Care Home: Suillean House

What the care home does well All the people we spoke with said they liked living there and had lots of choices. One said it was great and another said they liked to do lots of different things.The staff know all about the people living at the home and how they like to be cared for. Staff talk to them about what they want to do.The good care plans help staff know what people wantThere are regular meetings for the people so they can have a say in how the home is run.Staff help people make choices about what they want to do and how they wish to lead their lives. What has improved since the last inspection? This is a new service. Suillean House asks people for their views and makes improvements all the time. What the care home could do better: We made no requirements after this visit. We said that one of the bathrooms could be made made more homely with curtains, pictures or plants. Key inspection report Care homes for adults (18-65 years) Name: Address: Suillean House 77 Sleaford Road Heckington Sleaford Lincs NG34 9QP 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: Julie Western Date: 2 2 0 1 2 0 1 0 The quality rating for this care home is: 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 © (2010) 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: Suillean House 77 Sleaford Road Heckington Sleaford Lincs NG34 9QP 07939086147 01522866001 angela.black@kisimul.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Kisimul Group Ltd Name of registered manager (if applicable) Mrs Angela Black Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 9 0 care home 9 learning disability Additional conditions: The maximimum number of people who can be accomodated is 9 The registered person may provide the following category of service, 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 Date of last inspection A bit about the care home Suillean House is in Heckington, a large village six miles from Sleaford town. 7 people can live in the home and everyone has their own bedroom. Trains and buses run to Sleaford Lincoln. There is also a minibus for trips out. Weekly fees range from £2445 to £3500 and information is available from the manager. The home says it wants to be a friendly and safe place where people will feel valued. 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 How we did our inspection: This is what the inspector did when they were at the care home The quality rating for this service is two star. This means the people who use this service experience good quality outcomes. We talked to the people who live at the home. We saw some care plans and talked to the people and the staff about them. We also looked at some of the policies in the office. Policies are rules about how to do things. What the care home does well All the people we spoke with said they liked living there and had lots of choices. One said it was great and another said they liked to do lots of different things. The staff know all about the people living at the home and how they like to be cared for. Staff talk to them about what they want to do. The good care plans help staff know what people want There are regular meetings for the people so they can have a say in how the home is run. Staff help people make choices about what they want to do and how they wish to lead their lives. What has got better from the last inspection What the care home could do better We made no requirements after this visit. We said that one of the bathrooms could be made made more homely with curtains, pictures or plants. 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 Julie Western CPC1 Capital Park Fulbourn Cambridge Cambridgeshire CB21 5XE 01223771300 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from a thorough assessment and can be assured that their care needs will be met. Evidence: The seven residents currently living at Suillean House previously lived at Acacia school. They transferred as a group from there with detailed assessments and care plans. There have been no new admissions. The manager outlined the process she would follow for a new admission. She confirmed that two senior staff always carried out the initial assessment, in order to form a complete picture of the needs of the person. The statement of purpose we saw was comprehensive and clear. There are two house guides, one with pictures. All other admission documents gave full details of the admission process and relatives/carers were sent a pre-admission form to complete. The manager said that trial periods would last as long as they needed to and staff confirmed this. We saw the service user guide, which contains up to date information about the type of care the home can provide, and it helps people to recognise the staff that work there. Photographs of the home and the activities it offers support the written information in the document. Assessments are in place for each person and cover needs such as communication, self care, independence skills, health care, diet, behaviour and leisure. The assessments are very detailed and tell people what the wishes and preferences of each person are. Records show that they are reviewed and, if necessary, updated at least every six months. The records also show that people, where they are able, relatives and other Evidence: relevant people are involved in carrying out the assessments. 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. Detailed care plans help students to develop their independence, whilst risks are minimised. They are consulted about their daily lives, and supported in an individualised and respectful way. Evidence: The three care plans we saw contained a lot of information and accurately reflected the needs of the residents. The manager has devised a handover file, where information on all the residents is updated three times a day as the staff come on to shifts. Staff members said they were easy to understand and quickly gave a profile of the residents needs. Car plans contained sensory profiles, communication profiles, speech and language therapy, triggers to behaviours and risk assessments on how to manage these. The risk assessments were carried out using a scoring system and staff we spoke with said this was very useful. Suillean House has its own health and safety officer, who assists in the recording of the risk assessments. Any progress made by people, for example, with shopping or making meals, was also recorded. All of the residents have a severe learning difficulty and most are unable to take part in the review process, therefore the views of parents or carers and other professionals such as placing authorities were sought. The current residents all have some degree of communication difficulty and we saw staff members using a wide range of methods to communicate with them during the inspection. Residents seen were relaxed and cheerful and had a good relationship with staff members. 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. People benefit from a wide range of social and educational opportunities, which help them to develop their skills and live a fulfilling life. Evidence: We saw individual programmes in the care plans, showing a variety of activities and events people could take part in. Activities such as cleaning and tidying rooms are included as well as free time. Other activities included swimming, horticulture, animal husbandry on the Acacia school site and various outings. A minibus is available but staff said people usually use the public transport. The manager said that people would shortly be asked where they would like to go for their annual holiday this year. One person we spoke with said she liked going to Klub AC, the weekly club operated from Kisimul school where people meet with their old friends from the school and Acacia, their previous school. The home is an accredited centre for the provision of the Award Scheme Development and Accreditation Network Towards Independence [ASDAN]; this enables people to work towards specific goals and awards. People had a framed certificates in their bedrooms and they were very proud of these. People are supported to have regular contact with their relatives, either by telephone or visits, according to the residents wishes. One resident said she went home to her parents every three weeks. Records of contacts are kept in care plans. The staff members prepare all food for people, with their assistance on occasions. The kitchen and dining room are domestic in nature. Attention is paid to where and how people want to sit to eat their meals and there are three places to choose from. Evidence: On the day of our visit, one person went shopping with a carer to buy food for the midday meal. Residents indicated that they enjoyed the meals. 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. There are good arrangements to make sure that the health needs of people are met, and they are protected by the medication policies and procedures. Evidence: Each person has a medical file, which contains information about their health needs, and this information links with care plans. Six of the current residents have some kind of prescribed medication. Care plans we saw were detailed and showed staff how to support needs such as behaviours and epilepsy and emotional needs such as anxiety. Records show when people have seen health professionals such as a GP, dentist or optician and they show that things like weight and seizures are monitored. People have an allocated key worker so that they have a consistent support network. Staff demonstrated through discussions and practice that they know the health needs of people very well. For example, they were able to describe how needs such as epilepsy are managed. They also made sure that any personal support was provided in a private and dignified way, and they respected decisions about things like what time people got up in the morning. Records show that all senior staff are trained in medication administration and all staff receive training in how to administer medications in a safe way. 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 are protected by clear procedures for handling complaints and allegations of abuse, and by the knowledge of staff who are well trained. Evidence: Records show that there has been one safeguarding complaint and one other verbal complaint made by members of the public since the home opened in June 2009. Both related to behaviours shown by people while they were out in public areas, were partly substantiated and have been addressed. The manager said that all staff had received training in safeguarding adults and staff confirmed this and staff spoken with confirmed this. The home uses the Local Authority guidelines for safeguarding adults. There are clear procedures for the recording and management of accidents or injuries. The manager said that all care staff are trained in restraint should it be needed. Any physical intervention is recorded in residents care plans. Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People enjoy a clean, comfortable and homely environment, which is well maintained. Evidence: Suillean House is a former private home that has been adapted to suit the needs of up to 9 people with a severe learning disability. The building is very well maintained externally and there is a large garden with a patio and barbecue area. Internally, it is decorated to a high standard, with modern furniture and plenty of communal spaces for people to sit in. The manager said that any repairs needing to be done are sent to the maintenance team at Kisimul school and are addressed quickly. Residents indicated that they enjoyed living in the home. One made a thumbs up sign to indicate how much they liked it and another said it was better than living at the school. Residents rooms were all en suite apart from one, which had a separate bathroom and were well personalised. The separate bathroom had not been made homely by the use of curtains, ornaments or pictures. Care plans indicated that some had chosen the colors for the decoration of their rooms. Staff said that they cleaned residents rooms, with assistance from the residents. The home was clean and smelled fresh throughout. Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A well-trained and supported staff team ensures that people are cared for safely. Evidence: We looked at records for three staff members. The recruitment records included criminal record bureau checks, application forms and two written references. They also contained identification and interview records. Staff members work in three teams of four [one Senior staff member plus three carers] at all times during the day. At night there are two staff members. Most present staff came from Acacia school, along with the residents; this gave added stability and support for residents as well as a good depth of knowledge of each resident, during the move to Suillean House. The manager said that there was a good list of bank staff and there were also back-up staff available in emergencies from the other schools. A training co-ordinator oversees the training programme, with all staff having a training day every three weeks to keep mandatory training up to date. The manager said that all staff members have National Vocation Qualifications [a nationally recognised award] at level 2 and all senior staff have NVQ at level 3. . Staff recruitment and selection procedures, including CRB checks, were managed from the head office. Staff files seen contained all the necessary information required. Staff we spoke with said that they receive training in subjects such as fire safety, moving and handling, and medication administration and records we saw confirmed this. Training also included physical intervention techniques and special communication skills. Records show that staff meetings and supervision sessions are carried out regularly with staff, and they confirmed this during discussion. They said that supervision helps them to look at their personal development, and they are able to voice their views and opinions. They said that there is good teamwork within the home, and they get good support from Evidence: their colleagues. Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed, which means that people receive a good standard of care and support. The systems within the home protect their health, safety and welfare needs. Evidence: The registered manager of the home has worked for the Kisimul group since 2003 and has managed Suillean House since it opened. She holds NVQs at level 3 in Caring for Children and Young Adults and Management and has the Leadership and Management in Care award. During our visit she was seen to have a good working relationship with the staff and an open door policy was maintained. The Support Manager conducts monthly monitoring visits and the information from these visits is used to identify any actions required by the manager. The support manager also carries out quality assurance, using the views of people and their relatives or advocates. Staff spoken with enjoyed working at the home, most having worked for the Kisimul group for a number of years. Minutes of the last staff meeting were seen and showed that staff are able to voice their opinions and concerns. The manager described the supervision process, with herself being supervised by the Support Manager and supervising senior staff, and they in turn supervising junior staff. Annual appraisals are also held. An annual quality assurance survey is being conducted by the Support Manager, who will collate the results and compile an action plan. Maintenance and health and safety checks were not inspected in great detail but there was evidence of risk assessments and checks and a member of the maintenance team was present on the day of the inspection. The documentation is very well organised and the manager and staff all said that the Evidence: organisation supported them very well. Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 24 The separate bathroom could be made more homely by the use of ornaments, flowers, curtains or pictures. 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. 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