Care Home: The Corner House Care Home

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What the care home does well The layout of the home provides small group living in a non-institutional environment. The manager leads and supports a strong staff team who have been recruited and trained to a high standard. The manager is aware of current developments both nationally and by CSCI and plans the service accordingly. The staff team have worked at the home for a long time and they are trained to look after people safely. The manager makes sure that she knows the home can meet people`s needs before she agrees their admission, making the move organised and staff prepared. The staff team encourage people to be independent and treat them with respect, allowing people to make choices and take risks as part of them having full and purposeful lives. People living at the home say they are happy and feel safe and benefit from having a key worker who understands them. The systems in place to consult with people are very good, there is a daily `get together` where people can decide what they want to do, monthly meetings where people can voice opinions about the service and quality visits from people within the external management to make sure that people remain happy and safe. All the working practices in the home are safe and there are no preventable accidents. What has improved since the last inspection? The storage of personal records is improved and all information is held securely. The home has been extended and registered with the commission. What the care home could do better: As part of the home`s quality assurance systems they must produce a report for the manager after each review of the home takes place to make sure that any required improvements are recorded and acted upon. Medicines must be managed more safely and the storage of controlled medicines must be in line with the Safe Custody of Medicines Act. CARE HOME ADULTS 18-65 The Corner House Care Home 1-3 St Margaret Street Mansfield Nottinghamshire NG18 2RE Lead Inspector Mary O`Loughlin Unannounced Inspection 27th November 2008 09:00 The Corner House Care Home DS0000008656.V373320.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Corner House Care Home DS0000008656.V373320.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Corner House Care Home DS0000008656.V373320.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Corner House Care Home Address 1-3 St Margaret Street Mansfield Nottinghamshire NG18 2RE 01623 657 117 01623 657 117 cornerhouse@lha.org.uk www.lha.org.uk Leicester Housing Association Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Miss Joanne Hardwick Care Home 12 Category(ies) of Learning disability (12) registration, with number of places The Corner House Care Home DS0000008656.V373320.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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: 2. Learning Disability - Code LD The maximum number of service users who can be accommodated is: 12 14th June 2007 Date of last inspection Brief Description of the Service: The Corner House is a converted property situated in a residential area close to Mansfield town centre and local amenities. The premises provide 12 long term stay places for adults with a learning disability The manager confirmed that the weekly fee range is from £360 to £1,100.00 This does not include hair care, chiropody, outings and holidays. A copy of the last report is located in the main office, and is available to people on request. The Corner House Care Home DS0000008656.V373320.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of the inspection undertaken by the Commission for Social Care Inspection is about the outcomes of the care that people receive, and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice, and focuses on aspects of service provision that require further development. This was an unannounced key inspection undertaken by one inspector. The main method of inspection used is called ‘case tracking’ which involved selecting two people at the home and tracking the care they receive through checking their records and discussion with them, observations of the care received and asking staff about their needs. 4 people living there and three members of staff were spoken with as part of the inspection other people who were not part of the case tracking were observed and also spoken with. A partial tour of the premises was undertaken which included communal areas, and a sample of bedrooms to ensure that the environment was pleasant, homely and safe. A review of all the information about the home received by the Commission since the last inspection was taken into consideration in planning this inspection and helped in deciding what areas of care were looked at, this included a completed Annual Quality Assurance Assessment (AQAA) and surveys that we sent to people living and working at the home. The quality rating for this service is 3 star, this means that people who use the service experience excellent quality outcomes. What the service does well: The layout of the home provides small group living in a non-institutional environment. The manager leads and supports a strong staff team who have been recruited and trained to a high standard. The manager is aware of current developments both nationally and by CSCI and plans the service accordingly. The Corner House Care Home DS0000008656.V373320.R01.S.doc Version 5.2 Page 6 The staff team have worked at the home for a long time and they are trained to look after people safely. The manager makes sure that she knows the home can meet people’s needs before she agrees their admission, making the move organised and staff prepared. The staff team encourage people to be independent and treat them with respect, allowing people to make choices and take risks as part of them having full and purposeful lives. People living at the home say they are happy and feel safe and benefit from having a key worker who understands them. The systems in place to consult with people are very good, there is a daily ‘get together’ where people can decide what they want to do, monthly meetings where people can voice opinions about the service and quality visits from people within the external management to make sure that people remain happy and safe. All the working practices in the home are safe and there are no preventable accidents. What has improved since the last inspection? What they could do better: As part of the home’s quality assurance systems they must produce a report for the manager after each review of the home takes place to make sure that any required improvements are recorded and acted upon. Medicines must be managed more safely and the storage of controlled medicines must be in line with the Safe Custody of Medicines Act. The Corner House Care Home DS0000008656.V373320.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Corner House Care Home DS0000008656.V373320.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Corner House Care Home DS0000008656.V373320.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1-2 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Significant time and effort is spent planning to make admissions to the home personal and well managed. People are treated as individuals and with dignity and respect for the life-changing decisions they need to make. EVIDENCE: The service has a sustained track record of ensuring that people admitted to the home have their needs met and that they are provided with information about the home to help them decide if the services offered could meet their expectations. The commission approved a major variation of the home’s registration in October 2008 to provide a further 4 places after the provider had purchased an adjoining property and carried out various alterations to join the two houses into one home. Information we have about the service through previous inspections and the AQAA tells us that they have provided information about the home in a suitable format that helps people who want to use the service to understand what is The Corner House Care Home DS0000008656.V373320.R01.S.doc Version 5.2 Page 10 available. We also saw that the document has been reviewed to reflect the changes in the registration. People living at the home tell us that they feel the staff team have the right knowledge and experience to look after them. We examined the records of 2 people who had been recently admitted and found that significant time and effort was made by staff to make the transition for people as smooth as possible. They had visited the home, chosen their room, the décor and furnishings before they came to stay. The staff took time to collect all the information from external professionals that were involved to ensure that they could plan how they were to support the person’s health, personal and social needs. The staff involved the person and their family and completed assessments that where used to inform an initial plan of care that the person was to receive, to make sure that staff would know what was important to the individual and support them in accordance with their wishes. The Corner House Care Home DS0000008656.V373320.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6-7-9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There is a commitment to support individuals to lead purposeful and fulfilling lives as independently as possible. People using the service make their own informed decisions and have the right to take risks in their daily lives EVIDENCE: The last 2 inspections and at this inspection, we have found that people using the service receive good outcomes in this group of standards showing that the home has a sustained track record in how they support people to lead purposeful and fulfilling lives as independently as possible. Before this inspection we asked 5 people who live there if they were able to make decisions about their life at the home and all 5 people said they could. We examined 2 care files and saw how staff involve the person and seek their agreement to a plan of care that reflects their health, personal and social The Corner House Care Home DS0000008656.V373320.R01.S.doc Version 5.2 Page 12 needs. The plans are produced in a picture and simple word format to help people be fully involved in them. The plans were person centred and focused on the individual’s strengths and personal preferences. We saw how staff manage risks positively so they can help people be as independent as possible. People told us that they can choose what they do each day and that there were enough staff to support them, they knew their key worker well and felt that their preferred communication style was understood. We found from records and from speaking to people that personal development is encouraged, and they are supported and provided with opportunities to attend day centres and colleges. The care plans contained information on the personal financial management of each person along with the support that was required to protect their interests. The Corner House Care Home DS0000008656.V373320.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12-13-15-16-17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People live an ordinary and meaningful life, appropriate to their peer group, in both the home and the community. EVIDENCE: Information we have received about the home, from our findings at previous inspections, responses from our Have Your Say surveys, the AQAA and at this inspection shows that there is a sustained track record of ensuring that people living in the home receive their chosen personal support and are fully consulted about their aspirations to live a meaningful life appropriate to their peer group. The Corner House Care Home DS0000008656.V373320.R01.S.doc Version 5.2 Page 14 The service actively supports people to be independent and involved in all areas of daily living in the home. This includes where appropriate, taking responsibility for shopping, planning meals, and meal preparation. Each person’s care plan details what domestic tasks they want to do in the home, some younger adults are supported to do their own laundry and room cleaning whilst other older people wish to have staff do it for them. A member of staff helps people make their beds if they wish or they do it for them. Each person has a detailed graphic plan of what they are responsible for which helps them to understand what to do and when. Each person is provided with a key to the house and their bedroom and is able to plan what they want to do each day. People told us about attending day centres, visiting the local swimming baths, dances and various public amenities. They spoke about visiting their families, using local taxi services and how they used their mobile phones to keep in touch with relatives and friends. A person told us that they take turns each week to plan the menu for everyone, but if some meals are not liked by everyone they get lots of choices and can have what they want instead. The manager told us they have just received a 5 star rating for their food hygiene practices from Nottingham County Council Staff training records show they are trained in food hygiene practices. The Corner House Care Home DS0000008656.V373320.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18-19-20-21 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Health and personal care is given in accordance with people’s wishes and systems in place ensure people have good access to health and remedial services, however medication systems do not follow good practice guidelines. EVIDENCE: The 5 responses to HYS from people using the service said that staff treat them well. We saw that people were dressed in their own clothes and in keeping with their preferred styles. We saw that each person has a health care plan that describes in detail all health related issues, this includes dentistry, chiropody, and ophthalmology access. Those people that have lived at the home for many years are now in the older age group and they told us they know that the service will continue to care for The Corner House Care Home DS0000008656.V373320.R01.S.doc Version 5.2 Page 16 them within a purpose built bungalow, which will provide more suitable facilities. Staff files show that they are trained to administer medication and the staff told us that they only undertake administration if they are trained. Medicines were generally well managed but some shortfalls were identified in the recording of medicines into the home, recording of the reasons why medication was omitted and the lack of signed and witnessed hand written medicines. There are no controlled medicines presently in use however the law around the safe keeping of these medicines has recently changed and the present storage facilities do not meet the required regulations. The Corner House Care Home DS0000008656.V373320.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22-23 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People living at the home are listened to and taken seriously and staff know how to protect them from abuse. EVIDENCE: The home has a sustained track record of meeting these standards and there have been no complaints or safeguarding investigations over the last 12 months received by the Commission or the home. People we spoke with said they felt safe and listened to. There were records seen of the monthly meetings held at the home that people take full part in and are able to voice opinions about the service. The complaint procedure is made available in the home and describes clearly what people can do if they are worried or need to make a complaint, it refers to other agencies that could help them including independent advocacy. The procedure is in a format that they can understand. We saw from staff records that staff working within the home are trained in safeguarding adult’s procedures, which ensures that they know how to respond in the event of an alert. The Corner House Care Home DS0000008656.V373320.R01.S.doc Version 5.2 Page 18 Robust systems were seen in place to protect people from financial abuse. The Corner House Care Home DS0000008656.V373320.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24-30 Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to this service. The living environment is appropriate for people’s particular lifestyle and needs and is homely, clean, safe and comfortable, well maintained and reflects the individuality of the people using the service. EVIDENCE: A site visit of the premises was carried out on 8 October 2008 with regard to the increase in the number of people that could be accommodated following alterations to the home. It showed that the new facilities are fit for purpose, and met National Minimum Standards for Adults and the Care Homes Regulations. People said they are encouraged to see the home as their own. It is a very well maintained, attractive home and has very good access to community facilities and services. The Corner House Care Home DS0000008656.V373320.R01.S.doc Version 5.2 Page 20 People told us that they are fully involved in decisions about the décor and any changes in their communal and personal accommodation. There is a selection of communal areas both inside and outside of the home, this means that people using the service have a choice of place to sit quietly, meet with family and friends or be actively engaged with other people who use the service. The kitchen and laundry are designed to enable and promote the involvement of people in domestic tasks and as part of developing or maintaining independence. There is a suitable infection control policy in place and staff are trained in safe infection control practices. The Corner House Care Home DS0000008656.V373320.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32-34-35 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Appropriate recruitment practices are being followed; competent and trained staff ensure that people are supported and protected. EVIDENCE: We examined staff files and found that the home continues to make sure people are properly checked before they start working with vulnerable people. Staff training files show that there is a high importance placed on making sure staff are suitably trained to undertake their role safely. The AQAA tells us that 100 of the staff team are trained to level 2 National Vocational Training. We identified how staff received specialist training in the needs of one person who was recently admitted to make sure they knew how to communicate with the person appropriately before they came to stay at the home. The Corner House Care Home DS0000008656.V373320.R01.S.doc Version 5.2 Page 22 The staff told me they had worked at the home for many years and were key workers for people. They said they have regular meetings and are supervised regularly by the manager. People using the service also report that they know the staff team well, know their names and are able to communicate with them freely and easily using their preferred method. The service has plentiful staff available at all times to support the needs, activities and aspirations of people in an individualised and person centred way as evidenced through talking to staff and people living at the home. The Corner House Care Home DS0000008656.V373320.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37-39-42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run and managed safely. EVIDENCE: The registered manager has the required qualification and experience to run the home. The information provided in the AQAA was fully supported by appropriate evidence. It includes a high level of understanding about the importance of equality and diversity and a wide range of evidence showing how staff listen to people who use the service. The Corner House Care Home DS0000008656.V373320.R01.S.doc Version 5.2 Page 24 The manager said that the home has appropriate, effective and regular support through a named line manager who visits the service and speaks to people about the care they receive. However the line manager visits but does not produce a report on the care practices for the manager and there are no reports available to inspect. The service completes some quality audits around the practices of the home such as accident analysis. However the management of medicines is not properly audited or measured against recognised best practice. All personal records are held securely to protect people’s confidential information. The management of health and safety is properly audited and supported by policies and procedures. The Corner House Care Home DS0000008656.V373320.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 4 2 4 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 4 3 X 2 3 X 3 X The Corner House Care Home DS0000008656.V373320.R01.S.doc Version 5.2 Page 26 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA20 Regulation 13 Requirement Obtain a suitable controlled medicine cabinet as required for the safe custody of controlled medicines. Make written reports of the quality visits available for inspection. Timescale for action 01/03/09 2. YA39 26 01/03/09 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA20 Good Practice Recommendations Sign and witness all hand written medicines and ensure that they include the frequency and strength of the medicine. Make sure that staff complete the required key on the Medicine record sheet when medicines are omitted. Audit the medicine management as part of the quality assurance systems. Improve the system of recording medicines into the home to make sure that it provides a suitable audit trail. 2. 3. 4. YA20 YA20 YA20 The Corner House Care Home DS0000008656.V373320.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Corner House Care Home DS0000008656.V373320.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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