Latest Inspection
This is the latest available inspection report for this service, carried out on 18th December 2009. it is an annual review prepared by CQC after examining previous reports and information from the provider. At the time of this report, CQC judged the service to be Good.
The inspector made no statutory requirements on the home as a result of this inspection
and there were no outstanding actions from the previous inspection report.
For extracts, read the latest CQC inspection for Remus Gate.
Annual service review
Name of Service: Remus Gate The quality rating for this care home is: The rating was made on: two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection We do an annual service review when there has been no key inspection of the service in the last 12 months. It does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection or annual service review.
Has this annual service review changed our opinion of the service?
No You should read the last key inspection report for this service to get a full picture of how well outcomes for the people using the service are being met. The date by which we will do a key inspection: Name of inspector: Rajshree Mistry Date of this annual service review: 1 6 1 1 2 0 0 9 Annual Service Review Page 1 of 10 Information about the service
Address of service: 11 Remus Gate Brackley Northants NN13 7HY 01280709894 01280840049 Telephone number: Fax number: Email address: Provider web address:
www.livability.org.uk Livability Name of registered provider(s): Name of registered manager (if applicable) Ms Jill Lammond Conditions of registration: Category(ies) : learning disability Number of places (if applicable): Under 65 Over 65 3 0 Have there been any changes in the ownership, management or the Yes service’s registration details in the last 12 months? If yes, what have they been: Date of last key inspection: Date of last annual service review (if applicable): Brief description of the service Remus Gate is a care home, which is registered to provide personal care and accommodation for three people with a learning disability. Remus Gate is one of six homes in the area owned by Grooms - Shaftesbury, and known is The Brackley Residential Project. Remus Gate is situated in a residential area of Brackley, a small market town in Northamptonshire. There are good local amenities such as a range of shops, healthcare services and leisure facilities. There is a good local bus service that operates during the weekdays, but public transport is limited at other times. People who use the service rely on transportation provided by the home. New Registered Manager Annual Service Review Page 2 of 10 The accommodation in the detached property, consists of four single rooms with shared access to a bathroom. There are communal areas that include a lounge, kitchen and a dining room. There is also a well-maintained garden for people to use. The Registered Manager is also the Registered Manager for the sister homes: Hawkins Close, Holly Close, Westminster Croft, Tudor Way and Hanover Drive, where the main office is based. The range of fees for 2009/10 are not known. People who are interested in using Remus Gate should contact the Regsitered Manager or the home directly for the range of fees. Further information about Remus Gate can be obtained from the home in the form of a Service User Guide and a Statement of Purpose. The latest Inspection Report is available at the home or can be accessed via the Care Quality Commission (CQC) website: www.cqc.org.uk Annual Service Review Page 3 of 10 Service update since the last key inspection or annual service review:
What did we do for this annual service review? We looked at all the information that we have received or asked from since the last Key Inspection of the service. This included the Annual Quality Assurance Assessment (AQAA) that was sent to us by the service. This AQAA is a self-assessment that focuses on how well outcomes are being met for the people using the service. It also gave us some numerical information about the service. We assessed the information we have about the service and how the complaints received have been managed. We looked at what the service told us with regards to the things that have happened in the service. These are called notifications and are a legal requirement. We looked at the last Key Inspection Report dated 17th December 2007, the last Annual Service Review dated 28th November 2008 and any other visits that we have made to the service in the last 12 months. We looked at the relevant information from other organisations and what other people have told us about the service. We sent out surveys to the people who use the service, which included surveys for their relatives. Also also sent out surveys to the staff that support the people who use the service and health care professionals. What has this told us about the service? Remus Gate sent us their Annual Quality Assurance Assessment (AQAA) when we asked for it. It was clear and gave us all the information we asked for. We looked at the information in the AQAA and our judgement is that the service is still providing a good service. Remus Gate has demonstrated how it continues to maintain the standards to benefit the people who use the service. The AQAA was completed by the Assistant Manager that provided us with details of what the service does well and the evidence to support the practice. There were details about the new developments and practice in place to improve the quality of service people experience. This showed the service recognises the need to continuously improve in response to concerns, changes in best practice and legislation. The AQAA demonstrated that people considering using the service and their relatives are given information about the service and are encouraged to visit the home to help them decide whether the home can meet their needs and aspirations. The information people receive is the comprehensive Statement of Purpose and the Service User Guide, and both are available in written, pictorial and easy read formats. These have details about the range of services offered to meet needs and aspirations and is Annual Service Review Page 4 of 10 reviewed annually. The AQAA showed that there is a comprehensive pre-admission assessment process to ensure the service is able to meet the individual needs. The assessment process takes into account individual needs, preferences, routines and aspirations, which may involve other health and social care professionals. People considering using the service are encouraged to visit several times and have an overnight stay. This enables people to decide if this is the right place for them and ensures a planned move to the home. People who choose to move to Remus Gate are given a contract that has the agreed fees and the terms and conditions of the stay. The contract is being developed in alternative formats to suit individual needs, such as pictorial and easy read format. Remus Gate has a person centred care plan that takes into account individual choices, interests, health and personal care needs. Assessments of risks are completed to ensure peoples independence is promoted safely, which is detailed in the care plan. The care plans are reviewed monthly with the person to ensure it accurately reflects their wishes. The AQAA states people using the service take control and make decisions about their daily living. This includes having a day-off with the support of staff to pursue their own interest and meet friends for coffee or lunch. People can choose their own bedroom furnishings and colour scheme for their bedroom. People take responsibility in keeping the home clean and are involved in decisions made about the home environment. People help with the weekly food shop and choose their own menu. They help with the preparation of meals. Individual likes and dislikes of meals are recorded and known to the staff, which promotes peoples well-being. The improvements made for the people who use the service includes increasing lifestyle choices and access to more social activities than before through having one-toone support. This shows peoples experiences and aspirations continue to be met. The AQAA states people who use the service have at least one holiday a year with staff. Individual holiday diary is kept for people to share with their family. People keep in contact with family and friends. Some people invite family and friends to parties and meals. People using the service have the right to form appropriate personal relationships, who are supported by staff, if necessary. The AQAA told us two people attend the local day centre four days a week and one person attends 3 days a week. They have the opportunity to take part in peer and cultural activities that promotes their social life. The Link Worker from the day centre meets with the people using the service and the staff to identify changes to support needs and aspirations. One person who uses the service has a work placement in a large superstore, which shows their independence and personal achievement. The AQAA states the service has appointed an Activities Co-ordinator to support people using the service with their individual interests, aspirations and friendships. The AQAA states people using the service are supported to be as independent as
Annual Service Review Page 5 of 10 possible with regards to receiving personal care support and meeting their health needs. People are registered with the local General Practitioner (GP) surgery and have regular visits to the dentist, podiatrists and opticians. They also have the opportunity to have annual health checks. One person is supported to choose a dental practice preferable to the local dentist and another is being supported with an individual health issue, which is affecting their self-esteem. This shows peoples rights, choices and wellbeing is supported and promoted. Staff have a good understand of individual needs and how to support them. The improvements made include the life skills assessment carried out by the Community Team with the people using the service with regards to promoting their independence. Remus Gate has a good system for the management, storage and administration of medication. The staff have accredited medication training. People who wish to continue managing their own medication are able to do so and supported by staff when necessary. The AQAA states the complaints procedure is provided to everyone using the service in the form of a booklet known as how to make a complaint. This is provided in formats suitable to individuals such as pictorial format. The complaints procedure is also included in the Service User Guide, with the details of the process and timescales. The AQAA states all complaints are recorded and addressed. Staff are aware that some people do not always know their rights and are supported through the process of making a complaint. There are monthly house meetings and private monthly care plan meetings where people may express any concerns they may have. There are monthly monitoring visits carried out by the Operational Manager who has the opportunity to speak with the people using the service and receive any concerns. The AQAA states the service received no complaints. The Care Quality Commission received no expressions of concerns or complaints about Remus Gate. The AQAA states staff have received training in the safeguarding of vulnerable adults (SOVA) and have supporting policies and procedures in place. Safeguarding means promoting and protecting the well-being of people using the service from harm, risk and abuse. All staff are aware of their role and responsibility with regards to safeguarding adults. The monthly monitoring visits conducted by the Operations Manager also looks at any complaints, concerns and safeguarding matters that affects the well-being of people using the service. Remus Gate has made a number of improvements to support the people using the service. These included all staff receiving training in the Deprivations of Libertys and the Mental Capacity Act. This is to help staff have a better understanding of what is meant by libertys and capacity, with regards to supporting the people living at Remus Gate. The information on how to make a complaint has been improved. The people who use the service and their relatives also have the opportunity to comment and express their views and concerns through the annual quality questionnaires and surveys. Annual Service Review Page 6 of 10 The Care Quality Commission has received timely notifications with regards to events that have affected the well-being of people using the service. This is a legal requirement. The AQAA states Remus Gate is a well maintained detached property that blends in with the other private residential properties. People who use the service choose the bedroom furnishings and decor to reflect their personality and interests. People using the service take an active role in keeping the home clean and tidy with the support of staff. There is a garden that people use, which is maintained by the staff and one person that lives at the home who likes to help. The AQAA includes details of the systems, servicing and testing of appliances and equipment in the home. There is a programme of maintenance and a budget for the up keep of the home. The people using the service use the house meetings to bring issues about the home environment with regards to health and safety to the attention of each other and the staff. The monthly monitoring visits conducted by the Operations Manager also monitors and assess the home environment in relation to health and safety. Following the flooding experienced at Remus Gate in January 2009, new carpets have been fitted throughout the ground floor. The AQAA demonstrated that staff recruitment process is robust, whereby people who use the service are involved in the recruitment of staff. Pre-employment checks are carried out and maintained on file. These include two satisfactory references, criminal records bureau (crb) check and a protection of vulnerable adults (pova) check. These are checks to assess the suitability of the applicant to work with vulnerable people. The service also uses agency staff who undergo the same pre-employment checks. The AQAA states all staff complete a 6 to 8 week induction programme and are expected to complete the Learning Disability Qualification (LDQ) within 6 months of employment. The agency staff are required to complete an induction before they can work alone. All staff receive mandatory training and updates. The service has two staff that have attained the National Vocational Qualification (NVQ) level 2 in care and the third staff is in the process of completing the NVQ 2. All staff, including agency staff, receive supervisions and an annual performance review. There are monthly staff meetings, which include standard agenda items such as, adults protection, health and safety, care standards and sharing information with regards to the things that have happened in the service. The AQAA states the Registered Manager is experienced in managing a care home and working with people with a learning disability. She has attained NVQ level 4 and the Registered Managers Award. The management of the service includes the Deputy Manager who has attained NVQ level 4 and the Assistant Manager who has attained NVQ level 3 in care. The management of the service meets the needs of the people who use the service, through staff recruitment procedures, training and staff deployment. We have been informed that there will be changes to the management team whilst the Registered Manager has sabbatical leave for 3 months and returning in February 2010. They have sent us information with regards to the personnel managing the service and gave assurance that people using the service will not be affected. Annual Service Review Page 7 of 10 The AQAA states the policies and procedures are reviewed and some were last updated in June 2009. The AQAA details the range of quality assurance and monitoring systems in place. These include the Operations Managers monthly visits, known as Regulation 26 visits and are a legal requirement. There are monthly house meetings whereby the people using the service are consulted and informed about any changes that may affect or influence the quality of life they experience. People who use the service are involved in the annual reviews with the stakeholders. These are organisations that financially supports individuals using the service such as the Local Authority. People also have the opportunity to express their views and opinions about Remus Gate through the annual quality assurance surveys. We sent out 3 surveys to the people who use the service, which included relatives surveys. We received 1 survey from a person who uses the service and 1 from a relative. The person using the service completed the survey with the help of the support worker. The responses indicated people were given information about the home to help them decide if the home was right for them. All the responses indicated people made decisions about what they do each day, in the evenings and at the weekends. All the responses indicated people know who to speak with if they are not happy or need to make a complaint. All the responses indicated the home is fresh and clean. All the responses indicated staff treat people well, listen and act on what they say. The additional comments received in the surveys were: I go out a lot I like the food Its a nice place to live Staff take me out and take me where I want to do I like it here We sent out 4 surveys to the health and social care professionals such the GP and the Learning Disability Service, of which 1 survey was received from the GP. They indicated in the responses that peoples health and social care needs are properly monitored, reviewed and met by the service, including support with their medication, privacy and dignity. The responses indicated the manager and staff have the right skills and experience to support the people using the service and always responds appropriately to any concerns, if raised. We sent out 6 surveys to the staff that support the people that live at Remus Gate, of which 2 surveys returned. The responses received indicated staff receive up to date information about the people that use the service and their care and support needs. The responses indicated that staff were appointed with satisfactory pre-employment checks and receive induction training that covered their job role. The responses received indicated staff felt they had the right skills, knowledge and experienced to look after the people who use the service. The responses received indicated staff were
Annual Service Review Page 8 of 10 confident to respond to concerns and complaints from the people who use the service and/or their relatives. The responses received indicated staff receive support, supervisions from the manager and have meetings to discuss work issues. The additional comments received in the surveys were: Support residents and puts their needs first We have good communication and established staff team, which the service users respond very well to Staff are very supportive of me in my role of ..... and we all work well together for the promotion of dignity, choice and well-being of service users The home is well maintained, service users supports and records are up to date Individual and communal needs are met well and we have good links within the community and access to social events and leisure activities Health needs etc, are spot on Links with service users families are excellent The home runs really well and effectively with the staff team and service users all working together to make a positive environment We also received a couple of comments with regards to lack of communication and support from the manager and the role and responsibilities of staff in particular positions. There was also reference to the future of the service provision with regards to people choosing to live in supported living accommodation instead of residential care. We discussed these comments with the Interim Acting Manager who welcomed the comments and gave us assurance they would meet with staff to offer support and take steps to improving communication and support. They also said they would keep the people using th service, their family and staff informed of any decisions made about the future if and when they happen. Remus Gate continue to let us know about the things that have happened since our last Key Inspection. They have shown that they have managed issues. They work well with us and have shown that the service continues to provide good quality outcomes for the people who use it. What are we going to do as a result of this annual service review? The next inspection of this service will be based on the Fees and Frequency Regulations 2007 and the assessment of risk of the service. Further clarity will become evident as the new registration and inspection system under the Health and Social Care Act 2008 is confirmed. Annual Service Review Page 9 of 10 Reader Information
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