the summer. People said that they feel the home provides them with good opportunities to go out and do interesting things. Each person has an activity planner which shows what activities they have agreed to participate in. One person said ‘…I am never bored. I have lots of things I can do in my bedroom. Staff are always taking us out. I really enjoy going out with staff.’ People living at the home who returned surveys said: we are able to make our own decisions about what we do each day; staff ‘always’ treat us well; staff ‘always’ or ‘usually’ listen to and act upon what we say. Henshaws Rehabiliatation Service provides people with individual support to develop independent living skills in areas such as shopping, carrying out household tasks and cooking. The rehab team provides staff with written guidance based on an assessment of each person’s needs. On the day of the inspection, a worker from Henshaw’s Rehabilitation Service was providing a service user with support to walk to the local post office and collect their benefits. People said that the home’s staff are good at supporting them to do new things. They also said that they are supported to participate in the running of the home and enjoy attending householder meetings. Each person has a weekly ‘living skills’ day where they design their own menu, go shopping for the ingredients and prepare their own meal. Most other main meals are prepared by staff as people attend activities most days. People said they are very satisfied with the help they receive in this area and all commented that they enjoy the meals provided. Where people have specialist dietary needs, staff ensure that these catered for. On the day of the inspection, the kitchen was clean, hygienic, tidy and well equipped. There was a pleasant atmosphere during the meal time observed. Red Admiral Court (3) DS0000066171.V374790.R01.S.doc Version 5.2 Page 17 Staff support people to keep in contact with family members and friends of their choosing. One person said ‘…staff support me to get ready to go home. This is important to me as I enjoy seeing my mum and dad.’ This person also said that staff support them to speak with their family whenever they want. A member of staff who returned a survey said ‘…I have been employed at home for a number of years. The home has a wide range of activities going on and the service users are always listened to and respected by the dedicated staff team and manager.’ Another staff member said ‘…the home delivers very good care to service users. We endeavour to provide access to various activities which service users enjoy such as cycling and swimming. We also have a rehab team which provides support to service users to become more independent. Staff are trained to promote independent living skills.’ Red Admiral Court (3) DS0000066171.V374790.R01.S.doc Version 5.2 Page 18 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 18, 19 and 20 People receive the personal and healthcare support they need to stay healthy. This means that people using the service are able to benefit from living in a home where their health and well being is a priority and staff are clear about how their needs are to be met. EVIDENCE: Good arrangements are in place to meet people’s health care needs. All service users are registered with a local GP and dentist. Access to more specialist healthcare professionals, such as dieticians and physiotherapists, is arranged as and when needed. In the sample of care records looked at, each person had seen a dentist and optician during the last 12 months. Staff support people to attend GP, outpatient and optical care appointments when required. However, people’s care records do not contain copies of their Health Action Plans (HAPs). Following a recommendation made in the last inspection report, the manager Red Admiral Court (3) DS0000066171.V374790.R01.S.doc Version 5.2 Page 19 contacted the relevant local authority who confirmed that they are in process of agreeing a format for HAPs. The manager agreed to keep this matter under review. None of the people living at the home are at risk of under or over nutrition. However, following a recommendation made in the last inspection report, the manager obtained a copy of a nutritional health risk assessment tool which will be completed for all people using the service. This will help staff to identify any preventative action they should take to help people benefit from good nutritional health. Following a recommendation made in the last inspection report, a pressure care risk assessment has been completed for a person with limited mobility. This will help staff to identify any preventative action they should take to keep this person’s skin healthy and in good condition. The service operates a keyworker system which staff said works well. Key Workers act as a point of contact for families, friends and other professionals. They are responsible for developing people’s support plans and objectives, and for ensuring that all records are up to date. People said that they are provided with good support and staff look after them very well. Staff said that they are clear about how to meet people’s personal and healthcare needs. Following recent independence training, four service users are now able to shower independently. Moving and handling risk assessments have been completed for each person and those looked at had been reviewed during the previous 12 months. Arrangements are in place to ensure that medication is handled safely within the home. All medication has original prescription labels attached. Controlled drugs are not used within the home. There is no evidence that medication has been given in error since the last inspection. Following concerns identified in the last inspection report, the manager has: • • • • • • • Arranged for all staff to complete accredited medication training; Obtained a more up to date medication reference manual; Obtained a suitable container for storing medicines requiring cold storage; Assessed each staff member’s competency to administer medication; Ensured that staff complete people’s Medication Administration Records after administering their medication; Ensured that people’s medication records contain an identification photograph; Arranged for the service to be inspected by a community pharmacist; Red Admiral Court (3) DS0000066171.V374790.R01.S.doc Version 5.2 Page 20 • Improved the arrangements for storing people’s medication. Separate storage arrangements are now in place for internal and external medicines. Red Admiral Court (3) DS0000066171.V374790.R01.S.doc Version 5.2 Page 21 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 22 and 23 The arrangements for handling complaints and managing safeguarding concerns are good. This means that people are able to benefit from living in a home where concerns about their safety are promptly addressed and their views listened to and acted on. EVIDENCE: Details of the home’s complaints procedure are included in the service user guide. The procedure is available in Braille and large print. People using the service said that they have been told how to make a complaint and would feel comfortable raising concerns with staff. Neither the home nor the Commission have been notified of any complaints since the last inspection. Staff confirmed that they have been told how to handle complaints. A copy of the local authority’s safeguarding procedures is available within the home. Four safeguarding referrals have been made since the last inspection. On being notified of each concern, the manager and provider have taken immediate action to safeguard the people in their care. The most recent safeguarding concern, which came to light as a result of staff whistle-blowing, is currently subject to legal action and the staff member involved has been referred to the Protection of Vulnerable Adults List. The families of people using Red Admiral Court (3) DS0000066171.V374790.R01.S.doc Version 5.2 Page 22 the service were informed and advice and guidance was obtained from the local safeguarding team. Staff have received safeguarding training and are clear about how they would handle any safeguarding concerns that came to light during their shift. People living at the home said that they feel safe. Red Admiral Court (3) DS0000066171.V374790.R01.S.doc Version 5.2 Page 23 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People using the 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 arrangements for ensuring that the premises are well maintained are good. This means that people are able to benefit from living in a home that has good facilities, is generally well maintained, and has been adapted to meet their needs. EVIDENCE: The home is a large, family house in a modern housing estate. It is indistinguishable from neighbouring houses. It has been extended to provide six places for young people with visual impairments and learning disabilities. The house has a front driveway and a good-sized back garden. Two of the three bedrooms on the ground floor are suitable for use by people who are Red Admiral Court (3) DS0000066171.V374790.R01.S.doc Version 5.2 Page 24 wheelchair users. Two of these bedrooms have large en-suite shower rooms. There is a separate shared bathroom. The remaining three bedrooms are located on the first floor, and one of these has an en-suite bathroom. There is also a communal bathroom on the first floor. Modern blinds are fitted to all the bedroom windows to ensure privacy. Bedrooms are bright and cheerful, and are only occupied by one person. People said that they had been involved in choosing the décor, furnishings and fittings in their bedrooms. All bedrooms have been personalised to reflect the preferences of the occupant. The home has colour-contrasted paintwork and appropriate lighting levels to meet the needs of the individuals living there. The house is generally well decorated and furnished, comfortable, warm and clean. Some areas of the home have been decorated since the last inspection. There are appropriate symbols fixed to each door so that people can identify their own bedroom. A range of aids has been provided to help people be more independent. Staff from the provider’s Rehabilitation Team visit regularly to assess whether people need extra equipment to support more independent living. Other aids have also been provided. For example, the home has a talking microwave and scales. Staff and people using the service have access to taped recipes. A colour contrasted carpet has been fitted on the stairs. Although staff carry out the main domestic tasks, people are supported to clean their own rooms and do their own laundry. Following a recommendation in the last report, the Department of Health checklist for assessing infection control measures in residential care homes has been completed. All radiators have been guarded to keep people safe. No hazards or health and safety concerns were identified during the inspection. The Henshaws Property Services Director visits the service on an annual basis to discuss and address future needs and repairs. The home has a large back garden which is shortly due to be landscaped. This will make it easier for people using the service to access the garden area. Red Admiral Court (3) DS0000066171.V374790.R01.S.doc Version 5.2 Page 25 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36. People using the 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 cared for by competent and qualified staff that have the skills and knowledge to meet their needs, and people are protected by the home’s recruitment policies and procedures. This means that people are able to benefit from living in a home where their health, safety and well-being is treated seriously. EVIDENCE: There are rotas that show which staff are on duty and at what times. The staff team consists of a manager and 11 support staff. Recruitment is currently underway to fill a vacant post. The rotas show that for six service users there is always a minimum of two staff on duty between 8 am and 10 pm. In addition, there are extra staff on duty during busier times of the day or to Red Admiral Court (3) DS0000066171.V374790.R01.S.doc Version 5.2 Page 26 support people attending community based activities. One member of staff ‘sleeps over’ in the building each night. Most staff acknowledged that staffing levels are generally satisfactory. However, some said that when there are only two staff on duty, it is difficult to support service users outside of the home. Service users said that staff are always available if you need them. One person said ‘I only have to ask for staff to help me and they are there. Sometimes if they are busy with someone else you have to wait. But that is okay with me. The staff are great. I feel well looked after.’ Following a requirement made in the last inspection report, arrangements have been put in place to ensure that staff receive regular supervision. Staff reported that they meet regularly with their manager and said that they receive the support they need to do their job. Although not all of the required staff records are kept at the home, the provider made them available on request. An examination of the records showed that a range of pre-employment checks are carried out before staff can start working at the home. For example, staff are required to complete an application form, attend a selection interview, provide statements about their physical and mental health and confirm whether they have any convictions. Also, each staff member’s identity is verified and two written references and a Criminal Records Bureau (CRB) disclosure certificate are obtained. However, none of the files contain an identification photograph and some staff have not provided a full employment history. Also, the original CRB certificate for a member of staff appointed following the last inspection had been destroyed. This action is against current Commission guidance which states that new staff’s CRBs must be held until the next inspection visit is carried out. There is documentary evidence that staff appointed by the current manager have received a thorough induction. Staff are expected to complete and regularly update their mandatory training. All staff have completed training in moving and handling, infection control, food hygiene awareness, first aid, fire safety and health and safety. However, it was identified that one member of staff has not updated their moving and handling training during the previous 12 months. Over 85 of the staff team have obtained a National Vocational Qualification in Care at Level 2 or above. Staff also complete training that is specific to the needs of the people they care for. For example, the majority of staff have completed ‘Sighted Guide’ training for staff who work with people with visual disabilities. Some staff have completed Autism, Community Housing Independent Living Skills and Mental Capacity Act awareness training. Staff said that they have received the training they need to do their job. They also said that the manager is always trying to source new training opportunities for them. Red Admiral Court (3) DS0000066171.V374790.R01.S.doc Version 5.2 Page 27 Arrangements are in place for staff to receive regular supervision. Staff who returned surveys said that the manager gives them enough support and meets with them regularly to discuss how they are working. Staff also said that they have enough support, experience and knowledge to meet the different needs of people living at the home. A member of staff said ‘…I think we are a good caring team that try and do what is best for the householders. Sometimes we are short staffed but we all pull together so that clients never miss out on anything. I feel we are a good staff team and the staffing levels will get better in the future.’ Red Admiral Court (3) DS0000066171.V374790.R01.S.doc Version 5.2 Page 28 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 and 42. People using the 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 arrangements for protecting and promoting people’s health and safety are good. This means that people are able to benefit from living in a well run home where their health, safety and welfare is treated seriously. EVIDENCE: Mrs Thornton has successfully registered with the Commission since the last inspection of the service. She is an experienced professional and has obtained the Registered Manager’s Award during the last 12 months. Mrs Thornton said that her statutory training is up to date and has completed advanced health Red Admiral Court (3) DS0000066171.V374790.R01.S.doc Version 5.2 Page 29 and safety training since the last inspection. She demonstrated good leadership skills and has a clear vision of how she would like the home to continue to improve. Staff said that the home has improved since the appointment of the manager. A more structured working routine has been introduced for staff to ensure that required jobs are carried out and people’s needs are met. There is also evidence that the manager is prepared to tackle poor practice and take disciplinary action to address concerns. Arrangements are in place to monitor the quality of the service. For example: • Regular householder meetings take place where people are encouraged to express their views and opinions about how the home is managed. People said that they think the home is well run; People are also encouraged to complete satisfaction surveys using the provider’s ‘What Do I Think’ questionnaire; An in-house quality audit is carried out every six months. Also, the community housing manager carries out three monthly quality assurance assessment visit to monitor the quality of services and care provided at the home. • • The provider submitted a well completed Annual Quality Assurance Assessment when asked to do so. This contained robust evidence to support the selfassessment judgements reached by the manager. An annual development plan has been developed taking into account the findings of the last inspection and the provider’s internal quality monitoring systems. People take responsibility for managing their own money. Each person has access to a lockable cashbox which is kept in their bedroom. A cash book is kept and includes details of when money is put in and taken out of the tin. A sample of records was checked against the actual balances held in people’s cash tins, all were found to be correct. The arrangements for promoting people’s health and safety are good. For example: • • • • • • The home has an up to date fire risk assessment and fire prevention checks are carried out on a regular basis with the exception of visual checks of the fire extinguishers; Requirements made by the fire service following their visit in October 2008 have been addressed. A member of staff has received fire marshal training. This will help the home to deliver better quality fire training; Staff have participated in at least two fire drills during the last 12 months; The water system is tested for the presence of Legionella; There is a current gas safety certificate; The home’s electrical equipment has recently been checked and there is a current electrical safety certificate; DS0000066171.V374790.R01.S.doc Version 5.2 Page 30 Red Admiral Court (3) • • • No health and safety concerns were identified during the inspection. Weekly health and safety checks are carried out; The emergency call system has recently been serviced; A range of workplace risk assessments have been carried out. Red Admiral Court (3) DS0000066171.V374790.R01.S.doc Version 5.2 Page 31 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 X 3 3 3 X X 2 X Version 5.2 Page 32 Red Admiral Court (3) DS0000066171.V374790.R01.S.doc No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA34 Regulation 7, 9 and 19 Requirement Ensure that: • Criminal Records Bureau disclosure certificates are held until they can be checked by a CQC inspector during their next visit to the service; The provider has obtained a recent identity photograph for all staff. Timescale for action 01/07/09 • This will help people using the service to be confident that they are in safe hands at all times. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA7 Good Practice Recommendations Carry out an assessment of each person’s competency to DS0000066171.V374790.R01.S.doc Version 5.2 Page 33 Red Admiral Court (3) make everyday decisions taking into account the guidance set out in the Mental Capacity Act. 2. 3. 4. 5. 6. 7. YA9 YA17 YA19 YA35 YA42 YA24 Ensure that people’s risk assessments are reviewed every 12 months. Ensure that a preventative nutritional assessment is completed for each person. health risk Obtain a copy of each person’s Health Action Plan once completed by the local authority. Ensure that staff update their moving and handling training each year. Ensure that visual checks of the home’s fire extinguishers are carried out at least once a month. Arrange for the garden areas to be made more accessible to people using the service. Red Admiral Court (3) DS0000066171.V374790.R01.S.doc Version 5.2 Page 34 Care Quality Commission North Eastern Region Citygate Gallowgate Newcastle Upon Tyne NE1 4BA National Enquiry Line: Telephone: 03000 616161 Email: enquiries.northeastern@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. Red Admiral Court (3) DS0000066171.V374790.R01.S.doc Version 5.2 Page 35 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!