Care Home: The David Lewis Centre - 5 Station Road

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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 health and social 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 27 July 2009 What the care home could do better: We consider that 5 Station Road 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 - 5 Station Road 5 Station Road Holmes Chapel Crewe Cheshire CW4 7AU     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 5 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 26 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 26 Information about the care home Name of care home: Address: The David Lewis Centre - 5 Station Road 5 Station Road Holmes Chapel Crewe Cheshire CW4 7AU 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 physical disability Additional conditions: The registered person may provide the following category of service only: Care home only (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 (LD) The maximum number of service users who can be accommodated is: 4 Date of last inspection Brief description of the care home The David Lewis Centre - 5 Station Road, Holmes Chapel, Crewe, Cheshire is a four bedroom detached house and is within walking distance of the village. The four people who live there are accommodated in single bedrooms. There is easy access to local facilities such as shops, leisure facilities, public transport and places of religious worship. Staff are on duty twenty four hours a day to support the people who live in the home and to ensure their safety and well being. Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 0 4 0 Brief description of the care home For information on accommodation fees and other charges please contact the manager for the home. Care Homes for Adults (18-65 years) Page 5 of 26 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 the 15 December 2009. It was carried out by one inspector and took a total of 4 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 27 July 2009. Care Homes for Adults (18-65 years) Page 6 of 26 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. Care Homes for Adults (18-65 years) Page 7 of 26 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 26 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 26 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 so 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 homes run by 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 about 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. We spoke with the people who live in the home. They told us that they like living in Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: their new home. We were told by staff that before the people moved they were able to visit the home and also spend time together to get to know each other. We were also told that the families of the people living in the home were fully consulted about the move to the home and were kept up to date so they knew what was happening. Care Homes for Adults (18-65 years) Page 11 of 26 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 our visit we looked at 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 dealt with by the staff, a list of the people (including the person and their family) who were involved in drawing up the plans of care and a copy of monthly evaluations that were carried out with the person. 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 areas in the home. We saw risk assessments in the care plans that showed that level of support required by the person to ensure their safety and well Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: being and also to help them maintain their independence. The risk assessments covered the level of support people needed whilst in the home and whilst using community facilities. We were told that the people who live in the home required the support of staff when using community facilities so as to ensure their safety. We were also told that action will be taken to minimise risk so that the people can use community facilities without endangering their safety and well being. Care Homes for Adults (18-65 years) Page 13 of 26 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 who told us that they like living in the home. We saw people who live in the home being supported by staff to visit the local village. They were also suppported by staff to attend line dancing at a community centre. We were told that the David Lewis Centre had opened a shop in the village where the people who live in the home help out. We saw the care folder for one person who lives in the home. This had information about the persons daily routines, their likes and the involvement of their families in their care. During our visit we saw one of the people who lives in the home receive two phone calls from his family. We saw the member of staff take the phone to the Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: person so that they could receive the calls in private. We spoke with the staff who told us that relatives and friends are encouraged to maintain contact with the people living in the home. The care folder seen during the visit had a record of contact made by the persons family. We saw one of the people who lives in the home helping staff prepare for the evening 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 the people who live in the home with their meal; 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 15 of 26 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 health care 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 health care 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 were told each of the people who lives in the home has a patient passport which contains information about the person and their health care 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 health care 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 Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: 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 satisfactory. The medication is kept in a secure cupboard in the home. The staff we spoike with during our visit told us 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 helping people with their meals and with their day to day needs. The support was offered in a caring and sensitive manner so that the persons privacy and dignity was maintained. Care Homes for Adults (18-65 years) Page 17 of 26 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. The staff told us that there had not been any complaints or concerns raised about the home since it opened but were able to show us the record that would be used if a complaint was made. This would mean that the way the complaint or concern was investigated and the outcome would be properly recorded so that people raising concerns could be confident that these would be taken seriously and looked into. There is a safeguarding adults policy for the home and the procedures in place 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 safeguarding adults training and also will be receive refresher training every two years. Care Homes for Adults (18-65 years) Page 18 of 26 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 well maintained so the people living there do so in safe, comfortable surroundings that suit their needs. Evidence: The home is a domestic type, detached four bedroom house which is within walking distance of Holmes Chapel where there are shops, public transport and other community facilities. The four single bedrooms are on the first floor of the home along with bathroom/toilet. Two of the bedrooms have an en suite shower and toilet. There is a communal lounge/dining room, kitchen and large utility room with a toilet and laundry facilities on the ground floor. The staff office is also on the ground floor. There are large gardens to the front and rear of the home. The bedrooms are individually furnished and decorated. People who live in the home 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 environment for the people who live there. The training records we saw during our visit showed that staff had received training on infection control and food hygiene and staff confirmed this when we spoke with them. Care Homes for Adults (18-65 years) Page 19 of 26 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 we saw during our visit showed that there are normally two/three 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 the nine staff who work in the home have completed an induction programme and that eight staff have achieved an National Vocational Qualification (NVQ) Level 2 or above in health and social care. These are nationally recognised qualifications for staff working in care and show they have been assessed as competent to provide good quality care. The training record we saw during our visit showed that all staff receive yearly training updates that include medication awareness, safeguarding adults, health and safety, epilepsy, infection control, food safety/hygiene, equality and moving and handling. The staff we spoke with during our visit said they receive regular support and supervision from the senior staff who manage the home. They also confirmed they had received the training identified on the training record we saw. The staff personnel files are kept at the main David Lewis Centre offices and have Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: been checked as part of inspections for other David Lewis services. We spoke with the residential manager who confirmed that there are thorough recruitment checks in place that include criminal record bureau checks, 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 21 of 26 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 with the commission as the manager for a number of services within the David Lewis Centre . She has worked for the organisation since 2002 and has other areas of responsibility 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. Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: During our visit to the home we looked at the fire safety record. There was a fire risk assessment for the home. The record showed that four evacuation drills had been carried out since the home first opened in July 2009 and that these had involved all the people who live in the home and the staff group. The record also showed that checks on emergency lights are carried out monthly and that staff training sessions on fire safety had been carried out. These measures all help to make sure the home is safe and that everybody knows what to do if a fire breaks out. We also saw a copy of the Gas Safety certificate and a copy of the emergency lghts service record. 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 23 of 26 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 24 of 26 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 25 of 26 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. 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