Care Home: The Banyan Tree Bostock Avenue

What the care home does well There is ongoing assessment of individual`s needs. Support workers are very knowledgeable about the needs of people using the service. Person centred plans are in place and individuals are supported to be as independent as possible. Health care needs are monitored and appropriate action is taken. People who use the service said `I like living here` `I know who to talk to if I have a complaint or concern` `I feel safe` `I am supported to do activities of my choice`. People who use the service have a range of daily activities of their choice. They are supported to be included within the community and have built a positive relationship with others in the surrounding area. Safeguarding procedures are in place and everyone is aware how to respond The home is maintained to a high standard. Everyone has access to single rooms that reflect their personal preferences. Communal areas enable a range of activities to be undertaken within a family setting. The support workers show a high level of commitment to the work and bring a range of skills to support people using the service. Support workers are well trained and receive regular supervision. What has improved since the last inspection? This is the first inspection since registration What the care home could do better: The service at The Banyan Tree is meeting national minimum standards and demonstrates that it exceeds in some areas. Key inspection report Care homes for adults (18-65 years) Name: Address: The Banyan Tree Bostock Avenue 53 Bostock Avenue Northampton Northants NN1 4LN     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: Judith Roan     Date: 2 2 1 2 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 25 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 25 Information about the care home Name of care home: Address: The Banyan Tree Bostock Avenue 53 Bostock Avenue Northampton Northants NN1 4LN Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Maria Jane Watts Type of registration: Number of places registered: care home 4 Living Life (UK) Ltd T/A The Banyan Tree Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: Maximum numbers 4 The registered person may provide the following category of service only, Care home 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 Mental Disorder Code MD Date of last inspection Brief description of the care home The Banyan Tree, Bostock Avenue, offers four placements to young adults from the age of sixteen. The service has been created to support those young adults Care Homes for Adults (18-65 years) Page 4 of 25 Over 65 0 0 4 4 Brief description of the care home experiencing Mental Health Difficulties, Dual Diagnosis, Emotional and Behavioural Difficulties, and Learning Difficulties. The service offers medium to long-term placements to work with the young adults to effect positive changes in their emotional and behavioural well-being, and ability to keep them safe. The aim is to empower the young adults to gain appropriate life and independence skills at their own pace and to support their abilities to move on to a more independent living situation. The accommodation provides a family setting comprising of single rooms with access to shared bathrooms with one room having ensuite facilities. There is a choice of communal areas, dining room and kitchen where people living at the home can undertake daily activities. There is access to a secluded and safe garden to the rear of the property. The house is in a residential area of Northampton close to the town centre and community facilities. The statement of purpose and other information is available from the Registered Manager. Care Homes for Adults (18-65 years) Page 5 of 25 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: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This inspection was unannounced and lasted 5 Hours. The home tells us about the things that has happened and how they look after the people and make them safe. The information is recorded on a report called the Annual Quality Assurance Assessment (AQAA) and through Notifications. This service is new and there is ongoing work of further admissions. At present one person uses the service. There has been one safeguarding referral which at the time of the inspection was still under investigation. We spoke to the manager to find out how they were looking after the people. Care Homes for Adults (18-65 years) Page 6 of 25 We spoke to one person to find out how their needs were being met. We looked at support plans to see how the people are being looked after by the home. We check that the home has safe policies that tell them how to do things properly. We looked at the training that the support workers do to help them understand the needs of the people better. Care Homes for Adults (18-65 years) Page 7 of 25 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 25 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 25 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. The admission process ensures that needs are assessed and that people using the service are fully involved within the process. Evidence: People living at the home were fully consulted during the admission process. It was evident from case records that a through assessment of need was undertaken at the time of admission to ensure that individual needs could be met. Needs are continually reassessed to ensure that the service can continue to meet peoples needs. Files contain good information that has been gathered as part of the assessment process. This information is updated with ongoing work especially in relation to social and health care needs. Support contracts are clear and agreed by people using the service. Care Homes for Adults (18-65 years) Page 10 of 25 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 using the service can expect that practices within the home promote their involvement and independence. Evidence: Support plans in place for people using the service are in an accessible format, person centred and reviewed on a regular basis. An annual review is undertaken with the funding authority. Regular meetings with individuals and their key workers are held so care needs are reviewed ensure that there is continuous development. People spoken with during the inspection were very positive about living at the Banyan Tree. They said that we are happy and that their views on how they are supported were respected. Outcomes for people using the service are excellent and that needs are being met within the systems in place at the home. In discussion with support workers it was evident they are very knowledgeable about the needs of individuals using the service. Care Homes for Adults (18-65 years) Page 11 of 25 Evidence: Support for people using the service enables them to maintain and develop their skills by participating in everyday activities. Learning is achieved by the consistent approaches used by support workers and people using the service having access to and observing a broad spectrum of daily living activities. Risks within activities are considered on an individual basis and plans are made to minimise these for each person. There is a robust on call system in place to support staff on occasions when additional staff are required to support the needs of people using the service. People using the service are encouraged to be as independent as possible with appropriate support. In this way individuals are included within activities and not excluded because of any behaviour that may arise. Care Homes for Adults (18-65 years) Page 12 of 25 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. Planned intervention enables and respects individuals rights by supporting them to develop personal skills and to take opportunities within social and community activities. Evidence: The inspector was shown records for the individual case tracked. A weekly activities programme was available that is updated to take into account of special events, behaviours and wishes of people using the service. New activities are tried out to extend the choices and personal experiences. In meeting with the person who uses the service it was noted that they were supported to maintain good social relationships with others outside the home. Careful planning is undertaken for all activities to ensure that they are protected and enjoy the experience. Activities are both planned and spontaneous and individuals felt that Care Homes for Adults (18-65 years) Page 13 of 25 Evidence: there was a wide range of opportunities available to them. It is planned that as more people move into the home that there would be regular house meetings to enable people to contribute to the decision-making processes within the home. Experiences for people using the service were good and varied. Individuals are involved within their ability with day-to-day living tasks within the home. They are supported to maintain their rooms and undertake personal shopping, banking and other activities with agreed support. Personal development in the management of personal finances was seen to be ongoing for the person case tracked so that their skills and understanding in this area were increased. Behavioural management plans were seen to be in place to support the individual with lifestyle choices. Meals are freshly cooked by support staff inclusive of people living at the home joining in if they are able to do so. The menu is recorded and indicates that it is balanced varied and healthy. People using the service are fully involved with decision making for their individual activities. Throughout the inspection the inspector observed positive work with the person using the service that promoted their rights to make choices and enabled them to be fully involved in community life. There are good relationships with the community. Feedback within the questionnaires about the service provided in this area was good. Care Homes for Adults (18-65 years) Page 14 of 25 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. A trained staff team ensures that people using the service are supported in meeting their healthcare needs. Evidence: People using the service users are supported to have regular health checks and there is evidence on files that GP, specialist, dentist and optician appointments are made. Personal support is provided in a discreet manner, with individual preferences being a top priority. The support plans are person centred and clearly state how people wish to be supported. Medical profiles have clear information given about individuals health care needs. The files contained background information on specific medical condition that aide support workers understanding of the peoples health care needs. The home has a good recording system that does demonstrate the path of medication coming into the home with safe administration and disposal. The manager works with the local pharmacist to ensure that the system meets with current national guidelines. Care Homes for Adults (18-65 years) Page 15 of 25 Evidence: All incidents are recorded on file to show how support workers have reviewed practice to minimise future risks. Individuals have detailed plans that support their healthcare needs. Support workers were found to be fully aware of the details of these plans. Care Homes for Adults (18-65 years) Page 16 of 25 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service users are protected by policies and practices within the home. Evidence: The organisation has comprehensive policies and procedures in relation to handling concerns and complaints made. In meeting with the person during the inspection they said that I would tell a member of staff if I was not happy. Support workers undertake safeguarding awareness training as part of their induction/ foundation training with regular updates. The inspector was able to check out their understanding during the inspection. There has been one safeguarding incident referred for multi-disciplinary discussion and the provider is reviewing the procedures to ensure that support staff have and feel well supported at the times when they are challenged. The open approach of the support workers enabled individuals using the service to feel comfortable if there was a need to make a complaint or express a concern. The service has received three complaints which have been investigated and upheld. CQC has not received any complaints since registration. Care Homes for Adults (18-65 years) Page 17 of 25 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 maintained to a high standard, providing a warm and relaxed environment with good personal and communal space. Evidence: There are adequate rooms to enable everyone to have their own personal space in the large converted dwelling. Individual rooms are personalised, comfortable and well maintained. People using the service are supported in maintaining their rooms to a high standard of cleanliness and safety. The home is well maintained and decorated to a high standard. There is a family size kitchen with a dining room leading from it. A large dining area enables people to share meal times in a relaxed and warm environment. The communal space provides for individuals to undertake a range of activities within the house. Records demonstrate that health and safety checks are undertaken with people using the service to maintain a safe home. Care Homes for Adults (18-65 years) Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The trained, competent and supported staff team ensure that the service is professional and meets identified needs of people using the service. Evidence: Recruitment procedures are robust as files seen contained all of the required documentation to confirm that security and employment checks had been undertaken. References and Criminal record Bureau checks were in place. People using the service participate in the interview process for prospective staff. This was also confirmed within the AQAA Selection procedures include involving residents as well as staff in the recruitment process; however, this is an informal practice at present. Fully supported in-house induction, mandatory and bespoke training is provided. New support workers undertake an induction programme and work alongside experienced members of the team to gain full knowledge about the needs of people using the service living at the home. There is a very low turnover of support workers, which promotes continuity in support for people living at the home. Support workers are offered a range of opportunities to train. All support workers hold National Vocational Qualification (NVQ) in care at level two or above. Specific training to meet the needs of the people using the service is available. Care Homes for Adults (18-65 years) Page 19 of 25 Evidence: Supervision is available with the manager meeting with staff on a regular basis. The staff team also meet to discuss development and day-to-day management issues. Staff surveys were very positive and said that The support is brilliant. The home is always a welcome place for people that live there and staff. The AQAA confirms the findings made at the inspection Staff are encouraged to develop their role through training and supervision. Long standing and good relationships also exist with external trainers. It also confirmed that the service has a stable staff team and flexible rotas. There is an effective training programme and responsibility for tasks are delegated to individual staff to increase skills. Care Homes for Adults (18-65 years) Page 20 of 25 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 effectively managed and ensures that people using the service receive a quality service where their views are respected and their safety is safeguarded. Evidence: The Registered Manager effectively manages the home in the best interests of people living at The Banyan Tree and the support workers. The AQAA states that it carries out the following activities to gain the views of people using the service We hold residents meetings on a weekly basis and a key worker system is in place. Quality assurance questionnaires are held yearly and the feedback acted upon. Residents have input to choose social activities. The service hold reviews and residents have access to case managers and advocacy services. Social services are part of the reviews. We run an open door policy. the comments from surveys were very positive about the service. Placing authorities say that there is good communication, good at working on the strengths of people living at the home, staff are conscientious and consistently seek out the views of the people there are supporting. Families are also consulted and confirm that the service is provided in the Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: best interests of their relative. The provider strives to monitor the service on a continuous basis; this is done by having internal reviews, unannounced monthly regulation visits by senior managers and annual quality assurance audits. The service has good records of evidence on how staff work with individuals who use the service that link back to the support plan. Individual finances are recorded with two signatures and receipts. People using the service are involved with their finances within their ability and are assessed to have direct access to bank accounts All health and safety checks required have been completed. Care Homes for Adults (18-65 years) Page 22 of 25 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 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 24 of 25 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 25 of 25 - 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!