Care Home: The David Lewis Centre

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What the care home does well There is information about how the home works and who it is for (the statement of purpose) so people wishing to move in have the information they need to make an informed choice about moving there. The person centred plans (care plans) for the people who live in the home accurately reflect their care needs. They include up to date information and guidance for staff so they know what they must do to meet the needs of each person. Information about people`s healthcare needs is up to date and shows how these needs are being met by staff at the home. There are enough staff available to meet the needs and choices of the people who live in the home. There is a complaints procedure in place that ensures complaints are recorded to show how they have been investigated and what action has been taken to resolve them. This shows that complaints and concerns about the home are taken seriously and acted upon. The general decor and appearance of the home, both inside and outside, is of a high standard so ensuring the people live in comfortable and safe surroundings. Staff have received training which includes safeguarding adults, moving and handling, fire safety, first aid, food safety and medication awareness. This will make sure that staff know how to provide safe care, in line with up to date practice, for the people who live in the home. The registered manager has, with the support of the residential manager and other staff within the David Lewis Centre, put procedures in place so ensuring a good quality service for the people who live in the home. We saw that people living in the home were comfortable with staff who were working with them. Over half the staff at the home have achieved a National Vocational Qualification in care at Level 2 or above. This is a nationally recognised qualification for people involved in providing care and shows they have the skills to make sure that the needs of the people they work with are met. What has improved since the last inspection? This is the first key inspection of the home since it was first registered on the 1 June 2009 What the care home could do better: We consider that Westbury Drive provides good outcomes for the people who live there so would expect that the home continues to review its practice in order to ensure that the high standard of care provided to the people at the time of the inspection is maintained and where possible improved. Key inspection report Care homes for adults (18-65 years) Name: Address: The David Lewis Centre 19 Westbury Drive Macclesfield Cheshire SK11 8LR     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: Val Flannery     Date: 1 2 1 1 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 24 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 24 Information about the care home Name of care home: Address: The David Lewis Centre 19 Westbury Drive Macclesfield Cheshire SK11 8LR Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Lorraine Riley Type of registration: Number of places registered: care home 4 www.davidlewis.org.uk David Lewis Centre Ltd Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home The home is part of the David Lewis Centre and provides personal care and accommodation for four people who have a learning disability. Located on a residential estate in Macclesfield the home is close to shops and other facilities and is in keeping with the local community. Staff are on duty twenty four hours a day to provide care and support to the people who live in the home. Please contact the manager for information on accommodation fees and other charges. 4 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 24 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 overall quality rating for the home is two stars. This means that the people who live in the home experience good quality outcomes. This visit took place on 12 November 2009. It was carried out by one inspector and took a total of 4.5 hours. The report will say we when referring to what we did and what we found because it is written on behalf of the Care Quality Commission. During our visit we spoke with the people living in the home, the manager and staff. We looked around the premises and looked at various records held by the home. The visit was just one part of the inspection. The manager had completed a questionnaire to provide up to date information about the home. CQC questionnaires were made available to the people living in the home so they could tell us what they think about it. This is the first key inspection of the home since it was first registered on 1 June 2009. Care Homes for Adults (18-65 years) Page 5 of 24 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 6 of 24 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 7 of 24 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 8 of 24 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. Information about the care needs of the people living in the home was made available for staff when the people moved in staff would know how to provide them with support in the way they preferred. Evidence: We saw a copy of the information about how the home works and who it is for (the statement of purpose) which sets out the aims and philosophy of the home. This document also included details on how to contact the Care Quality Commission and how to make complaints and raise concerns. The people living in the home have moved there from other locations within the David Lewis Centre. A copy of the Transitional plan - Moving Home was seen for one of the people who live in the home. This included information for the person on the move, the reasons for moving, people who would support the person with the move, getting ready for the move, planning ahead for the move and moving on. The document was provided in picture book format to help the person understand what was happening. Care Homes for Adults (18-65 years) Page 9 of 24 Evidence: We spoke with the people who live in the home. They told us that they knew each other before they moved into the home. We were told by staff that before the people moved they were able to visit the home and also spend time together. We were also told that although the families of the people living in the home were worried that the move may upset their relatives, they are now very pleased with the improvements to their quality of life. Care Homes for Adults (18-65 years) Page 10 of 24 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. The people living in the home are supported by staff to be as independent as possible and to take responsible risks so ensuring life at the home meets their expectations. Evidence: During the visit we saw the care folder for one of the people who lives in the home. Included in the folder were person centred plans that showed how the person wished to live their daily lives, how any changes to their care needs would addressed by the home, a list of the people, which included the person and their families, who were involved in drawn up the plans of care and a copy of monthly evaluations which were carried out with the person and their key worker. We spoke with staff who told us that the people living in the home are always consulted about their care plans and that their views and wishes are included in the plans. We saw the people who live in the home moving freely between their bedrooms and the communal lounges. One of the people we spoke to said they like to watch videos in their bedroom. We saw risk assessments in the care plans that showed that level of support required by the person to ensure their safety and well being and also to help them maintain their Care Homes for Adults (18-65 years) Page 11 of 24 Evidence: Independence. The risk assessments covered the level of support people required whilst in the home and whilst using community facilities. One person spoken with said they walk to college very day but need staff to help them cross the busy road. Care Homes for Adults (18-65 years) Page 12 of 24 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to take part in activities that suit their lifestyle and interests so ensuring their expectations about their chosen lifestyle are met. Evidence: During our visit we spoke with the people who live in the home. One person told us how they attend a local college which is within walking distance of the home. Another person spoke about doing their paper round. The people who live in the home told us how they are supported by the staff to visit local community facilities such as the cinema, swimming pool and other leisure facilities. We saw the care folder for one person who lives in the home. This had information about the persons daily routines, including shopping, walking and helping with the household chores. During our visit we saw one of the people who lives in the home receive a phone call from his family. We spoke with the staff who told us that relatives/friends are encouraged to maintain contact with the people living in the home. The care folder for one of the people living Care Homes for Adults (18-65 years) Page 13 of 24 Evidence: in the home seen during the visit had a record of contact made by the persons family. We saw one person living in the home helping staff prepare the evening meal and another person helping clear away and wash up following the meal. People are offered a choice of meals and are actively involved in buying the food and planning the menus. We saw support being given to one person with eating and this was done in a caring and sensitive manner. The meal time seen during our visit was relaxed and unrushed. Care Homes for Adults (18-65 years) Page 14 of 24 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. The personal and healthcare needs of the people living at the home are well managed so ensuring their care needs are met in a way they prefer. Evidence: We saw the care folder for one of the people who lives in the home. This showed the level of support the person required with their personal and healthcare needs. Information was also included in the care plans about the level of support the person needed with personal care such as using the bathroom and dressing. The care plans also showed that the person required support with their medication and attending doctors and hospital appointments. We saw a patient passport in the care folder which contained information about the person and their healthcare needs. The person takes the passport with them when they attend doctors and hospital appointments. There was information in the care folder about the specific healthcare needs of the person and the action staff should take to ensure the persons safety and well being. We could see that this was being monitored to make sure that the right actions were being taken. We were told that the people living in the home need help to make sure they take their medications safely as prescribed. The record of the medication administered by staff to one of the people living in the home was seen and was Care Homes for Adults (18-65 years) Page 15 of 24 Evidence: satisfactory. The medication is kept in a secure cupboard in the home. The staff spoken with said they have received medication awareness training and also receive regular updated training so they are able to maintain the well being of the people living in the home. The record of staff training seen during the visit showed that all staff have received training on administering medication to the people who live in the home. During our visit we saw staff support people with using the bathroom and with their meal. The support was offering in a caring and sensitive manner and maintained the privacy and dignity of the people living in the home. Care Homes for Adults (18-65 years) Page 16 of 24 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 living in the home are protected by the complaints and safeguarding procedures in place so ensuring they are safeguarded from harm and possible abuse. Evidence: During our visit we saw a copy of the complaints procedure for the home which included details on how to contact the Care Quality Commission. We saw the record of complaints received by the home. There was one complaint recorded from a family member of one of the people who lives in the home. The complaint concerned the persons personal care and was dealt with satisfactorily by the home. We spoke with staff who told us procedures have been put in place to ensure the concerns raised would not happen again. The home has safeguarding vulnerable adults policies and procedures in place that include the Department of Health guidelines No Secrets. We were told by senior staff that the home has not made any referrals under the safeguarding procedures. Staff also said that they have received protection of vulnerable adults training and also will be receive refresher training every two years. Care Homes for Adults (18-65 years) Page 17 of 24 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 provides clean, comfortable surroundings and single bedrooms so ensuring the privacy and dignity of the people who live in the home are maintained. Evidence: The home is a domestic type, detached four bedroom house on a residential estate in Macclesfield. It is close to shops, public transport and other community facilities. The four single bedrooms are located on the first floor of the home along with the bathroom. There is a communal lounge/dining room, kitchen/laundry, shower/wet room and staff office on the ground floor. The area to the front of the home is used as car park. The garden to the rear of the home is well maintained and provides a safe, secure area for the people who live in the home. The bedroom we looked at during our visit was individually furnished and decorated. We spoke with the people who live in the home who told us that they choose the furniture and decor for their bedrooms and communal areas with support from staff. The home is very well maintained and provides a safe and comfortable for the people who live there. The staff training record showed that all the staff have received training on infection control and food hygiene. Care Homes for Adults (18-65 years) Page 18 of 24 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 people living in the home are supported by well trained and qualified staff so ensuring they are cared for by people who have the skills to support them Evidence: The staffing rota seen during our visit showed that there are normally two staff on duty during the day/afternoon/evening and that there is one person on waking night duty. Information provided by the manager showed that seven care staff have completed an induction programme and that six staff have achieved an NVQ Level 2 or above. The training record seen during the visit showed that all staff receive yearly training updates including medication awareness, safeguarding adults, health and safety, epilepsy, head injury, infection control, food safety/hygiene and moving and handling. The staff spoken with during our visit said they receive appraisal from the residential manager and receive one to one supervision from a senior care officer. They also said they receive training which includes adult protection, moving and handling, medication and food hygiene. The staff personnel files are kept at the main David Lewis Centre offices in Warford. We spoke with the residential manager who told us that there are thorough recruitment checks in place that include criminal record bureau checks, protection of vulnerable checks (POVA) and that two written references are obtained on each person before they are offered employment by the organisation. Care Homes for Adults (18-65 years) Page 19 of 24 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 run in the best interests of the people who live there so ensuring their welfare is promoted and protected. Evidence: The manager for the home is also registered by the commission as the manager for a number of services within the David Lewis Centre. She has worked for the DLC since 2002 and has other areas of responsibility within the DLC in her role as Head of Community and Business Development. The information received in the managers application to the Care Quality Commission to be the registered manager for the home showed that she has achieved an NVQ Level 4 in Care and and NVQ Level 4 in Management. She has also completed a degree in autism and has attended periodic training in order to up date her knowledge and skills in managing a care home. We were told that questionnaires, residents meetings, residents reviews, one to one meetings and independent advocates are used to find out the views of the people living in the home on the quality of the service offered. During our visit to the home we looked at the fire safety record, which included a copy Care Homes for Adults (18-65 years) Page 20 of 24 Evidence: of a letter sent following a visit by the Cheshire Fire Authority in May 2009. There was also a fire risk assessment for the home. The record showed that three evacuation drills had been carried out in since the home first opened in June 2009 and that these had involved all the people who live in the home. The record also showed that checks on emergency lights are carried out monthly and that three staff training sessions on fire safety had been carried out since June 2009. These measures all help to make sure the home is safe and that everybody knows what to do if a fire breaks out. A copy of the health and safety procedures are available in the home, as is a file on all the safe use of all chemical products used in the home. This helps to make sure that staff have guidance to be able to make sure the home is a safe place to live and work in. Care Homes for Adults (18-65 years) Page 21 of 24 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 22 of 24 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 23 of 24 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). 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