Care Home: Shian

Similar services:

• 22 Sandown Road
• The Highlands
• Dilston College Of Further Education
• West View House
• Prince Bishop Court
• Park View (15)
• Craigmore House
• 1 Lanark Close

What the care home does well The ladies who live in the home have complex needs, but staff are well able to meet those needs. They are guided by having good, detailed and person-centred care plans and support plans, which help staff communicate with them, understand their needs and help them make decisions and choices. The health needs of the ladies are also carefully monitored and met. Staff provide a warm, caring environment for the ladies and treat them with respect and sensitivity. The ladies have choice in the meals, and menus are varied and nutritious. There is a good range of social activities and other social stimulation, both in the home and in the community. The ladies are encouraged and supported in keeping contact with their families. Staff receive good training, and have a high percentage of qualified staff. The ladies are protected by the home`s policies and procedures for safeguarding their safety and well being. The home is run in the best interests of the ladies who live there. What has improved since the last inspection? The only area where the home failed to be rated as `good` at the last inspection was the building. Since then, there has been significant improvement to the environment, with substantial refurbishment and redecoration in most parts of the home. What the care home could do better: The ladies` needs must be formally re-assessed by their care managers before any transfer of ownership of the home. Staff still lack training in recognising signs of Dementia. Key inspection report Care homes for adults (18-65 years) Name: Address: Shian 1 The Paddock High Spen Rowlands Gill Tyne & Wear NE39 2BD     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: Alan Baxter     Date: 1 7 1 1 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 26 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 26 Information about the care home Name of care home: Address: Shian 1 The Paddock High Spen Rowlands Gill Tyne & Wear NE39 2BD 01207545534 01207549534 Shian@nap.nhs.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Northumberland, Tyne & Wear NHS Trust care home 3 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 Shian provides ordinary housing for people with learning disabilities, all of whom were formally resident in a long stay hospital. Shian can provide personal care for 3 people. The service cannot provide nursing care. The home is a large detached bungalow situated in a residential area. There is a dining room, lounge with conservatory, kitchen and four bedrooms, one of which is a sleep-in room and office. The home is surrounded by a well-maintained garden which service users can access safely. There are separate laundry and storage facilities. The home is situated close to the town centre of High Spen where a range of community facilities such as shops and public houses can be easily accessed. There are bus stops nearby which link with the main regional centres. The home also has its own transport. The home has developed a Service User Guide so service users and other interested Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 3 1 8 1 1 2 0 0 8 Brief description of the care home people are informed about what this service provides. Care Homes for Adults (18-65 years) Page 5 of 26 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: An unannounced inspection of the home took place on 17th November 2009. This visit took approximately six hours in total. During this visit we spent time with the ladies who live there, including taking lunch with them. We also spent time with the team leader and her deputy, who were both on duty that day. We looked at information about the ladies to check how well they were being looked after. We also looked at other information that the home has to keep. We checked that the staff have the knowledge, skills and training they need to meet the needs of the ladies. We looked around the building to make sure that it was safe, comfortable and clean. Care Homes for Adults (18-65 years) Page 6 of 26 We checked what improvements have been made since the last inspection. We told the team leader what we found. Care Homes for Adults (18-65 years) Page 7 of 26 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 8 of 26 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 9 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is not able to demonstrate that the needs of the ladies have been comprehensively assessed using a Care Management assessment. Evidence: All service users have signed and dated contracts on their personal files. The original formal assessments of needs by the ladies social workers were not available (they having been resident for a number of years); but nor were there any annual re-assessments of needs seen. The team leader (manager) stated that the ladies care managers have said that they will be carrying out re-assessments prior to the planned transfer of ownership of the home. Mental Capacity Act assessments confirm lack of capacity for each of the ladies, and they are provided with advocates when necessary. Risk assessments are also carried out, and these are detailed, knowledgeable and sensitive. All staff sign to show that they have read all risk assessments. Care Homes for Adults (18-65 years) Page 10 of 26 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. There is good information available to staff to help them meet the individual needs of the people living in the home are met. Evidence: Care plans drawn up by social workers were reasonably detailed, but had not been updated since November 2007. However, the team leader and carers have drawn up very detailed and highly individualised support plans for each of the ladies (although these need to be signed and dated). Included in the support plans are care plans regarding the ladies self-image and self-esteem, and good detail on their communication needs and abilities, including input from speech and language therapists. Staff have knowledge of equality and diversity issues and this is reflected in the support plans. The support plans are evaluated every month, with updates on health, social activities, relationships and family contact, and current training and progress. Care Homes for Adults (18-65 years) Page 11 of 26 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 in the home are well supported in leading fulfilling lifestyles, both inside and outside the home, and have their rights and independence promoted and protected. Evidence: Each of the ladies in the home has her own weekly activities programme. The daily records show that these programmes are generally well adhered to. There is usually a separate activity for each lady every morning, afternoon and evening, as well as ongoing one-to-one attention. Activities include aromatherapy, going to discos, meals out, shopping, swimming, trips to pubs, walks, keep fit and assisted cycling. The ladies also enjoy a takeaway meal every month. The home also a range of snoozelen sensory equipment in the conservatory, and uses similar equipment and a water bed at Newburn Leisure Centre. Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: An enabler comes twice a week to help support the ladies activities. This person also helps them keep contact with family and friends by escorting them on visits. However, over the past year, staff say that they have had to reduce the range and frequency of leisure activities over the past twelve months, due to staff shortages across the trust and the loss of one of the two enablers previously available to the ladies. Regrettably, no Day Centre places are available for the ladies level of skills. The ladies use the local pub and shop. Mealtimes are flexible to fit around the ladies routines. Menus are nutritious and varied. They are based on the known likes and dislikes of the ladies, and use a picture format to aid informed choice. Main meals usually include three different vegetables and fruit is given every day at breakfast time. There is a choice of supper, and snacks and drinks are available throughout the day. None of the ladies is on a special diet. However, there was evidence that when one lady began to lose weight in the past, the home referred her to a dietician and the problem was solved. Lunch was observed to be a relaxed and low key affair, with staff showing sensitivity and good knowledge of the likes, dislikes and habits of the ladies. Care Homes for Adults (18-65 years) Page 13 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are given good, informed and up to date information about how to meet the individual needs of the people living in the home. Evidence: The ladies in the home are supported in using the normal range of community-based health services. They are escorted to attend health professionals such as their doctor, chiropodist, optician, dentist etc., and these visits are recorded in their support plans, along with the outcome of the visit. Staff know their ladies very well, and quickly spot any changes in their health or behaviour, and respond appropriately, with referral to specialist support, where necessary. They also make good use of advice and guidance offered by health professionals, by incorporating such advice in the care and support plans. None of the ladies present any challenging behaviours, currently, staff having made good use of professional advice when previous behavioural problems arose. The system for administering and storing medications is appropriate. Guidelines are in place for staff to follow for administering medication. The Boots blister pack system is Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: in use. All staff who administer medications have had the appropriate training. There is a system of daily auditing of the medication administration record, so any errors or omissions are picked up quickly and addressed. The home has no controlled drugs on the premises. Care Homes for Adults (18-65 years) Page 15 of 26 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. There are good systems in place to protect the people living in the home and to address any concerns or complaints received. Evidence: The home has a complaints procedure written in a way that attempts to help the ladies living there to understand its contents (although, in practice, they lack understanding and capacity, as described by the Mental Capacity Act). The home keeps a record of any complaints received and the outcome of the subsequent investigation. In practice, no complaints have been received in the past ten years. The team leader is currently exploring with the staff team how best to reflect any issues on behalf of the ladies. All four staff who returned surveys said that they knew what to do if they had concerns about the home. There is a whistle-blowing policy and a copy of the local authoritys Safeguarding Adults procedure. All staff have been given training provided by Gateshead Council on the protection of vulnerable adults. This is updated annually, as part of the mandatory training provided by the Trust. Each of the ladies living in the home has her own bank account. An appropriate Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: system is in place for dealing with their monies. Receipts are kept for any purchase made on their behalf, and there are two staff signatures for each transaction. The team leader consults with relatives and/or advocates before any large purchases are made with a service users money. There is a monthly external audit of the accounts. All four staff who returned surveys said that they knew what to do if they had concerns about the home. Care Homes for Adults (18-65 years) Page 17 of 26 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 living in the home experience a comfortable and clean environment which has been improved over the past year by significant refurbishment and redecoration. Evidence: Since the last inspection, there has been significant improvement in the furbishment and decor of the home. One ladys bedroom has been redecorated, and all the bedrooms have been recarpetted and have had new curtains fitted. In addition, the living room has been recarpetted and has had new curtains and a large plasma television screen fitted. Passageways, kitchen, dining room and shower room have all been redecorated. Plans have also been submitted to the Trust to redecorate the bathroom and the staff sleep-in room, and to provide new bedroom furniture for one lady. The kitchen units remain shabby and should be added to the refurbishment list for the next financial year. All areas seen in the home were clean, tidy, hygienic and odour-free. Staff have received training in the control of infection. One staff member commented, Since new management the home has been upgraded Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: throughout, with new carpets, bedrooms and house painted. It is a nicer place to work in and a nicer place for the ladies to live in. Care Homes for Adults (18-65 years) Page 19 of 26 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. Appropriate staff recruitment processes are in place, and the home provides the people living there with suitable numbers of trained, competent and well supervised staff. Evidence: The staff in the home ensure that they have good knowledge of individual needs and how they should be met. Staff on duty displayed respect for the ladies they care for, and showed sensitivity and good values and attitudes. Seven of the nine support staff hold National Vocational Qualification (NVQ) level 2 in care. Two staff are due to start NVQ level 3 in March 2010. The team leader and assistant team leader both hold NVQ level 4 in both care and management, and the Diploma in Learning Disabilities. The normal support staff level is two, with a third staff member being brought in when outings are planned. Bank staff have been made available to the home since the last inspection and, as the homes own support are often available as bank staff, this significantly assists in ensuring continuity of care for the ladies. Extra permanent staff are currently being recruited. Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: The team leader felt that the current staffing levels generally did meet the day-to-day needs of the ladies living there. However, none of the four staff who returned surveys felt that there was always enough staff to meet the individual needs of the ladies living there. One said that the home could do with more staff so they can give more time to the clients needs and activities. One staff member commented, Staff pull together when there are staff shortages as continuity needs to be kept for our three ladies. Another said that the home could do with more staff so they can give more time to the clients needs and activities. All four staff who returned surveys said that their employer carried out the proper checks on them (such as Criminal Record Bureau checks and references) before they started work. All four staff who returned surveys said that they are given training that is relevant to their role, and that helps them understand and meet the individual needs of the people they care for. They also said that the training keeps them up to date with new ways of working, and gives them enough knowledge about health care and medication. All staff were up to date with the training required by law. However, a recommendation of the last inspection that support staff should be given training in the care of persons with Dementia has not been carried out. With the increasing age of the ladies living in the home, such training is again recommended. Most of the staff felt that they have enough support, experience and knowledge to meet the different needs of the people who live in the home. Staff said they get enough support from their manager and that they meet regularly with the manager to discuss how they are working. Records showed that every support worker receives formal supervision every 8 weeks, and that these sessions are minuted, signed and dated. Care Homes for Adults (18-65 years) Page 21 of 26 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. There are good management systems in place to help ensure that the home is run in the best interests of the people who live there and to help ensure their safety. Evidence: The current team leader, Claire Marrs, has previously been registered as the manager of Shian. Having spent time in other of the Trusts establishments, she is now back at Shian and is in the process of being re-registered as manager of the home. She has the necessary experience and qualifications to carry out this role, and showed herself to be suitably knowledgeable and competent in the course of this inspection. The trust has a comprehensive internal quality assurance system in place, known as Total Quality Management. Elements of this include regular medication audits, health and safety checks, building inspections etc. An Annual Development plan is in place. Staff meetings take place regularly. Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: Appropriate records are held with respect to accidents. Fire fighting and fire detection equipment are checked at appropriate intervals, and a fire risk assessment is in place. Maintenance and servicing records are up to date. Any deficiencies are clearly recorded and responded to, promptly. There is a monthly visit by a representative of the Trust to fulfill the trusts responsibilities under Regulation 26 of The Care Homes Regulations 2001. Care Homes for Adults (18-65 years) Page 23 of 26 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 24 of 26 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 1 2 14 People living in the home must have their individual needs re-assessed before the home is transfered to new ownership. This is to make sure that those needs are clearly known, and any new owners can decide whether they can fully meet those needs. 31/12/2009 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 35 The manager should make arrangements for staff to receive training on dementia as the people living in the home are growing older. Care Homes for Adults (18-65 years) Page 25 of 26 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). 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. Care Homes for Adults (18-65 years) Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!