Care Home: The Martins

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What the care home does well The Martins provides a tailored programme for each person that focuses on their strengths. There are specialists available in all areas of health care that provide a service to the home. There are spacious single bedrooms where people can have their personal possessions and they are provided with a key to their room. There are separate communal rooms that provide quiet space to relax or meeting points for therapy sessions. People living there have a say in how the home is run and they have choices in what they do each day. People told us " the therapy programme provides an excellent routine thats suits my needs" What has improved since the last inspection? The service has continued to improve, providing changes to the environment to meet the needs of people they admit. The manager has addressed the shortfalls we identified at the last inspection and he works well with us, always informing us of any issues that are required under regulation. What the care home could do better: We have made no requirements as a result of this inspection. We consider the service is meeting regulatory requirements and the manager tells us his focus is on continued improvement to provide best practice. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Martins Abbingmoor Farm Laxton Road Egmanton Nottinghamshire NG22 0EU     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Mary OLoughlin     Date: 2 1 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. 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 Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI 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 28 Information about the care home Name of care home: Address: The Martins Laxton Road Abbingmoor Farm Egmanton Nottinghamshire NG22 0EU 01604864466 01604864491 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Oakleaf Care (Newark) Ltd care home 10 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Additional conditions: 10 The maximum number of service users who can be accommodated is:10 The registered person may provide the following category of service only: Care Home with nursing - Code N To service users of the following gender: Male Whose primary care needs on admission to the home are with the following categories: Mental Disorder - not including a learning disability or dementia - Code MD Date of last inspection Brief description of the care home The Martins is a low secure 10 bedded unit and offers places to males with acquired brain injury and neurological conditions who require a clear and comprehensive care pathway. The accommodation provides a lounge with two conservatory areas and a dining area. It is set in 6 acres of grounds and gardens. All 10 single bedrooms have en-suite facilities. The home is owned by, The Oakleaf Care Group. The home is accessible for people with mobility difficulties. The fees are £376.38 per day. Care Homes for Adults (18-65 years) Page 4 of 28 Brief description of the care home An up to date Service User Guide was viewed on the premises. Care Homes for Adults (18-65 years) Page 5 of 28 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: three star excellent 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 focus of inspections undertaken by the Care Quality Commission is about the outcome of the care provided to people using the service. This process considers the providers capacity to meet regulatory requirements and focuses on aspects of service provision that need further development. The main method of inspection used was called case tracking. This involves selecting the care records and looking at the quality of the care people receive by talking to them, examining their care files and discussing how support is offered to them by staff members. People living at the home, their relatives, members of staff and the manager were spoken with as part of this inspection, documents were read and medication inspected to form an opinion about the quality of the care provided. Care Homes for Adults (18-65 years) Page 6 of 28 We looked at what the provider told us they were doing in their Annual Quality Assurance document (AQAA) that they sent to us. We received good responses from our have your say surveys, 5 from people who live there and 3 from staff, the information was used to plan what we looked at. A copy of the inspection report was seen in the home and people are informed how to access this in the guide they receive on admission. 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 set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 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 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is clear information available to people on the specialist services the home provides and admissions to the home are not made until people are properly assessed. Evidence: We looked at the records of 2 people who live at The Martins and we asked both of these people about how their admission had been arranged. We also talked to one persons relative and spoke with the Family Liaison Manager. What we found was that people had been provided with information about the services the home provides and opportunities to visit the home as often as they wished along with family members. The Liaison officer supported both the person and their representatives during and after the process of the admission. Trained staff had completed assessments along with gathering information from external professionals who knew about the person and their needs. Each person was then offered an initial 12 week assessment placement where nurses and therapy Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: professionals could make a full assessment and make recommendations about the persons future care needs, this ensured that the service was fully able to meet the needs of each person it was offering to provide care for and the person knew what support was being offered to rehabilitate them. We asked 4 staff through our surveys if they had been given enough information about people who come to the home and if they had the skills and knowledge to provide the care that was needed to support people safely, each person told us they were required to be familiar with peoples care plans and that they received lots of training to make sure they understood how to manage the specific needs of people such as dealing with epileptic seizures. Care Homes for Adults (18-65 years) Page 11 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home have an individual care plan that sets out a therapeutic programme which respects peoples right to make decisions about their lives and take responsible risks. Evidence: We looked at the records of 2 people living at the home and we found they had each had a clear plan of care that was regularly reviewed. People living there and their relatives tell us they are involved in their care plans and are asked about what is working for them and what needs to change. Each plan contained comprehensive risk assessments which focused on managing risks safely to help people live the life they want. There was an active rehabilitation programme in place which offered people choices on a daily basis. The staff team focus on what people can do and use this positive attitude throughout Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: their work, encouraging and supporting people to have choices and improve their quality of life. There was evidence that people had improved since their admission to the home, relatives told us that the staff had done everything they said they would, they received regular visits at the family home from the Liaison worker who supported the whole family. The 2 people we case tracked told us they were happy, liked the staff team and made decisions about their life. Care Homes for Adults (18-65 years) Page 13 of 28 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. People are supported to achieve their goals, follow their interests and be integrated into community life. Evidence: We identified through looking at peoples care plans, talking to them and their relatives that people take part in valid and fulfilling activities. The staff team includes physio, educational, occupational and speech and language therapists who provide assessment and programmes that help people achieve their potential. We identified that many opportunities are available to people to participate in activities such as horse riding, tae kwondo, local shopping trips and days out. People benefit from individual sessions with their therapists such as reading and news Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: groups and there is a fully equipped gym on site that people use after they have been provided with an exercise programme by the homes physiotherapist. There is a full time horticultural therapist and those we case tracked told us how they enjoyed participating in these sessions and helping develop the gardens. There is a lot of emphasis placed on keeping people in touch with their families and friends, we saw how the family liaison worker regularly visits families or telephones them on a regular basis, supporting them also, one relative told us they know what Im going through too and I can talk to all of the staff easily The daily routines promote peoples independence and any restrictions on freedom is subject to peoples agreed plan of care. Each person receives a nutritional assessment on admission and any specialist guidance is provided through a dietician. People tell us they are very happy with the variety of food provided. Care Homes for Adults (18-65 years) Page 15 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have effective health and personal care support based on their needs and wishes. Evidence: The homes guide informs people that the service is part of a group of homes that is made up of a large multidisciplinary team, this means that people have access to a wide range of trained specialists to assess people and regularly check that they are physically and mentally well. People living at the home told us they always see a doctor if they are not well and care records showed that they have a monthly review by the retained services of a General Practitioner and they also have visits from the groups clinical neuropsychologist. There are trained nurses on duty at all times and all the staff have received training in the individual needs of people they care for. Medicines are managed safely, staff accurately record everything they do and Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: thoroughly audit every medicine that comes into and out of the home to make sure there is no misuse. Relatives tell us that the staff recognise the importance of reviewing medication and work with people to reduce the need for any medicines, one person had been supported to stop taking medicines and had improved enormously since then. Care Homes for Adults (18-65 years) Page 17 of 28 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. The procedures and culture of the home ensures that people are safe and supported to share any concerns in relation to their protection and safety. Evidence: Everyone who comes to stay at The Martins is issued with a copy of the homes complaint procedure which informs them of what to do if they have any concerns. Each person has their own named nurse and key worker that they can discuss issues with and there is a monthly meeting where people can raise any issues or make suggestions. We have not received any complaints about the service and there have not been any alerts made under the safeguarding adults procedures. The staff are properly trained to manage difficult behaviour in a way that protects people from any abuse and they are also trained to recognise and respond to any concerns in relation to peoples safety. People using the service tell us they feel safe and that staff listen to them and act on what they say. Relatives tell us they have never had any reason to complain. Care Homes for Adults (18-65 years) Page 18 of 28 Care Homes for Adults (18-65 years) Page 19 of 28 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 comfortable and safely maintained. Evidence: The home is within a rural setting but provides transport for people who live there. Each person has a single room that is above average size, we saw that rooms were furnished to a high standard and individually personalised. Those we case tracked either had a key to their own room or were in the process of learning to use one. People are given information about the home environment telling them that they have access to all communal areas and are welcome to access the gardens and grounds. We saw how people were fully able to use all areas without restriction. The external grounds houses offices and therapy rooms including the multi gym. Each area of the home is regularly audited to ensure it complies with health and safety legislation. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: The staff are trained to control infection and have plenty of access to protective equipment. Each area was clean and very well maintained. Care Homes for Adults (18-65 years) Page 21 of 28 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. People who use the service benefit from a skilled staff team. Evidence: The service has plentiful staff and is proactive with its staffing, recruitment and training, ensuring that people have all their needs met safely. The staff are properly recruited and the manager ensures that each person is checked to ensure they are suitable to work with vulnerable people. The staff team comprises of trained nurses, and support workers. There are also specialist therapists and liaison staff. We observed during our inspection how staff worked closely with people and were always respectful and supportive. People tell us they are treated well by the staff and that they get on well with them. Relatives tell us they feel supported by the staff team. The training records show that the manager places a high importance on making sure Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: that the staff have all the right skills and competencies to do their job well. Care Homes for Adults (18-65 years) Page 23 of 28 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 safe and managed well and people have a say in how the home is run. Evidence: The manager is also the provider of the company and he has the required skills and competencies to manage the service. He has demonstrated continuous improvement since our last inspection and he addressed the requirements we made within the timescale. The AQAA gave us some good information on what the service has done and intends to do but could have more detail. There are good systems in place to ensure the quality of and continued improvement of the service, through regular consultation with people using the service and their representatives. People have access to safe financial arrangements with suitable accounting procedures Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: to ensure their is no abuse of peoples personal finances. The staff team are properly trained in areas of health and safety, this includes how to move and handle people and provide first aid. There are appropriate checks on equipment including all fire and evacuation procedures. Care Homes for Adults (18-65 years) Page 25 of 28 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 26 of 28 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 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. 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