Care Home: Scarborough House

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What the care home does well The staff team including the management continue to demonstrate their openess in the day to day running of the care home. The assessment and admission process is robust, which ensures that the needs of residents are identified and care is planned accordingly. Care plans are `person centred` and reviewed on a regular basis to address the changing needs of individuals. The care planning approach involves the resident and significant others, in order to ensure the needs, wishes and aspiration of the individual are at the centre of service delivery. Each person using the service has a programme of day care activities. They are also supported to pursue their leisure activities and access local community facilities and amenities. The home is well maintained and a high standard of cleanliness was evident throughout those areas viewed. The systems in operation including complaint and safeguarding adults should offer adequate protection to people using the service. There is a competent and trained staff team who are knowledgeable about the individual needs of people using the service. Staff are provided with relevant training, formal supervision and yearly appraisal to ensure that they are supported in the work they perform and have their training needs met. In relation to equality and diversity, the home has this policy in place and staff spoken to were aware of it and ensured that people were treated equally irrespective of their age, race, disability, religious beliefs, cultural background and sexual orientation. What has improved since the last inspection? No requirements or recommendations were made at the last inspection. The home continues to audit the quality of the service provision as part of the quality monitoring procedures in line with Hertfordshire County Council policies. What the care home could do better: No areas were identified for improvement during this inspection. Key inspection report Care homes for adults (18-65 years) Name: Address: Scarborough House 395 Scarborough Avenue Stevenage Hertfordshire SG1 2QA     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: Bijayraj Ramkhelawon     Date: 0 7 0 4 2 0 1 0 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 21 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) © 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 21 Information about the care home Name of care home: Address: Scarborough House 395 Scarborough Avenue Stevenage Hertfordshire SG1 2QA 01438361196 01438354751 scarboroughhouse.residentialunit@hertscc.gov. uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Hertfordshire County Council Name of registered manager (if applicable) Mrs Susan Jenkins Type of registration: Number of places registered: care home 7 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 Scarborough House respite unit is a seven bedded, single storey unit within a four-unit complex providing short stay accommodation for adults with learning disabilities. 7 Over 65 0 The respite unit was separately registered as a care home in June 2005. The home is situated in the Symonds Green area of Stevenage, within easy reach of local shops and other community facilities. The unit is furnished and decorated in domestic style, with single bedrooms, bathrooms, kitchen, laundry and spacious communal areas. Special equipment to aid mobility is available. The unit is staffed twenty-four hours a day. Over 80 clients currently use the respite service. Stay frequencies and periods are negotiated and booked in advance. Care Homes for Adults (18-65 years) Page 4 of 21 Brief description of the care home The fees for the service are £1547.47 per week (this is correct as of 07/04/10) for further information and up to date fees contact the unit direct. A copy of the homes Statement of Purpose, Service Users Guide and the last inspection report can be obtained from the manager on request. Care Homes for Adults (18-65 years) Page 5 of 21 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 peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced key inspection was carried out on the 7th April 2010 and took one day. It included talking to staff, examining care plans, staff files, staff training records, fire safety procedures, medicine records, maintenance records, all other records and documents and a tour of the premises. Care Homes for Adults (18-65 years) Page 6 of 21 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 21 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 21 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 using the service can be assured that their needs would be assessed prior to admission. Evidence: Information is available to current and prospective residents about the care home so that they are able to make a decision whether to use the service or not. People using the service have an assessment of needs carried out before they are admitted for short breaks. They also have an opportunity to visit and view the care home. Care Homes for Adults (18-65 years) Page 9 of 21 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. People who use the service have comprehensive care plans in place and are able to make decisions about their lives, and appropriate risk assessments are in place. Evidence: Three care plans were examined during this inspection and each showed that individual needs are assessed; care plans are very detailed in providing the action required by staff on meeting the identified needs of each individual. Reviews are carried out and personal goals are recorded and progress tracked. Care Homes for Adults (18-65 years) Page 10 of 21 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 using the service are able to take part in appropriate activities of their choice. Staff respect and promote their individual rights and encourage them to take responsibility in their daily lives. Evidence: On the day, 7 residents were using the care home for short breaks. All of them were attending their respective day care centres. The use of local community facilities is encouraged. The staff try to strike a balance in encouraging independence and allowing them to relax and enjoy a break away from their normal home routines. There is a good professional relationship between the staff team and the families of people using the service. Healthy eating is promoted and choices of menu provided, the people look forward to their meals and were observed enjoying the evening meal. Care Homes for Adults (18-65 years) Page 11 of 21 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. People using the service receive health and personal care support in the way they prefer. Policies and procedures protect those who use the service in regard to the administration and management of medicines. Evidence: Care plans contain comprehensive information on meeting the personal and healthcare needs of the individuals using the service. Plans gave clear guidance on dealing with specific areas such as continence, dietary and behaviour needs. Medication is secured in a locked cabinet in the lounge. Good procedures for safe practice are in place and the administration, recording, management, storage and disposal of medicines were in good order. There were no controlled drugs held at the time of this inspection. Care Homes for Adults (18-65 years) Page 12 of 21 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 using the service can be assured that their concerns would be listened to and acted upon and that they would be protected from harm. Evidence: There is a complaints procedure in place. Three complaints have been received by the care home and all were resolved satisfactorily. There were a number of compliments from relatives and others. There is a procedure to follow in the event of an allegation of abuse being made. Staff have a good understanding of the protocol to follow and receive regular training to ensure they remain up to date. Care Homes for Adults (18-65 years) Page 13 of 21 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. People using the service are supported in an environment that is homely and comfortable. Evidence: The home is reasonably well maintained and furnished in a domestic style to provide a homely, comfortable and safe environment. All bedrooms viewed were personalised to reflect individuals interest and sensory needs. A good standard of cleanliness was evident throughout those areas viewed. The home has an infection control policy and procedures in place and staff encourage residents to follow good hygiene practice. Arrangements for the storage and disposal of domestic and clinical waste remain satisfactory. Staff members spoken to are conversant with infection control procedures. The unit is suitable to meet the needs of the people who use the service including those who have limited mobility. Some single bedrooms have overhead tracking for those who require hoisting as part of meeting their care. The communal areas are comfortable and are light and airy. All areas seen were clean and tidy on the day of the inspection. Laundry facilities are available but these are only used in an emergency, as the people who use the service are only there for short breaks. Care Homes for Adults (18-65 years) Page 14 of 21 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. People using the service do benefit from the care and support they receive from a competent and qualified staff team and that they feel protected by the homes recruitment policy and practices. Evidence: Information gained from duty roster and staff members provides evidence that the day and night staffing levels remain adequate to meet the needs of the residents. Staff members have the necessary skills and they receive appropriate training to meet the varying needs of the residents. Staff spoken with indicated that they have opportunities for relevant training and this gives them greater confidence to do their jobs. Staff were very knowledgeable about the needs of individuals whom they were supporting and caring for. Currently, there are 20 care staff, 8 of whom have completed the NVQ Level 2 and 6 staff have completed NVQ Level 3. Six staff files were examined and these were found to contain all the required documents including two written references and CRB checks were carried before an offer of employment was made. Staff spoken to confirmed that they received one to one formal supervision on a Care Homes for Adults (18-65 years) Page 15 of 21 Evidence: regular basis. Supervision records were maintained. Staff also confirmed that they received support from the management team and that senior members of staff were approachable and available for advice as and when needed. They stated they have a yearly appraisal to ensure that they are supported in the work they perform and have their training needs met. Care Homes for Adults (18-65 years) Page 16 of 21 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. People using the service can be assured that their health and welfare are protected by policies and procedures, a proactive management and staff team. Evidence: The implementation of a number of systems including assessment and admission process, care planning and review, consultation and communication, recruitment, induction, training, supervision and appraisal of staff ensures that the home operates in an manner that benefits people using the service and the staff team. The home has a quality assurance system in place and seek the views of people using the service, relatives, staff and other interested parties. The individuals are encouraged to be involved in the running of the service and to ensure that it continues to meet their needs. Hertfordshire County Council as part of their quality monitoring respite forums are held and designed to identify and address any shortfalls in the service provision. All statutory records were available for inspection and maintained in accordance with legislation. Records inspected were up-to-date and accurate and were held securely. Staff spoken to were aware that people using the service can access their records and Care Homes for Adults (18-65 years) Page 17 of 21 Evidence: information held about them in accordance with the Data Protection Act 1998. There were policies and procedures in place to ensure that the health, safety and welfare of people using the service and staff are promoted and protected. These records were accessible to all staff. All accidents and injuries are recorded in the accident book. Regular checks on hot water temperatures (weekly) and moving and handling equipment were recorded. A valid Employers Liability insurance certificate was displayed and expires on the 27th April 2010. Care Homes for Adults (18-65 years) Page 18 of 21 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 19 of 21 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 20 of 21 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. 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