Care Home: Templefields

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What the care home does well The service is being well managed and no new admissions have been taken. This has meant that the main house is more settled. Staff are working with some of the people in the home to help them move on to live more independently in the community. Care plans give good information about how people like to be supported with their personal care. This means that staff know what people`s personal preferences are. People`s health care needs are met. Staff will support people as necessary to attend health care appointments. Staff get training that is relevant to their job. All of the staff either have or are working to-wards a qualification in care. This means that they have or are being assessed as competent at their job. People know about the complaints procedure and who to talk to if they are unhappy about anything. This means that they can raise any concerns they may have. Staff understand the safeguarding procedures and take appropriate action when necessary. This means that people living in the home are kept safe. There are some good quality systems in place and people living in the home are able to have their say about what they want from the service. What has improved since the last inspection? Care plans have been re-written in a more person centered way and are up to date. They give good information about how people like to be supported. There is a new television in the lounge in the main house. The records about staff recruitment are better and clearly show that staff have had all the necessary checks before they start working in the home. Staff have received infection control and Mental Capacity Act training. What the care home could do better: Make sure that details of the any complaint, the action taken to resolve it and outcome are recorded. This will make sure that complaints are dealt with properly. Make sure that staff sign the medication records as soon as they have given medication. This will make sure records are fully completed and show people received their medication as prescribed. Key inspection report Care homes for adults (18-65 years) Name: Address: Templefields Temple Road Templefields House Dewsbury West Yorkshire WF13 3QE     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: Paula McCloy     Date: 1 8 0 5 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Templefields Temple Road Templefields House Dewsbury West Yorkshire WF13 3QE 01924461056 01924461008 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): VALEO Limited Name of registered manager (if applicable) Miss Joanne Jackson Type of registration: Number of places registered: care home 14 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 14 The registered person may provide the following category of service only: Care Home only Code PC To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following category: Learning Disability, Code LD Date of last inspection Brief description of the care home Templefields is a care home for 14 people with learning disabilities and associated challenging behaviours. Templefields is located on Temple Road, Dewsbury, off the main Huddersfield Road. The home is close to public transport links and Dewsbury with all its facilities is close by. The accommodation at Templefields is arranged in two buildings. There are ten single Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 14 Brief description of the care home bedrooms in the main house and four bedrooms in the Coach House. Each building has its own lounge, dining room, bathrooms, laundry and kitchen. There is also a hydrotherapy pool and aromatherapy room available on the same site. Care Homes for Adults (18-65 years) Page 5 of 28 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: This inspection was carried out to assess the quality of care provided to people living at the home. The manager completed an annual quality assurance assessment (AQAA), which provided us with information about the service. We have used some of that information in this report. The inspection process included looking at the information we have received about the home since the last key inspection as well as a visit to the home, which lasted approximately 4 hours. During the visit we spoke to one person living in the home, 3 members of staff and the manager. We also observed staff delivering care, looked at various records and looked around the home. Care Homes for Adults (18-65 years) Page 6 of 28 Surveys were sent to 9 people living in the home and 10 staff; these cards provide an opportunity for people to share their views of the service with us. Information received in this way is shared with the home without identifying who has provided it. One person using the service, and eight members of staff wrote to us with their comments. Their comments have been used in this report. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use the service are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Care Homes for Adults (18-65 years) Page 7 of 28 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. Care Homes for Adults (18-65 years) Page 8 of 28 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 9 of 28 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 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Anyone thinking of moving into the home would be assessed to make sure that staff could offer the right care and support. Evidence: There is a Statement of Purpose and Service User Guide available that contain up to date information about the service. The Service User Guide is also available in an easy read style if people want the information presented in this way. There have been no admissions to the home since we last visited in September 2009. Before anyone new would admitted, staff from the home would assess their needs to make sure that staff would be able to offer the right care and support. The manager is also aware that she also needs to consider how that person would fit into the existing group of people living in the home, to make sure everyones needs continue to be met. At the current time the three people living in the Coach House are very settled and there is one vacancy in this house. Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: There are six people living in the main house at the moment and staff are working with some individuals and their social workers to help them move on to live more independently. The organisation are then going to look at the changing the current Statement of Purpose for the home, as they recognise that it is very difficult to meet the needs of a potential group of ten people who often challenge the service. Care Homes for Adults (18-65 years) Page 12 of 28 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 are able to make their own decisions and are supported to take risks. Evidence: We looked at the care plans and risk assessment records for two people and found that they gave clear information about peoples needs together with the action staff must take in order to meet those needs. Since our last visit in September 2009 new, more person centered, care plans have been put in place. We found that these were up to date and information about peoples support needs is easy to find. Staff have completed training about the Mental Capacity Act and this has given them a better understanding about people being able to make their own decisions and offering appropriate support. We also found that there were clear agreements in place with people about managing their finances and that some people are using advocacy services to support them with their decisions. Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: Care Homes for Adults (18-65 years) Page 14 of 28 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff need to continue working with people to offer them new experiences and opportunities. Evidence: There are some people living in the home who go to college. Staff also told us that that they had been looking at employment with for one person but, to date, nothing has been arranged. Information about this was not in the care plan. It is important that staff create a plan for seeking employment so that they can look at ways to facilitate this and put strategies in place to address any problems that arise. People living in the home use the local shops and hairdressers and facilities in Dewsbury. People go out to the pub, shopping and for walks in the local area. Some people go out independently and some with support from staff. Staff have put together a long list of places that may interest people for trips out, some of which are Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: free. This will help people participate in their own and the wider community. People are given support to keep in touch with family and friends. Some people go and visit their family and friends. People can also invite relatives and friends to the home if they wish. There is a weekly menu that is prepared in consultation with people living in the home and incorporates their choices. Staff are aware of peoples preferences and make sure an alternative meal is available. Some people also prepare and cook their own meals. People are also encouraged to take part in the domestic routine of the home, for example, cooking meals and doing their own laundry and cleaning. Again on this visit we found a lot of information about peoples interests, but no care plans to show how staff would support them to take up different interests and activities. For example peoples interests included the following: church, fishing, cinema, snooker and football. Again staff told us that there is no budget for activities and people are expected to pay for things themselves. This means that for some people it isnt possible for them to experience a a range of activities, develop their skills and interests and social contacts. There are some people living in the home who require very little support with personal care but do need to develop their social skills and interests. Some of the interests people have listed have no or very little cost attached. Staff need to make sure they put plans in place with people to improve their leisure activities. Care Homes for Adults (18-65 years) Page 16 of 28 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. Peoples personal and health care needs are being met. Evidence: The care plans give clear information about how people like to be supported with their personal care. Good records are kept of health appointments and their outcomes. Staff make sure people are given support, if they want it, to attend their appointments. It was easy to find out when people last saw, for example, opticians and dentists. This means that it is easy for staff to check if people are up to date with routine check ups. The medication system is generally well managed with people getting their medication at the right times. There is clear information about when any as required medication should be given. This means that people will only be given these if they are needed. We did note that there were a number of occasions when staff had not signed someones medication record to show that creams/lotions had been applied. Staff must make sure they sign the medication records when they apply any prescribed creams Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: or lotions. We also discussed with the manager the need to implement the following as good practice: There should be a a medication care plan for each individual that sets out what medication they have been prescribed, how they like to take that medication and other information that will be helpful relevant to that individual. Any medication that is received into the home, that has not been put into a blister pack by the pharmacist, should have two staff members booking it in and checking the medication, frequency to be given and dosage. Both staff should sign the medication record. These measures will make sure that medication is managed safely. Care Homes for Adults (18-65 years) Page 18 of 28 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 who use the service are able to express their concerns and are protected from abuse. Evidence: The home has a clear complaints procedure that is on display and is in the Service User Guide. We could see that the complaints procedure is also discussed at residents meetings. This means that people know how to raise any concerns that they may have. We looked at the complaints log and saw that 5 complaints have been made since January 2010. Whilst the manager was able to tell us about the complaints and what she had done about them there were no details written down. It is important that details of the complaint, the action taken to resolve it and the outcome for any complaint are documented. This will make sure that complaints are dealt with properly. Staff have reported safeguarding issues to us and the safeguarding team in Kirklees. Staff have also implemented the advice that has been given following safeguarding meetings. This means that staff are protecting people from any abuse. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean and tidy and generally well maintained. Evidence: Templefields is located on Temple Road, Dewsbury, off the main Huddersfield Road. The home is close to public transport links and Dewsbury, with all its facilities, is near by. There is a large garden to the rear of the house that people can use in fine weather. One person living at the home has started a vegetable plot and is growing a variety of vegetables. The home was last inspected by Environmental Health in June 2009 and was awarded 3* for hygiene. This means that adequate standards of hygiene are being maintained. At our last visit in September 2009 we found that the bathrooms were in need of some general refurbishment and redecoration. We were told at this visit that all of the bathrooms are going to be redecorated and re-tiled. The home was clean and tidy when we visited. There are laundry facilities for people to use with support from staff if needed. There is an infection control policy in place and staff have received infection control training. This means that they know about infection control issues and know how to work in a safe way Care Homes for Adults (18-65 years) Page 20 of 28 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. Staff are suitable, safe and well trained to work with vulnerable people. Evidence: The main house and the Coach House are staffed separately. There are three people living in the Coach House. There are two staff on duty throughout the day and one waking member of staff at night. Staff told us these staffing levels were adequate and that the people living in this house are very settled. There are six people living in the main house. There are three/four staff on duty throughout the day and one member of waking night staff. in addition to this one person receives 3.5 hours per day of additional staff time, for one to one support. There are twenty three staff working at the home and fifteen of them have completed their National Vocational Qualification (NVQ) training in care at level 2 or 3. The remaining staff are also undertaking this training. This means that staff have been assessed as competent in their role. The homes recruitment procedure is robust and all new staff are thoroughly check to make sure they are suitable and safe to work with vulnerable people. Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: There is a training matrix in place that clearly shows what training people have completed and when. This means that training updates can be arranged as necessary. Care Homes for Adults (18-65 years) Page 22 of 28 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 home is being managed in the best interests of the people living there. Evidence: The manager has been working at the home for 8 months and has applied for registration with us. She is also working towards achieving the Leadership and Management of Care Services award and a Level 4 NVQ. There has been a complete change of the management team and a new deputy manager has been recruited and is due to start shortly. The home sent us their annual quality assurance assessment when we asked for it. This self assessment tool focuses on how well outcomes are being met for people using the service. This told us about improvements that have been made and what the home hopes to do in the next 12 months. People living in the home are consulted about the way it is managed through residents meetings. Minutes of these meetings are available. There are some good quality assurance systems in place. The company have their own quality assurance team who Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: visit the home and look at how it is being managed. These visits highlight any action that needs to be taken to improve the service for people living there. The manager has also sent out surveys to people living in the home, relatives and staff to get their views. She is aware that when these are returned she needs to write a report about the results. This will give people information about what people think of the service and what action is going to be taken to address any issues that have been raised. In the AQAA we were told that all of the servicing of equipment and insurance certificates are in place. Care Homes for Adults (18-65 years) Page 24 of 28 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 25 of 28 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 20 13 Staff must sign the medication records as soon as they have administered the medication to each individual. This will make sure medication administration records are completed properly and that people are getting their medication at the right times. 30/06/2010 2 22 21 Details of any complaint that 30/06/2010 is received must be documented together with the action taken and outcome. This will make sure complaints are dealt with properly. Care Homes for Adults (18-65 years) Page 26 of 28 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 14 Staff need to put plans in place to show how peoples opportunities to pursue the leisure interests of their choice will be met. The manager should implement the good practice advice given in this report in relation to medication. 2 20 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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