Care Home: Sampson House

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What the care home does well Sampson House is clean and tidy. All residents have their own bedrooms. Some live on their own in flats. The staff help residents to become independent and do things for themselves. Residents help to write their own care plans. Some residents go to work. They do cleaning and cafe work, look after horses, and help at a nature reserve. Residents do lots of activities. They go to the cinema and the gym, shop, have daysout, and swim. Residents and staff cook the meals together. Staff help residents to look after their own medication. Residents know who to tell if they are not happy. Staff know how to keep the residents safe. Residnets told us they like the staff. One said, `The staff are nice and I always get on well with them.` What has improved since the last inspection? Parts of the home have been redecorated and there is some new furniture. What the care home could do better: The home needs a better safeguarding policy. The care staff are called `house parents` but they are not the `parents` of the residents. Residnets might like to pick a new name for them. Key inspection report Care homes for adults (18-65 years) Name: Address: Sampson House 400 Skellingthorpe Road Lincoln LN6 7YD The quality rating for this care home is: three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Kim Cowley Date: 0 5 0 2 2 0 1 0 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. The first part of the review gives the overall quality rating for the care home:  3 stars – excellent  2 stars – good  1 star – adequate  0 star – poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Care Homes for Adults (18-65 years) Page 2 of 27 Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by:  Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice  Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983  Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services.  Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Sampson House 400 Skellingthorpe Road Lincoln LN6 7YD 01522682397 01522690384 susan.kennedy@linkage.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Linkage Community Trust Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 15 Number of places (if applicable): Under 65 Over 65 15 0 learning disability Additional conditions: The maximum number of people who can be accommodated is 15. The registered persons may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission are within the following category: Learning disability - code LD Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 27 A bit about the care home Sampson House is in Lincoln. Up to 15 people with learning difficulties live there. Some live in the main house and some live in flats. The home has two lounges, a games room, and a big garden. There are bus stops and shops nearby. If you want to know more about Sampson House you can ask the Manager. Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 27 How we did our inspection: This is what the inspector did when they were at the care home This home has 3 stars. It is an excellent home. We did a key inspection of Sampson House. We looked round the home and saw some care plans. We talked to some of the people who live in the home. We also talked to some of the staff. In this report we have called the people who live in home residents. This is what they asked to be called. What the care home does well Sampson House is clean and tidy. All residents have their own bedrooms. Some live on their own in flats. The staff help residents to become independent and do things for themselves. Residents help to write their own care plans. Some residents go to work. They do cleaning and cafe work, look after horses, and help at a nature reserve. Residents do lots of activities. They go to the cinema and the gym, shop, have days Care Homes for Adults (18-65 years) Page 7 of 27 out, and swim. Residents and staff cook the meals together. Staff help residents to look after their own medication. Residents know who to tell if they are not happy. Staff know how to keep the residents safe. Residnets told us they like the staff. One said, The staff are nice and I always get on well with them. What has got better from the last inspection What the care home could do better The home needs a better safeguarding policy. The care staff are called house parents but they are not the parents of the residents. Residnets might like to pick a new name for them. Care Homes for Adults (18-65 years) Page 8 of 27 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Kim Cowley CPC1 Capital Park Fulbourn Cambridge Cambridgeshire CB21 5XE 01223771300 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 9 of 27 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 10 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Potential residents have their needs assessed to ensure the home is suitable for them. Information about the home is available in user friendly formats. Evidence: People who want to live at Sampson House have a written assessment to see if the home is suitable for them. A Manager completes this, taking into account their views, and the views of their families/friends and any advocates involved. Health and social care staff are also consulted, where applicable. This helps to ensure the home will be able to meet their needs if they decide to move in. They are then invited to visit the home to see what they think of it. They are encouraged to come for tea initially, and then for a longer visit including, for example, an overnight stay if they wish. The residents who already live in the home are encouraged to meet them, and have a say in whether or not they move in. Information about the home is available in a number of user friendly formats, including widget, and on DVD. Page 11 of 27 Care Homes for Adults (18-65 years) 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Detailed care plans help staff to identify and meet the needs of the people who live in the home. Residents are encouraged to be independent. Evidence: All the residents and relatives we met told us Sampson House excelled at encouraging the people who live there to become independent. One relative told us, The best thing about this home is the way staff help the residents to do things for themselves. Since being here my son had learnt to use the bus on his own. A resident commented, I can do what I like in my flat. The staff pop in now and again to see if Im OK. I do my own cleaning and cooking with the staff helping me. Care plans are well organised and up to date. Care workers review them monthly and then pass them to the Acting Manager for further checking and comment. Records showed that residents are consulted on every aspect of their care plan and sign to say they are in agreement about how they are being cared for. Each resident also has an annual review of their care which is attended by the resident themselves, and their family, and placing authorities, where appropriate. This gives the resident, and others Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: involved in their care, the opportunity to comment and make suggestions about their progress. All residents have the opportunity to develop person centred plans which identify their hopes and aspirations for the future. Some residents have talking diaries which they develop with staff using words and pictures. They can use these to share their progress with families and friends. Risk assessments are written for all aspects of care. We looked at a sample of these and saw that key information was highlighted so staff were clear when a resident needed extra support and supervision. If a resident needs help with a particular situation, where they may put themselves or another person at risk expert advice is available from a psychologist or counsellor. This helps to ensure residents who live at Sampson House remain safe. Care Homes for Adults (18-65 years) Page 13 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Daily living and social activities enable residents to lead full lives and grow in independence. Evidence: All the people who live in the home have their own weekly timetable of recreational, educational, and vocational activities, depending on their needs and what they want to achieve. They also have home days when they focus on their housekeeping skills. The Owning Body has its own employment service. Dedicated staff assess residents, find out their interests, and arrange suitable work placements for them. These currently include cleaning, cafe work, looking after horses, and helping out at a nature reserve. The Owning Body also runs an arts and crafts shop in a nearby town and residents have the opportunity to work there if they want to. Leisure activities are decided at a weekly meeting when residents get together and write down what they would like to do. Current activities include cinema trips, swimming, gym, Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: shopping, and days out. Activities take place on a group or one to one basis depending on what suits the resident. Staff support the people who live in the home with their friendships and relationships, providing guidance, support, and referral where necessary. During the inspection residents in the main house helped staff prepare lunch. Residents in the flats are responsible for their own menu planning and shopping, and have their own domestic kitchens. Catering arrangements are flexible, which enables residents to make individual choices about meals. Care Homes for Adults (18-65 years) Page 15 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have their personal and health care needs met in the way they want by staff in the home. Evidence: The residents are encouraged to be as independent as possible and are supported to care for themselves. Records showed that where necessary, help and guidance is offered in a sensitive and flexible manner. Care plans provide the information staff need to work with the residents and made them aware of their likes and dislikes. Residents use local health care services, for example GPs, opticians, and dentists. Specialist services such as Psychology, Psychiatry, and Speech and Language Therapy are available from the Owning Bodys Clinical Services Team. All residents have Health Action Plans in place which help staff to ensure their health care needs are met. Where possible residents are expected to become responsible for their own medication. They are all on the homes nine stage medication plan. This helps them acquire the skills they need to eventually look after their own medication. Staff are trained in medication administration and medication is kept securely and regularly audited by senior staff. Care Homes for Adults (18-65 years) Page 16 of 27 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. Staff know how to safeguard residents and help them express any concerns they might have. The safeguarding policy needs improving. Evidence: The residents we spoke to all said they knew what to do if they had a complaint or werent happy about something. Comments included If I wasnt happy Id tell the staff. Id tell one of the staff if I had a complaint. My shower was cold so I told the staff and its being fixed. The homes complaints procedure is available in writing, and there is also a more userfriendly DVD version for the residents. All complaints, however minor, are recorded along with the action taken to resolve them. CQC have not received any complaints about the home. We discussed safeguarding with the staff. All knew what to do and who to go to if they had concerns about a residents well being. Staff training in safeguarding, the Mental Capacity Act and the Deprivation of Liberty Safeguards has been provided. All staff have been issued with a pocket guide to safeguarding which they can refer to if they have any concerns. The home uses the Owning Bodys corporate safeguarding policy. This refers to residents as learners and is not clear about the role of social services as lead agency in any Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: safeguarding investigation. It should be amended so it is more accurate and easier to follow. Care Homes for Adults (18-65 years) Page 18 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is spacious, well decorated, and maintained to a high standard. Evidence: The home is well maintained, and is furnished and decorated to a high standard. Care has been taken to create a calm environment with muted colours in communal areas (although resident can have any colours they want in their own rooms). There are two lounges, both have televisions and one has a wii, and a dining room. There is a small computer room off the reception, and a garden room with a table tennis table and exercise equipment. The home is surround by a large garden with seating and games areas. Within the building are four self-contained flats for residents who are ready to live more independently. We visited two of these and were shown round by their occupants. Both flats were well equipped and had decor and furniture chosen by the occupants. There are no call bells in the flats, but residents have mobile phones and staff visit regularly to check they are OK. One resident told us, I like it that Ive got my own place here. Since the last inspection there have been a number of improvements to the home including new dining chairs and other furniture, and the redecoration of five of the bedrooms and two of the flats. Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: Residents clean their own bedrooms, with help from staff, and a cleaner is responsible for communal areas. All areas inspected were clean, fresh and warm. Care Homes for Adults (18-65 years) Page 20 of 27 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Friendly, professional, and well trained staff meets residents needs. Evidence: All the residents and relatives we spoke to praised the staff team. Residents said, The staff are nice and I always get on well with them, and The staff are very helpful. A relative commented, We feel we can talk to the staff and they are all very helpful. They look after our son like we do and keeps him looking nice. The home is well staffed which means residents get plenty of one to one support and are able to take part in a wide range of activities. A staff member told us, I think the service is brilliant. The best thing is helping the residents to become independent and take up new opportunities. When new staff are recruited residents are involved. They sit on interview panels or get to meet potential staff when they look round. This means they have a say when new staff are being chosen to work at the home. Recruitment procedures were discussed with the Acting Manager. She told us that all staff are subject to CRB and POVA checks, and references are obtained. Staff files were sampled and had the appropriate documentation in place. This helps to ensure residents are safeguarded. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: Staff receive excellent training opportunities including five paid days per year to attend courses. We discussed training with one of the care staff and viewed his training file. This showed that he had undergone a six week induction, followed by a range of short courses including Equality and Diversity, Autistic Spectrum Disorders, and Epilepsy and Emergency Medication. All staff are encouraged to take NVQs (National Vocational Qualifications) in Care. The home also has its Investors in People Award. There is programme of appraisal and supervision in place. In addition management welcome comments and suggestions from staff. A staff member told us, It was made clear to me when I started that I could talk to anyone at any level, and in my experience any issues are swiftly addressed. This helps to ensure that staff are listened to and have the support and training they need to carry out their work effectively. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is safe and well managed and residents are involved in the way it is run. Evidence: The home is being run by an Acting Manager, as the previous Registered Manager left in January 2010. The Acting Manager is employed by the Owning Body at a senior level and has considerable experience in running care home. She is being supported by her line manager, who is also the Deputy Director of Linkage. The Owning Body are in the process of advertising for a new Registered Manager. In the meantime the home is being run effectively and outcomes remain excellent. Consultations with residents are central to how the home is run. Every day staff chat to them informally, either in groups or on a one to one basis, to gather their views and encourage them to play an active part in choosing the days meals and activities. The Owning Body also runs a user group called the Pointers Committee and representatives from Sampson House are on this. The care staff at Sampson House are known as house parents. The Acting Manager and Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: Deputy Director told us this is the term used in all Linkage homes, and that the residents agreed to it in a ballot held three years ago. While this is understood, the term house parent can be seen as confusing (the staff are not the parents of the residents), and at odds with Sampson Houses commitment to resident independence. It is recommended that residents are consulted and helped to choose a new term for staff that better reflects their role in the home. Linkage employs its own health and safety officer who is responsible for risk assessing both the premises and working practices in its homes, including Sampson House. She also completes Fire Risk Assessments. Linkage also has its own maintenance department and the Acting Manager said staff there are quick to respond when repairs and improvements are needed. These resources help to ensure that the health and safety of those who live and work in Sampson House is protected and promoted. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes  No  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 25 of 27 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 Description 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 Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 23 The homes safeguarding policy should be amended so it refers to the people who live in the home as residents rather than learners, and makes clear the role of social services as lead agency in any safeguarding investigation. In consultation with residents, consideration should be given to calling staff something other than house parents, as this term could be seen as misleading and inappropriate. 2 39 Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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