Care Home: The Hailey

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What the care home does well The Hailey provides a conducive environment for up to 34 people with mental health issues. The premises have been extensively refurbished over a number of years and have been designed with the needs of the service users in mind. There is an attached day centre that provides activities for service users of both a recreational and occupational nature and a full-time activities co-ordinator. Service users stated that the staff team are respectful of their needs. There is a stable staff team over half of whom have achieved National Vocational Qualifications (NVQ) at level 2 or above. The home has developed a professionally produced welcome pack for all new and prospective service users and good processes of pre-admission assessment have been developed. Residents are able to make decisions affecting their day-to-day lives and confirmed that they are supported by staff in undertaking activities of their choice. All of the service users spoken to stated that the food in the home is good. Health and safety issues are well managed and the organisation has developed effective quality monitoring processes. Staff have received training in adult protection issues and the Mental Capacity Act amongst other service specific topics. What has improved since the last inspection? Systems for administering medication have been improved and now are completed in a less institutional manner. Medication records were up to date and well kept. Staff training has improved with the majority of staff having received all required mandatory training. There remains some gaps in training, but there is evidence that the home has been proactive in addressing these and an annual staff training and development plan is now completed. All staff personnel files examined contained all of the required information and checks. What the care home could do better: No requirements and 1 recommendation were made as a result of this inspection process. It was noted that the current system for recording complaints does not fully protect individuals confidentiality and it is recommended that a method for ensuring this is introduced. A discussion was held with the manager regarding information contained in one individual care plan for a newly admitted service user. It was noted that some care plan and risk assessment information could have been developed further, although sufficient information was kept on file from other sources. Key inspection report Care homes for adults (18-65 years) Name: Address: The Hailey 7/8 The Downs Herne Bay Kent CT6 6AU     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: Joseph Harris     Date: 0 7 0 8 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 Hailey 7/8 The Downs Herne Bay Kent CT6 6AU 01227742366 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: allaboutcare@btconnect.com allaboutcare@btconnect.com All About Care Ltd care home 34 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users to be accommodated is 34. The registered person may provide the following category/ies 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: Mental disorder, excluding learning disability or dementia (MD). Date of last inspection Brief description of the care home The Hailey looks out over The Downs and out to sea. It is only a short distance from Herne Bay town centre and so offers ready access to a range of community based facilities. The main part of the premises is two older two-storey properties, which have been joined together and adapted for their present use. The accommodation for clients is arranged on each of the floors. On the ground floor there are various lounges and other communal areas. The first and second floors are used for service users bedrooms and there are also toilets and bathrooms on these levels. To the rear of the Care Homes for Adults (18-65 years) Page 4 of 24 Over 65 0 34 Brief description of the care home main buildings, there is a suite of purpose built bedrooms. When the Home is full, there is provision for three of the bedrooms to be shared. The remaining bedrooms all offer single occupancy. All of the bedrooms have a wash hand basin, with those in the new build section having a full en-suite service. The newly built bedrooms form a quadrangle with the main building. This is a popular area with the service users because it is out of doors while at the same time being private. To one side of the site, there is also a more conventional garden area. The current fees for the service at the time of the visit are 476.62 pounds per week. Information on the Home services and the CSCI reports for prospective service users will be detailed in the Statement of Purpose and Service User Guide. The e-mail address of the home is allaboutcareltd@btconnect.com. Care Homes for Adults (18-65 years) Page 5 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: This key unannounced inspection process culminated in a site visit to the service on 7th August 2009. The site visit commenced at 09:30 hours and lasted for approximately 6 hours. Prior to the site visit a range of documentation was examined relating to the service including the Annual Quality Assurance Assessment completed by the home providing statistical information and things that have changed over the past 12 months. Information received by us including notifications, any information from other professionals and details of any concerns, complaints or allegations. During the course of the site visit discussions were held with service users, staff and the manager. A tour of the premises was undertaken and a range of records were examined. These included records relating to service users, staff, health and safety and the day-to-day running of the home. Care Homes for Adults (18-65 years) Page 6 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. 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. Prospective service users are able to make an informed choice about moving into the home and their needs are assessed. Evidence: The home has developed a detailed range of information for prospective service users including a service user guide and a professionally produced brochure for the organisation. Both documents are written in an accessible format providing clear information on the facilities and expectations of the service. Prospective service users have the opportunity to visit the home before deciding whether or not to move in. These visits can be flexibly arranged dependent on wishes from day to overnight stays. The needs of prospective service are assessed prior to admission. The individual file for one new resident was examined that contained evidence of information being received from care managers including the most recent care programme approach information and risk assessments. The home completes their own assessment tool, which addresses all key areas of need in good detail. These assessments form the basis of the initial care plan. Care Homes for Adults (18-65 years) Page 9 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 individual needs and choices of service users are planned for and residents can make decisions affecting their daily lives. Evidence: Two individual service user plans were examined both of which contained sufficient information to ensure that the needs of the service users could be met in a consistent manner. In one instance the individual concerned had recently moved into the home and an initial plan of care was in place based on the needs assessment. It was discussed with the manager that aspects of this plan could have been further developed. Service users are involved in the development of care plans and there is evidence of regular review. Service users confirmed in conversation that they are able to make decisions affecting their day-to-day lives. This includes choosing daily routines, activities and other aspects of daily life. Service users are given information about the Mental Capacity Act and their rights under this legislation. One person said, this is a really good home, i can spend my time as i want to, the staff are really good. Care Homes for Adults (18-65 years) Page 10 of 24 Evidence: Risk assessments are developed on an individual basis and reflect current perceived risks based on assessment information. The risk management plans include guidance to minimise risks and promote positive, responsible risk taking. Service users are involved in the development of risk management plans and they are reviewed on a regular basis. Care Homes for Adults (18-65 years) Page 11 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users have a lifestyle suited to their needs. Evidence: Many of the service users in the home are of an older age. The residents reported that there is a relaxed and comfortable environment with enough activities to do. There is a day centre attached to the home and a full-time activities co-ordinator. A weekly activities programme is in place for those that wish to participate. There is an activity/games room and in the day centre another activity centre with a kitchen for residents to develop their cooking skills. Service users are supported to develop their independent living skills in a range of ways and it was reported that some people have successfully moved on to more independent accommodation. A number of residents also engage in groups and activities outside the home including college courses, the workwise project and the umbrella club. Another person takes part in sports group. Residents said that they can come and go as they please and access the facilities in Care Homes for Adults (18-65 years) Page 12 of 24 Evidence: the nearby town centre. It was stated by residents that their visitors are made welcome in the home and they are able to receive guests at times convenient to themselves in private space if they wish. All residents spoken to said that the quality of the food is good and they have choices at each mealtime. The home employs a full-time and a part-time cook. The kitchen is well-equipped and menu records demonstrate that a healthy and balanced diet is provided. Care Homes for Adults (18-65 years) Page 13 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 service users are met. Evidence: The personal care needs of service users are clearly identified in plans of care for those people who are not fully self-caring. Preferences are identified and residents spoken to said that the staff in the home are respectful of their choices and wishes. One service user said the staff are really good, everyone gets on well. Everyone trusts each other. The healthcare records for a number of service users were examined and records are kept of all appointments and the outcomes of consultations. All service users have a care manager and are subject to care programme approach processes. The home reported varying degrees of support from the local Community Mental Health services. All service users are registered with local GPs and healthcare needs are referred appropriately. Complimentary healthcare needs such as chiropody and dentistry are accessible. Medication processes have been developed including policies and procedures. All staff administering medication have received the required training. Medication storage facilities are suitable for the needs of the home and the medication administration Care Homes for Adults (18-65 years) Page 14 of 24 Evidence: records are kept up to date and well managed. Care Homes for Adults (18-65 years) Page 15 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. Service users are protected from abuse and their views are listened to and acted upon. Evidence: The home has a well established complaints procedure in place, a copy of which is included in the welcome pack and displayed within the home. A record of complaints is maintained, the outcomes of complaints are recorded. It is recommended that the complaints book is completed in a loose leaf format to protect confidentiality. Service users spoken to stated that they would feel comfortable raising any concerns with staff. There have been two recorded complaints since the last inspection process, both of which were resolved in a satisfactory manner. The home has clear policies and procedures in place relating to protection from abuse and adult protection protocols. Staff have received training covering the topics of abuse awareness and the Mental Capacity Act. Senior staff have also recently completed training on the Deprivation of Liberty Safeguards. There have been no Adult Protection alerts raised in relation to the service over the past 12 months. Care Homes for Adults (18-65 years) Page 16 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The premises are suitable for the needs of the service users. Evidence: A tour of the premises was undertaken during the course of the site visit. The home has been well-furnished and service users stated that it is comfortable and homely. The environment is clean and hygienic and has been subject to extensive refurbishment over a number of years. The house is located on the seafront close to the local town centre and public transport links. There is parking available in front of the building and there is a large, well tended garden to the rear. The home has a good range of communal space available including a number of lounges, dining rooms, quiet rooms and a games room. There is also an attached day centre providing further space for specific activities. There are bedrooms on all three floors of the home. The ground floor bedrooms are all single occupancy and were built a few years ago. These rooms are all en-suite and have doors to both the home and the outside. One resident showed me her room and said I really like my chalet, its very comfortable. There are three double rooms on the upper floors, only one of which is currently used as a double room for people who have expressed a wish to share. The kitchen and laundry facilities of the home are suitable for the needs of the service. There is also a small kitchenette for use by service users and a practice kitchen in the Care Homes for Adults (18-65 years) Page 17 of 24 Evidence: activity centre for developing skills. The manager reported that all maintenance issues are dealt with in a timely manner and stated that there are no works outstanding that require attention. It was reported that the home meets the requirements of the environmental health and fire safety. departments. 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. There is a competent and well trained staff team able to meet the needs of the service users. Evidence: There is a stable staff team working in the home many who have been employed for a number of years. Over 50 of the staff team have achieved an NVQ level 2 or above in care, a number of staff have progressed on to level 3 qualifications. All new staff work through an induction process including the Common Induction Standards. The majority of staff have gained all required mandatory training and the home completes an audit of training needs and requirements to ensure staff training is kept up to date. Issues relating to a small number of staff training needs were discussed and the manager agreed to address these in conjunction with the registered provider and the staff concerned. Additional staff training is provided covering topics such as the Mental Capacity Act, mental health awareness and other service specific courses. Three staff personnel files were examined all of which contained all of the required checks including CRB and POVA checks, two written references and proof of identity. There is a supervision system in place and staff receive regular formal supervision with a senior member of the team. Staff stated that they feel supported in the roles by he manager of the home and her deputy. 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 well managed in the best interests of the service users. Evidence: The registered manager has been in post for a number of years and has achieved all required qualifications. She has extensive experience in the field of mental health for over 30 years and has been in her current role for 10 years. Staff and service users spoke positively about her management style and influence on the service. She is supported by a deputy manager who has also worked in the home for approximately 10 years. The home have developed quality assurance processes including regular monitoring visits by the registered provider and systems for feedback about the quality of the home. The home produces an annual report detailing the results of these feedback exercises. Regular staff and resident meetings are held and, according to the minutes taken, discuss relevant and positive issues. All health and safety records are kept up to date and include monthly health and safety audits. Fire safety and accident records are maintained. all service certificates and checks are completed gas safety, electrical wiring, waste disposal and PAT tests. Care Homes for Adults (18-65 years) Page 20 of 24 Evidence: Safe working practices are supported by policies and procedures and environmental risk assessments are completed and kept under review. 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 1 22 To develop a format for recording complaints to ensure confidentiality. 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). 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. 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