Care Home: Saughall Road (88)

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What the care home does well The service at Saughall Road is specifically tailored to meet the needs of the sole person who lives there. The staff we spoke to were enthusiastic, committed to the welfare of the service user and well trained. Most of the staff have worked at the home for several years so there is a very stable staff group. The service user is supported in taking part in activities and pastimes of his choice, both within the home and in the wider community, including holidays abroad from time to time. The family are closely involved in all aspects of the service user`s welfare. The building is spacious and well equipped. What has improved since the last inspection? There have been significant changes at the home since we last visited. The registered manager left in less than ideal circumstances and there is now only one person living there. These changes have been managed effectively. The home is well maintained and medication is managed safely. The statement of purpose and service user guide have been fully updated and give a good account of what the service provides. What the care home could do better: The manager should apply for registration with the Care Quality Commission as soon as possible. Clothing needs to be properly ironed before it is worn to go out. It would be worth considering if the current floor covering in the bedroom is still appropriate. Key inspection report Care homes for adults (18-65 years) Name: Address: Saughall Road (88) 88 Saughall Road Saughall Massie Wirral CH46 5NG     The quality rating for this care home is:   two star good 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: Peter Cresswell     Date: 0 2 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 20 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) 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 Care Homes for Adults (18-65 years) Page 3 of 20 Information about the care home Name of care home: Address: Saughall Road (88) 88 Saughall Road Saughall Massie Wirral CH46 5NG 01516789751 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Alternative Futures Limited Name of registered manager (if applicable) Type of registration: Number of places registered: care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The registered person 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 to the home are within the following categories: Learning disability - Code LD. The maximum number of service users who can be accommodated is: 3 Date of last inspection Brief description of the care home 88 Saughall Road is a bungalow in the Saughall Massie area of Wirral. The home provides care and personal support to one person who has a learning disability and needs one to one care. Although the home remains registered for three people there is no intention to accommodate more than one. The service user has a single bedroom and an activities room. There is also a main lounge, conservatory, dining room, kitchen, walk in shower, bathroom, office and a utility room. There is a large enclosed back garden and car parking space at the front. The home has its own vehicle, so the service user can go out with staff. There are at least two support workers on duty through the day and at night there is one member of staff who sleeps in the home. Care Homes for Adults (18-65 years) Page 4 of 20 3 Over 65 0 Brief description of the care home Fees are negotiated individually with the commissioning authority. Care Homes for Adults (18-65 years) Page 5 of 20 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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: As part of this inspection we visited the home without telling anyone exactly when we were going. We had established beforehand when people were likely to be in to avoid wasted journeys. During the visit we talked to the sole person who lives there, the newly appointed manager and the two care workers who were on duty. The service manager and his successor also called in and we spoke to them very briefly. We looked at all areas of the home and examined care plans, risk assessments, daily reports, personal financial records and safety records. Before we visited, the manager and service manager had sent us an Annual Quality Assurance Assessment (AQAA) that includes the services own assessment of how it is meeting peoples needs as well as useful statistical information. Care Homes for Adults (18-65 years) Page 6 of 20 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 20 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 20 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People would be fully assessed before moving into the home. The existing service user has enough information about what the home provides. Evidence: The statement of purpose and service user guide have been combined into one document. It has been brought up to date and contains all of the information needed, including staffing levels and details of how to complain. There has only been one person living at Saughall Road for over a year now and there are no plans to admit anyone else. This person has been at the home for many years. The owners, Alternative Futures, have well established procedures for assessing people before admission to their services, should that be necessary. The service user has a Licence Agreement (contract) which sets out in detail the terms and conditions of his residency. Care Homes for Adults (18-65 years) Page 9 of 20 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users needs are met on the basis of detailed care planning and reviews. Evidence: The service user has a detailed care plan (Person Centred Plan) that sets out in detail his history, his needs and how they are to be met. The file includes a vivid pen picture and a communication dictionary to enable staff to understand what he is saying. There is a long and detailed list of things that are important to him that serve as the basis of the care and support that staff provide. Staff have drawn up risk management plans for eleven areas, setting out the risks the service user faces in everyday life and how those risks can be managed and minimised. Staff make detailed reports every day, describing what went well today as well as was did not go so well and what could be done differently. The daily reports we looked at were detailed and informative, with at least two entries a day. The entries are summarised and analysed once a week and every month. As well as this, the organisation holds six monthly reviews which are attended by the service user, staff, relatives and other professionals (where appropriate). The care plans are updated where necessary after the reviews. Care Homes for Adults (18-65 years) Page 10 of 20 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service user is able to enjoy a varied lifestyle. Evidence: Staff have put a great deal of effort into understanding the likes and dislikes of the service user. Activities and daily routines are organised around these, including swimming, walks, eating out, routine daily tasks such as shopping as well as special events such as trips to a theme park or holidays. Staff have devised a pictorial system of showing the routines and activities planned for the day and the service user also uses this to communicate what he likes to do. Staff have other ways of communicating future activities, including a blackboard wall in his bedroom. The service user has paid for holidays abroad and another is planned for later this year. The home has a minibus but this is to be replaced soon by a motability car, which will be more flexible and comfortable as well as less conspicuous. The service user was looking forward to getting his new car. We looked at a record of the menu which is varied and Care Homes for Adults (18-65 years) Page 11 of 20 Evidence: interesting, including fresh vegetables and fruit to help ensure a healthy, balanced diet. Care Homes for Adults (18-65 years) Page 12 of 20 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal care is provided safely and discreetly. Medication is safely administered. Evidence: Only one person lives at the home so personal care can be provided if required in complete privacy. Staff need to make sure that shirts and other clothing are properly ironed before the service user goes out of the home. All necessary community and specialist healthcare services are available and are fully recorded in the case file. This is done in the form of a Health Action Plan. Medication is securely stored and accurately recorded on Medication Administration Record (MAR) sheets. Staff have been trained in the administration of medication and receive regular refresher courses. Care Homes for Adults (18-65 years) Page 13 of 20 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service user is protected from abuse by the owners safeguarding and complaints policies and practices. Evidence: The owners, Alternative Futures, have a well established complaints system and safeguarding adults policies. The complaints procedure has been produced in a form that is specific to the sole resident. In practice any significant complaints are likely to be made via relatives. The procedure is set out in the service users guide. Care Homes for Adults (18-65 years) Page 14 of 20 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The building provides a comfortable, safe, clean and suitable environment for its resident. Evidence: The home is a spacious, secluded three bedroomed bungalow that has been adapted for occupation by one person. One of the former service user bedrooms is now used for staff who sleep in overnight and there is an activities room. The bungalow has a separate dining room, a lounge, conservatory and a large well maintained back garden. Parts of the garden are fenced off to make sure it is safe to use. The furniture and fittings are as homely as can be but in some cases are specially protected for safety reasons. When we visited we looked all round the house and it was reasonably decorated and maintained. It was clean, hygienic and well suited to the needs of the person who lives there. The bedroom has a vinyl floor that is not especially homely and the owners may want to consider if this is really necessary or if there is a more homely alternative (such as laminate flooring). Care Homes for Adults (18-65 years) Page 15 of 20 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service user is supported by enthusiastic, committed, well trained staff. Evidence: There are always at least two staff on duty in the day, with one on duty at night. The manager and owners consider that this is sufficient staffing based on their assessment of the service users needs. All of the staff have the relevant NVQ qualification. The staff group is very stable and there have been no new staff recruited (apart from the manager) in the last twelve months. When anyone is recruited the resident is as involved in the process as possible. The manager described how he spent time with the resident before he was employed. The staff we spoke to were very enthusiastic and committed to their jobs, showing great care, affection and commitment to the service user. Staff are supervised by the manager and have one to one sessions every four to six weeks. These meetings help to identify any problems at work and training needs. The owners have an extensive training arm and training this year has included SPACE (Safety Protection Awareness) which is a system for dealing with conflicts and challenges and training which is mandatory such as manual handling, food safety and safeguarding. Care Homes for Adults (18-65 years) Page 16 of 20 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users safety and welfare is protected by the management of the service. Evidence: The home has a new manager who was just about to begin the process of seeking registration with the Care Quality Commission. He leads a committed and enthusiastic staff team. The family of the service user are closely involved in his care and are consulted over significant matters. They also complete customer satisfaction questionnaires so that the management have systematic feedback on how effective the service is. The involvement of the family was well recorded on the files we looked at. Senior managers visit the home regularly and make quality assurance assessments to make sure that the home is maintaining the quality of the service it provides. We looked at the records they complete to do this and they were up to date. Fire safety and food safety checks are carried out regularly and were up to date when we checked them during our visit. Staff look after the day to day finances of the service user and they were properly and accurately recorded when we looked at a sample of them. Care Homes for Adults (18-65 years) Page 17 of 20 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 18 of 20 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 19 of 20 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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