Care Home: The Old Rectory (Trowbridge)

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What the care home does well There is a clear admission procedure in place, which enables people to be assured that their needs will be met within the home. People benefit from a very clear, well written support plan which reflects their individual needs and aspirations. People are supported to reach their goals in step by step stages. Clear assessments are in place in order to reduce potential risks. Priority is given to identifying possible causes of self injury so that people`s wellbeing is promoted and such behaviours are minimised. The environment has been enhanced through redecoration and some refurbishment. The procedure for recruiting staff is organised and thorough so that people can be assured that any prospective staff member is suitable to work with them. Staff training is given priority so that staff have the knowledge and skills to meet people`s needs effectively. What the care home could do better: When staff give a person their medicines, they must ensure that they sign the medicine administration record, as per the home`s procedures. People`s support plans should be fully reviewed on a regular basis so that all information is up to date and remains relevant. Random inspection report Care homes for adults (18-65 years) Name: Address: The Old Rectory (Trowbridge) 27 Stallard Street Trowbridge Wiltshire BA14 9AA two star good service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Alison Duffy Date: 2 7 0 5 2 0 1 0 Information about the care home Name of care home: Address: The Old Rectory (Trowbridge) 27 Stallard Street Trowbridge Wiltshire BA14 9AA 01225777728 Telephone number: Fax number: Email address: Provider web address: old.rectory.dcc@craegmoor.co.uk www.craegmoor.co.uk Name of registered provider(s): Name of registered manager (if applicable) Miss Teresa Hibbs Type of registration: Number of places registered: Conditions of registration: Category(ies) : Parkcare Homes Limited care home 8 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: Date of last inspection Brief description of the care home 8 The Old Rectory provides care and accommodation for up to eight adults with a learning disability. People have autistic spectrum disorders. The home is part of Craegmoor Healthcare, a private sector organisation with four registered care homes for this client group within Wiltshire. The property is in a residential area of Trowbridge. A range of amenities are available in the town itself. Larger centres, such as Bath and Bristol, are within reasonable travelling distance. The service has been in operation since the mid 1990s, initially under different ownership. A number of people have lived at the service since its opening. The current group is well established and are all men. People have single bedrooms, some on the ground Care Homes for Adults (18-65 years) Page 2 of 9 Brief description of the care home floor. Two bedrooms have ensuite facilities and more are now being provided. The others have bathrooms and toilets nearby. Communal areas are on the ground floor. There is a large enclosed garden. Another plot is used to grow vegetables. An adjacent building is used for daytime activities. Care Homes for Adults (18-65 years) Page 3 of 9 What we found: This unannounced random inspection took place on the 27th May 2010 between 9.40am and 12.20pm. Miss Teresa Hibbs, registered manager was available throughout our visit and received feedback at the end. We sent the service surveys, for people to complete if they wanted to. We also sent surveys to be distributed to members of staff and health/social care professionals. This enabled us to get peoples views about their experiences of the service. Four people using the service completed surveys with staff support and returned them to us. Within our site visit, we looked at the assessment documentation and support plans of two people who had most recently moved to the service. We looked at accident reports and the recruitment and training documentation of two newly appointed members of staff. The last inspection of this service took place on the 12th September 2007. We saw that the assessments of the two people most recently admitted to the service were fully completed. They were dated and showed who had been involved in the assessment process. The assessments contained detailed information about peoples health, social and personal care needs. We saw that people were supported to have a clear, organised transition process from their previous placement to the service. Miss Hibbs told us that staff would meet and work with the person in their own environment before their admission. They would then visit to have a look around and to meet other people using the service and staff members. Miss Hibbs said that people could stay overnight so that they could experience the service. In order to get to know people, staff had developed life histories with individuals. The information was well written with many photographs of family, friends and important events, to complement the written text. We looked at the support plans of two people and saw that they were very person centred, comprehensive and well written. The plans gave details about peoples preferred daily routines, the support they required and their goals and aspirations. Targets were identified in relation to how the person would reach their goals. The plans were written in a user friendly format. This included areas such as whats important to me and what people who know me say they like and admire about me. The support the person needed to meet their individual needs was very clear and identified step by step tasks. This included for example when having a bath, I need staff to run the bath, pour in the bubble bath... There were a range of up to date risk assessments in place. These included going out in the homes vehicle and the potential of the person being scalded when bathing or using the kettle. The risk assessments corresponded to the persons support plan. The plan gave strategies to help alleviate the potential risk. For example, it was recorded when in the vehicle, I would like staff to talk to me... People had an additional file containing information about their health, in addition to their support plan. Each person had an up to date health action plan. There were details about the health care services people used such as the dentist, chiropodist and specialist nurse. We saw that one support plan had been updated as the persons needs had changed. The original information was dated 2008. Miss Hibbs told us that the organisation was Care Homes for Adults (18-65 years) Page 4 of 9 introducing new support plan formats. She said due to this, original information had not been re-written. Mrs Hibbs told us that once the formats were received, all information would be updated and transferred across. We advised that following this, the plans needed to be reviewed as a whole, to ensure all aspects were up to date and relevant. We looked at the medicine administration record. There was one day when there were no staff signatures to demonstrate that some people had been given their medicines as prescribed. Miss Hibbs said she would address this with the staff member concerned. As good practice, a member of staff had countersigned any hand written medicine administration instruction in order to minimise the risk of error. There were records to show the medicines received into the home. At the last inspection, we made a requirement that there must be clear guidance on the criteria for administration of medicines, prescribed to be taken as required. This had been addressed. The protocols were clear, well written and easy to follow. Ms Hibbs told us that all staff who administered peoples medicines had regular training in the safe handling of medicines. We looked at the accident records. All entries were factual and well written. Miss Hibbs told us that she reviewed the accident forms in order to identify potential causes or any trends. We saw that some entries detailed incidents of self injurious behaviours. Miss Hibbs told us that priority was given to identifying the potential causes of these behaviours so that they could be minimised. Miss Hibbs gave us examples of how this had been achieved with some people. At our last inspection, we made a requirement to inform us of any incident which adversely affected a persons wellbeing. This had been addressed. We saw at our last inspection that the environment was in the process of being developed. We made a requirement to continue with the planned renewal programme for the fabric and decoration of the premises. Miss Hibbs told us that following our inspection, the environment had been significantly improved upon. Areas such as the lounges, dining room and main hallways had been redecorated. New furniture had been purchased and new carpets fitted. We looked at the recruitment and training records of the two most recently appointed staff members. The files were ordered and well maintained. There was a recruitment checklist at the start of each file. We saw that there was an application form, two written references and a health care questionnaire. There were details about the prospective staff members interview and information about equal opportunities. The file contained documentary evidence of the persons identity. There was also evidence that the persons suitability to work with vulnerable people had been checked. Staff members had undertaken a range of mandatory training. This included first aid, health and safety, the protection of vulnerable adults, manual handling, the control of substances hazardous to health and fire safety awareness and fire extinguisher training. We saw that staff had also completed training in non violent crisis intervention, autism awareness, the safe handling of medicines and equality and diversity. The training files were ordered with certificates demonstrating the training staff had completed. We saw that there was a training session taking place during our visit. Miss Hibbs told us that all members of the staff team except two, had a National Vocational Qualification level 2 or above. Documentation showed that staff had been given a copy of Wiltshire and Swindon safeguarding procedures, No Secrets. Within surveys, people told us that they could make decisions about what they did each day. They knew who to speak to if they were not happy and they knew how to make a Care Homes for Adults (18-65 years) Page 5 of 9 complaint. They said the home was fresh and clean. Three people said that staff always treated them well. They told us that staff listened and acted upon what they said. One person disagreed with this and said that staff sometimes treated them well and sometimes listened to what they said. In relation to what the home did well, one person said helps me see my family. Supports me. A relative supported one person with their survey. They told us I think the staff are very caring and do their best to see that each individuals needs are met. XX likes to walk in the country so they take him/her on walking holidays. What the care home does well: 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 2. Care Homes for Adults (18-65 years) Page 6 of 9 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 7 of 9 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, 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 6 Staff should ensure that they fully review a persons support plan on a regular basis so that all aspects are up to date and relevant. Staff should consistently sign the medicine administration record to show people have been given their medicines as prescribed. 2 20 Care Homes for Adults (18-65 years) Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. 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