Care Home: Ryan Q.C. Homes, Farthings

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What the care home does well People living at the home feel that staff help then to follow their individual interests. This means for those who like to go into town to have lunch or others who may like to go to the cinema for instance have opportunities to do this, although it is mainly during the day. One person who had just returned said, "oh yes I like going out very much and I had something to eat, yes I go every week". Many of the people also attend day support facilities across Northants, here they can participate in a range of development programmes including life skills, music therapy and peer support programmes. Again staff at the home continue to be good at making sure people receive the medical support that they may need. If someone needs to see a Doctor if they feel unwell, staff are still quick to arrange this on their behalf if they need help with this. Staff will also find out if that person needs someone else to go with them, and will also arrange this. This means people living at the home receive prompt treatment and support to access medical treatment. People spoken with feel that the standard of food is good. Comments included, "All the food is good". There is a menu that people can choose from, the options on this menu are written by the residents. People feel that heir nutritional needs are met, and that they are provided with a nutritionally balanced diet that is of a good standard What has improved since the last inspection? We did not make any requirements at the last inspection. However the owner with a recently appointed Area Manager have been working on making further improvements to the service. What the care home could do better: We did not make any requirements at this inspection. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Ryan Q.C. Homes, Farthings 86 Lumbertubs Lane Boothville Northampton NN3 6AH     The quality rating for this care home is:   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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Katrina Derbyshire     Date: 1 3 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 25 Information about the care home Name of care home: Address: Ryan Q.C. Homes, Farthings 86 Lumbertubs Lane Boothville Northampton NN3 6AH 01604643726 01604492770 laurierqch@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Margaret Laurie Duggan Name of registered manager (if applicable) Mrs Margaret Laurie Duggan Type of registration: Number of places registered: 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 The Farthings is one of two homes run by Ryan Q.C. Homes and provides personal care for up to six younger adults who have learning disabilities. The home is situated in a residential suburb of Northampton and is indistinguishable from neighbouring houses. The home is a detached house with large private gardens and provides all single occupancy bedrooms. 6 Over 65 0 care home 6 Care Homes for Adults (18-65 years) Page 4 of 25 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: two star good 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: The quality rating for this service is 2 stars. This means the people who use this service experience adequate quality outcomes. This unannounced visit took place on 13th March 2009. During the visit the communal areas of the home were seen alongside some of the individual accommodation. The inspector spent time with some of the people who live at the home in the communal areas. Management and staffing records were examined. The care of two people was looked at in detail. Tracking peoples care is the methodology we use to assess whether people who use social care services are receiving good quality care that meets their individual needs. Care Homes for Adults (18-65 years) Page 5 of 25 Through discussion, observation and reading records, we track the experiences of a sample of people who use a service. Evidence used and judgements made within the main body of the report include information from this visit, feedback from people who live at the home and the managements submission of documentation. Observations of care practise and communication between the people living at the home and staff was also made at the inspection. The focus of this inspection was to look at the key standards. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 25 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 8 of 25 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 system in place for staff to assess the needs of prospective people is sufficient to ensure that they would have the information to know if they would be able to meet their needs Evidence: Documents seen within the records of people living at the home, showed several assessments of their needs. Representatives of, Social Services and staff of the service had completed documents. Each representative had completed their own assessment documentation and further evidence was seen to show all had been involved in the decision for the person to move to the home. Documents described in detail the needs of the person; this included any diagnosis that had previously been made, the behaviours of the person and their individual aspirations alongside any risks. People that live in the home and entries within the daily notes confirmed that they had also had the opportunity to visit, prior to moving in. The statement of purpose was seen to be displayed in the home. The document Care Homes for Adults (18-65 years) Page 9 of 25 Evidence: provided information on the staffing, accommodation and services available at the home. People able to indicate stated that they felt they had been given enough information, before they decided to move into the home. The use of pictures and signs are used to help the people living in the home. Copies of terms and conditions of residency were available in the files examined at this visit. Care Homes for Adults (18-65 years) Page 10 of 25 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. Opportunities for people to make decisions about their lives are available and make people feel in control of their own lives. Evidence: Through examination of care plans kept within the individual folders for each person it showed that there were documents in place, which indicated the needs of the person. The entries gave sufficient direction to staff to state how the person should be supported. One example was that one person had on several occasions been calling out. There were clear guidelines for this to staff in how the person should be supported during this time and some diversion that the person enjoyed. Additional documents were also in place to provide a comprehensive picture of the person and gave background information as well. Some people spoken to described how they still felt in control of their own lives. People described being able to choose what they were going to wear each day as an example Care Homes for Adults (18-65 years) Page 11 of 25 Evidence: of having choice, in addition contact with friends and family was not restricted. Observation at this visit also showed that people moved freely around the home, choosing to go to their private accommodation, sit outside or sit in one of the communal areas. Risk assessments were in place within the individual care files examined. Risks that had been assessed included diet and external contact when leaving the home. Staff through questioning confirmed that they had received training in the area of risk assessment; in addition they demonstrated a sufficient level of understanding in the possible risks to people living at the home. Care Homes for Adults (18-65 years) Page 12 of 25 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 at the home do have some access to local facilities so benefit from being part of the community and are supported in maintaining personal relationships. Evidence: People living at the home were not directly involved in the preparations for the evening meal, but some people were seen going into the kitchen to make themselves a drink. On the day of this inspection, one persons had stayed at the home whilst others attended varying day support facilities. A staff member had accompanied the person who stayed at the home into the local shopping retail park. The evening meal consisted of protein, carbohydrates and vegetables, people commented that they had enjoyed their meal. On examination of menus, these showed that there were varying options available and this was supported through looking at the type of food that the home had in stock. Care Homes for Adults (18-65 years) Page 13 of 25 Evidence: Through discussion with people living at the home on the day of this inspection and through examination of care records, alongside feedback from Northants Social Services it was evidenced that some people felt that there were sufficient choices and activities. Three people spoken with discussed the opportunities that they had to attend day centres and also when staying at the home during the week, being supported to go into town during the day. Feedback through examination of documents alongside discussion with people living at the home, all confirmed that people were able to maintain personal relationships and maintain contact with family and friends. Entries seen showed several people received visitors weekly and/or went to visit family members. Care Homes for Adults (18-65 years) Page 14 of 25 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. Staff are good at supporting people to access health care support so that their health needs are met Evidence: Through observation of the people living at the home it was noted that their clothes, hairstyle and makeup reflected their individual personalities. Guidance and support regarding personal hygiene was offered and the level offered by staff was reflected in the care plans tracked on this inspection. One care plan included the need for staff to prompt a person to have their shower, this was seen to be done. Within the individual care records examined it was noted that there were documents from a variety of medical specialists as assessed at the previous inspection. These documents showed that people received regular support from Doctors and Nurses. Staff confirmed that they assisted people to attend hospital appointments and the outcome of any medical intervention and subsequent guidance was recorded. The storage, receipt and administration of medication was examined. The medication Care Homes for Adults (18-65 years) Page 15 of 25 Evidence: administration sheets were noted to be correct, also the balances were also accurate. The storage of medicines were seen to be in a locked facility. Records were seen to show returns of unused medication. Staff confirmed that they did receive regular updates in the administration of medicines and observations were made of medication and noted to be appropriate and follow safe practise guidelines. Care Homes for Adults (18-65 years) Page 16 of 25 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home can be confident that their concerns will be taken seriously and action taken where required. Evidence: As assessed at the previous inspection a complaints procedure is available within the home, and although residents may not be able to read this information, those spoken to were aware of with whom to raise concerns and stated that they were confident these concerns would be acted upon. In addition the use of pictures and signs have been used to help the residents with this. No formal complaints have been received by the home since the last inspection. A member of staff spoken to confirmed that they had received training on the Safeguarding of Adults reporting system and was aware of reporting systems outside the home if needed. He also confirmed that they had received training in the types of abuse that may occur. Care Homes for Adults (18-65 years) Page 17 of 25 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. The standard of accommodation is good and provides a homely environment for people to live in. Evidence: As previously assessed communal areas of the home seen, were clean and tidy and were decorated and maintained in a homely manner. Several lounge areas are available as well as a pleasant garden for use when the weather allows. Residents are involved in the upkeep of the garden and enjoy raising some plants from seed. Individual rooms are furnished comfortably and had evidence of personalisation in the form of personal music systems, pictures, ornaments and soft toys as well as equipment for individual hobbies and interests. Each person spoken with confirmed that they were happy with their environment. Care Homes for Adults (18-65 years) Page 18 of 25 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. The number and deployment of staff and training is sufficient for all people to feel that they receive the support that they require. Evidence: Both staff and people living at the home advised that they felt there were sufficient numbers of staff on duty to meet the needs of the residents. Training records showed that staff had undertaken training in the statutory areas including fire safety and medication. Staff felt that they received sufficient training and support from the service so that they could carryout their roles safely. The homes recruitment policy and procedures was clear. References are taken prior to staffs commencement and the relevant Criminal Records Bureau check is also carried out and evidence of this having been undertaken was seen. Certificates of qualifications are present within staff files. This information was maintained within another of the homes, but the inspector had already examined this. Several of the people living at the home made positive comments on the skills of the staff team, one person said they seem very nice. Observation of the interaction Care Homes for Adults (18-65 years) Page 19 of 25 Evidence: between the staff and people at the home was relaxed and informal. Residents freely conversed with staff over the preparation of the evening meal. Care Homes for Adults (18-65 years) Page 20 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Health and safety systems are sufficient to reduce the risks associated with this area for the people living at the home Evidence: Staff and training records showed that heath and safety training had taken place including fire safety and food hygiene. The most recent inspection by the Fire Service showed that the home met the required standards..As assessed previously the policy on health and safety was noted to be clear in its guidance to staff and comprehensive. Records were seen that evidenced that required safety checks had been carried out relating to fire, gas and electrical equipment. Approved contractors had undertaken servicing of equipment and site visit paperwork to evidence that theses had been carried out were seen. Regular checks relating to water temperature for example had been recorded on charts. Stocks of aprons and gloves were noted to be available for staff to use, in relation to infection control. No staff at this visit were seen to use these items inappropriately, their use was only seen to be made in the area where they were needed, for example at the evening meal to reduce the risk of cross infection. Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: The home carries out consultation with the people in different forms. Staff confirmed that on a day-to-day basis people are asked for their views and these decisions are then integrated into the care plans. More formal methods such as residents meetings had taken place in the past and minutes were available for inspection, but the home recognised that the views of all residents could not be sought in this way and many did not wish to be involved. Everyone spoken with reported that they found the manager to be a very good listener and all felt that she was very easy to talk to and that they trusted her. Staff said that they found the manager to be both organised and approachable. A new Area Manager had been appointed since the previous inspection. She was working with the owner at this time to make further improvements to the service. Care Homes for Adults (18-65 years) Page 22 of 25 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 23 of 25 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 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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