Care Home: Sewells (6a)

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What the care home does well The home was very welcoming and friendly.They have adequate staffing to meet the residents care and support needs.Care plans are detailed and contain information for staff to support and care for the residents in a consistent manner. What has improved since the last inspection? Staff are aware about ensuring the residents make their own choices and risk assessments are in place to allow them to carry out their choices. Regular meetings are held with the residents to ensure they are given the opportunity to have a say in how the house is run. What the care home could do better: They need to continue with the decoration programme to ensure that where there is evidence of tired decoration this is brought up to an acceptable standard to provide a clean and fresh environment.When the safeguarding investigation has been completed they need to ensure they work on any action that have been identified and protect resident`s safety at all times. Key inspection report Care homes for adults (18-65 years) Name: Address: Sewells (6a) 6a Sewells Welwyn Garden City Hertfordshire AL8 7AQ two star good service The quality rating for this care home is: 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: Alison Butler Date: 3 0 0 7 2 0 0 9 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 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 Information about the care home Name of care home: Address: Sewells (6a) 6a Sewells Welwyn Garden City Hertfordshire AL8 7AQ 01707395187 01707321344 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : lifeopportunitiestrust.co.ukwww.lifeopportunitiestr Life Opportunities Trust care home 7 Number of places (if applicable): Under 65 Over 65 7 7 7 0 learning disability physical disability Additional conditions: Date of last inspection 1 4 0 5 2 0 0 7 A bit about the care home 6a Sewell is a purposebuilt modern style bungalow that was designed to accommodate seven adults with learning and physical disabilities. It is located at the end of a cul-de-sac on a housing estate in Welwyn Garden. City All bedrooms are offered for single occupancy and the home is equipped with appropriate adaptations and equipment to enable staff to meet the needs of people living in the care home. The aim of the home is to enable people to play a part in the day-to-day running of the home, ensuring that they have an input into how they live their lives. Particular regard is paid to the privacy of individuals, integration into the community and ensuring that people have a wide range of activities, experiences and relationships available to them. For up to date fees contact should made to the home. A copy of the Statement of Purpose, Service Users Guide and most recent inspection report is available from the care home. 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 How we did our inspection: This is what the inspector did when they were at the care home This inspection was carried out by one inspector who spoke to the staff and residents on duty. Care records were examined. Visits were made to a number of residents bedrooms. Information was taken from the AQAA (Annual Quality Assurance Assessment) this was completed by the manager. It gave us information of the plans for the coming year to improve the service for the residents. What the care home does well The home was very welcoming and friendly. They have adequate staffing to meet the residents care and support needs. Care plans are detailed and contain information for staff to support and care for the residents in a consistent manner. What has got better from the last inspection What the care home could do better They need to continue with the decoration programme to ensure that where there is evidence of tired decoration this is brought up to an acceptable standard to provide a clean and fresh environment. When the safeguarding investigation has been completed they need to ensure they work on any action that have been identified and protect resident’s safety at all times. 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 Alison Butler CQC Citygate Newcastle Upon Tyne Telephone 03000 616161 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 http:/www.cqc.org.uk/. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535. 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 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 judgment using a range of evidence, including a visit to this service. People who live at the home can be assured they are provided with the information to make an informed choice and their care and support needs will be fully assessed prior to admission. Evidence: They have produced the Statement of Purpose into a pictorial version which provides prospective residents information they need to make an informed choice in a easy to understand format. There is a phased approach for any prospective residents and this is set at the pace that is best suited to them. This is usually a visit for a meal, a day visit, followed by an overnight visit. During these visits information is recorded which forms the base of their individual plan and looks to ensure the home is able to meet their needs. The AQAA stated that in the coming year the staff are working on producing contracts and the Service Users Guide into pictorial formats to make them easier to understand for the residents. 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 live at the home an be assured that their care and support needs are recorded to ensure that their needs are met appropriately. They are also able to have an input into how the home is run. Evidence: One resident was happy to go through their care plan with us and were happy to discuss their care and support needs. They have a discussion meeting with their key worker on a monthly basis. These discussions are recorded and it lists any action to be taken and issues that have arisen. The residents were happy to talk about their activities and that they are able to choose what they like to do and these are incorporated into their plans. One resident who showed me their room, they have a large picture board on the wall showing their aims and goals for the coming year, for example holiday, engagement, attendance at church. This is regularly reviewed with their key worker and the pictures updated as necessary. The care plan showed appropriate risk assessments which had been reviewed were in place to ensure they are able to risks as part of an independent lifestyle. Staff have a clear understanding on the need of confidentiality and that records were held securely within the home. There is a regular residents meeting held and minutes are recorded in a book this gives them the opportunity to discuss any concerns issues they, may have and they are able to make choices, such as menu planning, days out and various activities they would like to take part in. 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 can be assured they have the opportunities for personal development and are able to take part in a wide range of activities of their choice. Evidence: The residents living at Sewells are able to choose from a wide range of activities, there are various day centres’ which provide daily living skills. They have a dedicated computer which they all have their own log in details and are able to access the internet and search their choice of activities, holidays etc. The staff at the home place their main emphasis on the residents making their own choices and as such take an active part in the local community. They have planned their holidays for this year and some of the residents have already been whilst other are waiting to go and are very much looking forward to them. The holiday destinations have included Cornwall and Disneyland Paris. One resident has chosen to have day trips as this meets their choice and needs more appropriately. The residents are encouraged and supported to maintain contact with their family and friends 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 who live at the home can be assured that they receive care and support in the way they prefer and are protected by the homes policies and procedures for administering their medication Evidence: Staff were seen to be offering support in a caring and dignified way. Care plans examined showed that the individual needs are recorded giving staff details on how these are to be met in line with the resident’s wishes. Details of their health care are well recorded giving details of any outcomes and follow up action recorded. CQC had received a number of notifications where there had been a medication error. The company has detailed policies in place to deal with these and as such staff usually have to complete further training in medication administration before they are able to administer without supervision. Additional training is provided for the administration of rectal medication as a number of residents may require this especially when away from the home. No residents are able to self medicate at this inspection. 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 people who live at the home can be confident that their views will be listened to and acted upon. Evidence: There are procedures in place to protect the residents from abuse and harm. All staff receive training in protecting vulnerable adults and there is the Hertfordshire County Council Safeguarding Policy and procedure available in the office. A safeguarding referral is still in the process of being investigated. The company has put measures in place to protect and support the residents. They have also reviewed policies and procedures in light of this referral being made. Each resident has had the complaints procedures explained to them but those spoken to told us they were very happy living at the home and get on exceptionally well with the staff. They also feel confident they are able to say if they are unhappy. There is further opportunity for them to meet regularly with their key worker where they can discuss any issues of concern they may have with them. 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 who live at the home can be assured they live in a safe and clean environment. Evidence: A tour of the building was conducted during the inspection and whilst the home was very welcoming, clean and friendly, a number of areas were looking tired and in need of a lick of paint. The AQAA stated plans are in place to make some improvement. A couple of the resident’s rooms are due to be redecorated and they are in the process of choosing colours etc. They were happy to show us their room and discuss their chosen colours. The staff are sorting out contractors to get quotes ready for head office authorisation, for the work to be completed. The kitchen is due for a revamp, a new cooker has already been purchased and the kitchen cupboard fronts are being changed in the very near future. The senior stated that a skip is waiting to be delivered to clear the large items of furniture out the front of the home. The AQAA stated they are to have the back garden landscaped and new gates to the front of the house over the next year. 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 people who live at the home can be assured there is sufficient number and appropriately trained staff on duty at all times Evidence: The company have robust recruitment procedures in place and whilst records were unable to be accessed due to the manager being on leave. There have been no information that has led us to believe that these are not adhered to. As previous inspections have found robust recruitment procedures in place. Appropriate staffing levels appear to be in place to meet the needs of the residents. Additional staff are provided if necessary to cover for appointments and activities if needed. Whilst agency staff are used this is kept to a minimum but where possible they use the same people to provide a consistent approach for the residents, if this is not possible they would always be working with a member of the permanent staff team. Staff feel well supported and receive regular supervision. Staff are involved in putting together a clear vision and mission statement for the home. The company promotes and support staff in achieving an NVQ qualification. There is a rolling training programme in place and all staff have received training in basic dementia care to meet the changing needs of some of the residents. 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 people who live at the home can be assured that they are able to have an input into the way the home is run and that health and safety of all those who enter the home is protected. Evidence: The manager has been in the field of learning disability for over 15 years and is in the process of completing NVQ 4 and then will go on to complete the registered managers award. The home have a core group of staff who have been at the home for a considerable number of years and this has been positive in providing consistency in the care and support of the residents. They are open and inclusive and ensure that the residents are able to express their views and therefore have input into the homes development. The health and safety of all who enter the home is protected through a series of checks and ensuring that equipment is regularly serviced. Are there any outstanding requirements from the last inspection? Yes No X 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 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 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. 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). 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. 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