Care Home: The Paceys

Similar services:

• Larch Avenue
• Alderson Road 12
• Cranworth Close Registered Care Home
• The Cornerstone
• John Street Nursing Home
• Pennine Camphill
• Whitwood House
• Whitwood Hall

What the care home does well People said they enjoy their visits to the service, one said, "I wouldn`t change coming here to the Paceys for anything". Another person signed that they were very happy at the home. Another said, "Yes it`s a nice place". The new Support plans and risk management plans that are being developed for people have clear and detailed instruction on how the needs of people who use the service are to be met. The plans show how people or their families have been involved in drawing them up. They are in an easy read format which includes pictures and symbols, making them more easily understood for people who do not read. The manager has been looking at ways of further involving people who do not use verbal communication in the development of their plans. Some staff have been trained in intensive interaction to enable them to do this. The staff and manager have also been working with a speech and language therapist and have set up an `Interactive Cafe` which promotes communication for people with complex needs. This has involved inviting people from other services too and has served as a social network group too for the people involved. Staff have very good knowledge of people`s individual support needs and can describe people`s routines well. People experience a wide variety of activity during their stay at the home. In the AQAA, the manager said, `Over the past 12 months we have made great strides in this area and have changed the whole ethos of the service from that of a service that provides just respite care to that of a true meaningful short break service.` It was clear during our visit, that people staying at the home were having a good time. People said they were happy and people who signed gave us lots of `thumbs up` signs. The atmosphere in the home was relaxed and people were confident and outgoing and seemed very willing to express their views. One person said, "I love the activities we do". Another said, "I had some lovely days out which made my stay a good holiday". The home is fully adapted to meet a wide variety of diverse needs, while remaining homely and welcoming. People who use the service spoke highly of the staff and said staff `always` treat them well. Their comments included: "The staff are great" "The managers and support staff are very caring and do their best in accommodating people with learning disabilities" "Staff are very understanding and take note of what I like to do". Staff were pleased with their training. Comments included: "Really enjoyed my training, given me good insight to the job" "Can`t fault the Paceys, you always get what you ask for" "The Paceys offers a wide range of training and encourages staff to attend as much as possible". The manager has worked hard to develop and lead a staff team who feel confident in their ability to deliver the service. The manager is committed to developing the service as a short breaks service that is outcome focused for people and that they have a `great time` during their stays. He is well organised and monitors the service well. Staff said they felt well supported and confident to take on any tasks delegated by the manager. They said, "My manager and staff are very helpful and supportive" "I am new into support work and what I have seen is very good. I am very well supported in every aspect of my job" "He is really very approachable, feel able to make suggestions, have ideas" "We get good support from the management team, including the area manager" "Feel listened to". What has improved since the last inspection? Pre-admission assessments are now carried out thoroughly to make sure they find out about peoples needs and wishes. Care plans and risk assessments have been improved and now give more detail on people`s care and support needs. This means their needs will be met well. In the AQAA the manager also told us how the environment in the home had been improved. He said,`We have moved the sensory room into the lounge. This has been a great benefit as it is being used more. We have turned the sensory room into a video and music room snug. All the bedrooms have been redecorated. The main living areas have also been redecorated.` The garden has been further developed since our last visit to the home. More planting has taken place and a poly tunnel has been introduced for people who use the service and staff to grow plants and vegetables. The manager also told us that they now have a more settled team of staff and they have reduced their staff turnover by half. He also said, `We have introduced senior support workers who have become an essential part of the management team. They are the first line of management and work closely with the staff team and have been given supervision training.` What the care home could do better: We did not make any requirements or recommendations at this visit. However, at our visit, the manager told us he is about to be transferred from the home to work in another part of the organisation. We discussed the on-going management arrangements of the home with the manager and the organisation`s area manager. Until a new manager is in post, the current manager will maintain weekly contact with the service and staff will also be supported by the area manager. The organisation should make sure that the staff team are supported to continue to deliver an effective service in the absence of a registered manager. Key inspection report Care homes for adults (18-65 years) Name: Address: The Paceys 1 Wakefield Road Swillington Leeds West Yorkshire LS26 8DT     The quality rating for this care home is:   three star excellent 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: Dawn Navesey     Date: 1 6 0 7 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 35 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 35 Information about the care home Name of care home: Address: The Paceys 1 Wakefield Road Swillington Leeds West Yorkshire LS26 8DT 01751474740 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Wilf Ward Family Trust care home 7 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: 7 places can be used for young persons from the age of 17 years. The maximum number of service users who can be accommodated is: 7 The registered person may provide the following category of service only: Care home only - Code 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 - Code LD and Code LD(E) Date of last inspection Brief description of the care home The Paceys is a purpose built, two storey, detached property, providing short term and respite care for young adults who have a learning disability. The service can be booked either weekly or on a flexible basis for a weekend or part week. The accommodation consists of seven bedrooms which all have an en-suite toilet and sink. There are three bathrooms, which cater for the needs of people who want a bath, shower, assisted shower or assisted bath. There is ceiling, tracking hoist to meet the Care Homes for Adults (18-65 years) Page 4 of 35 Over 65 7 7 Brief description of the care home moving and handling needs of people who use the service. There is a well-equipped kitchen, two lounges and a large dining room. There is also a separate laundry room. The home has a passenger lift too. People who use the service are encouraged to make full use of the facilities in the house, garden and patio area, which include sensory equipment, television, DVD player and music systems. The home is situated in east Leeds, near to local shops, public houses and a library. It is on a bus route, with buses going to Leeds and Wakefield. The home also has its own adapted transport. The charges at the home are 9 pounds 99 pence per night. Additional charges are made for leisure activities. Care Homes for Adults (18-65 years) Page 5 of 35 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 quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. The Care Quality Commission (CQC) inspects homes at a frequency determined by how the home has been risk assessed. The inspection process has now become a cycle of activity rather than a series of one-off events. Information is gathered from a variety of sources, one being a site visit. More information about the inspection process can be found on our website www.cqc.org.uk This visit was unannounced and was carried out by one inspector who was at the home from 11-35am - 5-10 pm on the 16 July 2009. The purpose of the inspection was to make sure the home was operating and being managed for the benefit and well being of the people who use the service. And also to Care Homes for Adults (18-65 years) Page 6 of 35 monitor progress on the requirements and recommendations made at the last inspection. Before the inspection evidence about the home was reviewed. This included looking at any reported incidents, accidents and complaints. This information was used to plan the visit. An AQAA (Annual Quality Assurance Assessment) was completed by the home manager before the visit to provide additional information. This was well completed and gave us all the information we asked for. Survey forms were sent out to people using the service, staff and health care professionals. A number of these have been returned. Information from those returned is reflected in this report. During the visit a number of documents and records were looked at and some areas of the home used by the people staying at the home were visited. Some time was spent with the people who use the service, talking to them and interacting with them. Time was also spent talking to staff and the manager. Feedback at the end of the visit was given to the manager and area manager. The last inspection of this home was on 19 July 2007. Care Homes for Adults (18-65 years) Page 7 of 35 What the care home does well: People said they enjoy their visits to the service, one said, I wouldnt change coming here to the Paceys for anything. Another person signed that they were very happy at the home. Another said, Yes its a nice place. The new Support plans and risk management plans that are being developed for people have clear and detailed instruction on how the needs of people who use the service are to be met. The plans show how people or their families have been involved in drawing them up. They are in an easy read format which includes pictures and symbols, making them more easily understood for people who do not read. The manager has been looking at ways of further involving people who do not use verbal communication in the development of their plans. Some staff have been trained in intensive interaction to enable them to do this. The staff and manager have also been working with a speech and language therapist and have set up an Interactive Cafe which promotes communication for people with complex needs. This has involved inviting people from other services too and has served as a social network group too for the people involved. Staff have very good knowledge of peoples individual support needs and can describe peoples routines well. People experience a wide variety of activity during their stay at the home. In the AQAA, the manager said, Over the past 12 months we have made great strides in this area and have changed the whole ethos of the service from that of a service that provides just respite care to that of a true meaningful short break service. It was clear during our visit, that people staying at the home were having a good time. People said they were happy and people who signed gave us lots of thumbs up signs. The atmosphere in the home was relaxed and people were confident and outgoing and seemed very willing to express their views. One person said, I love the activities we do. Another said, I had some lovely days out which made my stay a good holiday. The home is fully adapted to meet a wide variety of diverse needs, while remaining homely and welcoming. People who use the service spoke highly of the staff and said staff always treat them well. Their comments included: The staff are great The managers and support staff are very caring and do their best in accommodating people with learning disabilities Staff are very understanding and take note of what I like to do. Staff were pleased with their training. Comments included: Really enjoyed my training, given me good insight to the job Care Homes for Adults (18-65 years) Page 8 of 35 Cant fault the Paceys, you always get what you ask for The Paceys offers a wide range of training and encourages staff to attend as much as possible. The manager has worked hard to develop and lead a staff team who feel confident in their ability to deliver the service. The manager is committed to developing the service as a short breaks service that is outcome focused for people and that they have a great time during their stays. He is well organised and monitors the service well. Staff said they felt well supported and confident to take on any tasks delegated by the manager. They said, My manager and staff are very helpful and supportive I am new into support work and what I have seen is very good. I am very well supported in every aspect of my job He is really very approachable, feel able to make suggestions, have ideas We get good support from the management team, including the area manager Feel listened to. What has improved since the last inspection? What they could do better: We did not make any requirements or recommendations at this visit. However, at our visit, the manager told us he is about to be transferred from the home to work in another part of the organisation. We discussed the on-going management Care Homes for Adults (18-65 years) Page 9 of 35 arrangements of the home with the manager and the organisations area manager. Until a new manager is in post, the current manager will maintain weekly contact with the service and staff will also be supported by the area manager. The organisation should make sure that the staff team are supported to continue to deliver an effective service in the absence of a registered manager. 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 10 of 35 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 11 of 35 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. People who use the service and their representatives have the information needed to choose a home that will meet their needs. They are provided with thorough standards of pre-admission assesment which makes sure the service can fully meet peoples needs. Evidence: People said they enjoy their visits to the service, one said, I wouldnt change coming here to the Paceys for anything. Another person signed that they were very happy at the home. Another said, Yes its a nice place. In the AQAA, the acting manager said, The management of the service attend a respite allocation panel which is a multi disciplinary team made up of professionals from health services, social services, and other short break providers. At these meetings we look at potential guests care assessment plans and discuss how we can best meet their needs. We have a tea visit where a staff member works with the new guest and their carers Care Homes for Adults (18-65 years) Page 12 of 35 Evidence: to complete the support assessment and answer any questions the guest may have. We develop a risk assessment and a support plan for the new guest using information from the support assessment they completed at their tea visit and the care plans we receive from Social Services. We always discuss the risk assessment with the guest, explain why we are completing it and ask for their input. We would also include advice from any other relevant professionals (i.e. community nurse, physiotherapist, Speech and language etc.) This is completed before the guests first respite visit. We looked at pre- admission assessments for some people. We saw that peoples needs are assessed before they move into the home so that staff can be told about any specific needs they might have and know what help and support to provide. The assessments involve the person using the service, their family and any other professionals involved with their care. For example, community nurses or staff from day centres. This is good practice and means peoples needs are identified well. Peoples needs are re-assessed before each visit, by staff making a telephone call to the person and their family to see if there are any changes. Written information on medication and nutritional needs is brought in at each visit by the person to make sure these needs are properly met. At the start of each visit, staff sit down with each person to ask them what their wants and wishes are for the visit. They ask them what activities they would like to do, what they would like to have on the menu and if they have any special requests. This makes sure that people get what they want from their stay. The manager also told us that when planning peoples stays, they try to make sure people who are friends or have similar communication needs such as the use of sign language, can visit at the same time. Information on what the home can provide, has been produced in an easy read format, also using photographs and symbols. This has made it more accessible to people who use the service. This information has also been made available on the organisations web site, making it more widely available for people. The manager said they are now looking at ways of producing a DVD on what the service can provide. He said they would like to involve people who use the service in making this. Care Homes for Adults (18-65 years) Page 13 of 35 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 are encouraged to make decisions about their lives and are involved in planning their care and support. Evidence: In the AQAA, the manager told us they had improved their care plans and risk assessments. He said, All service users have plans which describe how they prefer to be supported in all aspects of their lives. Guest risk assessments are person centred and use a traffic light/picture based system so guests can take part in developing their own risk assessment. We have recently introduced the senior support worker role. Each senior leads a key worker group, this ensures every guest has a key worker regardless of staff illness or leave. The groups work to ensure that guest care plans, risk assessments and reviews are kept up to date. They also keep in touch with guests and their carers in the form of pre and post calls and attend any review meetings between stays to make sure that information held about guests remains accurate. Care Homes for Adults (18-65 years) Page 14 of 35 Evidence: The manager also told us We have developed a new Support Assessment form which is more person centred and allows us to get the information we need to develop risk assessments. He said they are now going to review and re-develop everyones plans to make sure they are person centred and outcome focused. This means that peoples plans will say what is important to them as individuals and how they want to develop their skills and abilities. We looked at care plan and risk assessment records for some people who stay at the home. We found the new support plans that had been completed to be person centred and individual to each person. Support plans and risk management plans had clear and detailed instruction on how the needs of people who use the service are to be met. The plans show how people or their families have been involved in drawing them up. They are in an easy read format which includes pictures and symbols, making them more easily understood for people who do not read. Only a small number of the new support plans have been developed but the manager has a plan in place with the staff team to make sure everyone who uses the service will eventually have a plan developed to this standard. We looked at some of the older style plans and could see these had been improved since our last visit to the home. However there were still some gaps in information and the use of vague terms such as needs support which does not give staff the detail on how peoples care needs are to be fully met. Staff were however, very familiar with peoples care and support needs and could confidently talk about the care they give. They had very good knowledge of peoples individual support needs and could describe peoples routines well. When we asked what the service does well, one member of staff said, Supports and promotes independence for service users , The home promotes an excellent service to guests and their relatives, suporting their needs and promoting their independence. Staff were also very positive about the new care planning format. One said, They are brilliant, cant wait for them all to be updated. The manager has been looking at ways of further involving people who do not use verbal communication in the development of their plans. Some staff have been trained in intensive interaction to enable them to do this. The staff and manager have also been working with a speech and language therapist and have set up an Interactive Cafe which promotes communication for people with complex needs. This has involved inviting people from other services too and has served as a social network Care Homes for Adults (18-65 years) Page 15 of 35 Evidence: group for the people involved. People are encouraged to make choices and decisions about what they do. As mentioned in the Choice of Home section of this report, when people begin their stay at the home they meet with staff to discuss choices for the coming week. Staff said they encourage people to make choices in their every day lives such as what to do, what to eat, what to wear and where to go out. We saw people being offerred choices throughout the visit. Staff also responded well to requests for anything from the people staying at the home such as requests for food, drinks, activities or just spending time with people. It was clear that staff knew peoples preferred communication styles such as signing and facial expressions. In the AQAA, the manager said he wanted to improve involvement in the service and was intending to set aside part of team meetings for guest to participate in and give their views to the staff team. Care Homes for Adults (18-65 years) Page 16 of 35 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 who use the service are able to make choices about their lifestyle. Social, educational, cultural and recreational activities meet peoples expectations. They also benefit from a good, healthy and varied diet. Evidence: In the AQAA, the manager said, Over the past 12 months we have made great strides in this area and have changed the whole ethos of the service from that of a service that provides just respite care to that of a true meaningful short break service. So much so that other services within the organization are adopting our practices. We have introduced theme weeks which focuses activities around a particular theme. The planning and organising of themed weeks has helped guests and staff to develop research skills and heightened their awareness of other activities in the local area and activities we can achieve within the service. We have also found that the amount of inCare Homes for Adults (18-65 years) Page 17 of 35 Evidence: house activities we are offering to guests are naturally increasing, outside of themed weeks. We have discovered that in a lot of cases the simplest ideas are often the most rewarding. An example of this is when we purchased some wooden boat kits from Hobby craft, the guests then built them and painted them and took them to Roundhay Park to race them and have a picnic. We work a flexible rota system to ensure that we can support guest to attend activities of their choice. We have developed guest visit planners where guests can plan their stay by choosing what activities they want to participate in, what food they want to eat and where they would like to visit. We have also introduced clubbing evenings on the request of some of our guest, the first one was very successful. Staff have been very flexible adjusting the rota so that they can support guests. On the last clubbing night, staff and guests did not return to the service until 3:30 AM. They have proved to be popular we will try to have them every four months to start with, increasing them to every two months. Records showed that people experience a wide variety of activity during their stay at the home. These include, bowling, cinema, pamper sessions, shopping trips, trips to the coast, test drives in sports cars, flag making, parties, arts and crafts pool tournaments and celebrations of religious festivals. The manager and staff have developed a monthly file with planned activities and have included a multi-faith calendar to make sure they are aware of all religious celebrations. They have also developed a photograph library showing people involved in activities. This can then be used to assist people to make choices about their activities. We looked at what happened on the themed week in May of this year. The themed weeks are planned out in advance so people can request their visit according to their interests. The theme was animals and people went to places of interest that included animals such as the zoo and farms. They also had animals visit the home and carried out craft activity such as making animal masks. It was clear during our visit, that people staying at the home were having a good time. People said they were happy and people who signed gave us lots of thumbs up signs. The atmosphere in the home was relaxed and people were confident and outgoing and seemed very willing to express their views. One person said, I love the activities we do. Another said, I had some lovely days out which made my stay a good holiday. Care Homes for Adults (18-65 years) Page 18 of 35 Evidence: Staff said that they felt they had enough staff to support people with their activities. Also there was plenty of social interaction between the staff and people who use the service. It was clear that staff and people who use the service get on well. When we asked staff what they thought the service did well, they said: The service users always have a choice in what they want to do The introduction of theme weeks has been very good for our guests, giving them lots of opportunities to access the community and discover new activities There is always plenty to do for people, we have two mini- buses and we use public transport to get people out. The things that guests get to do is amazing. In the AQAA, the manager said, Before each stay guest are sent a nutritional assessment survey which identifies any special nutritional/cultural needs and keeps the service updated on any changes. Guest choose their meals when they arrive in the service. They look through cook books with the staff and the guest is encouraged to choose healthy and well balanced meals. This is written down on the visit planner and added to the menus. On a daily basis the picture based menu board is updated with two meal choices from the menus developed by the staff and guests. We have introduced Taster evenings where guest can try many different food items from different regions and cultures (i.e. Chinese, Asian, Italian, Spanish, etc.). We hold them twice a month and have lots of activities during the days leading up to them like Chinese lantern making, flag making. We looked at menus at the home. These are planned around peoples likes and dislikes. They appeared to be well balanced and cater well for the varying cultural and dietary needs of people who use the service. People who stay at the home said they enjoy the food. Staff said, We offer guests a good balanced diet. Care Homes for Adults (18-65 years) Page 19 of 35 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. Overall, peoples general healthcare needs are well met and based upon their individual needs. Evidence: In the AQAA, the manager said, Staff are trained and experienced in providing and delivering personal support and promoting privacy, dignity and independence. Our service is very much user led and personalised to meet each individuals needs. Routines revolve around the service users needs and choice e.g. going to bed, waking up, which support worker they would like to assist them. Advice is sought from Outside Agencys / Professionals such as Physiotherapists, Occupational Health as to moving and handling techniques and suitable equipment needs. Where identified, grab rails, wheelchairs, specialised beds, hoists (ceiling and mobile), support belts, slide sheets, turn tables are used and staff are trained in their operation and use. Our service users are assessed regularly for any change in needs. All our guests have support assessments and support guidelines (if needed) which outline how they prefer to be supported for personal care. Where possible we provide Care Homes for Adults (18-65 years) Page 20 of 35 Evidence: gender specific care. It clearly states on guest support plans if they require gender specific care, e.g. Female only. Staff ensure that guest privacy and dignity is protected at all times. This is done by ensuring that personal care takes place in the appropriate place and that doors and curtains are kept shut. Staff also explain what they are doing and ask the guest to do as much as possible and support them only when they need support. As we are a respite centre we do not deal with annual health check-ups. But all our guests utilise the local PCT (Primary Care Trust) and the local GP (General Practitioner). Any requested appointments whilst guests are visiting will be supported by staff. Where specific needs are identified around an individuals healthcare, such as the use of gastrostomy feeds or blood-sugar recording, we liase with specialist nursing staff and arrange for them to demonstrate how to provide this support. Staff had good knowledge of peoples personal support needs. Staff were thoughtful, discreet and respectful of peoples dignity when attending to any needs. People who stay at the home looked well cared for, well dressed and groomed. Peoples privacy was respected by staff. They said they always knock on peoples doors before entering them and wait to be asked in. Respecting peoples privacy and dignity is also referred to in the support plans. Staff said they have received good training in meeting the health needs of people who use the service. Training has included: nutritional needs, PEG feeding, moving and handling and complex behaviours needs management. Some staff said they would like more training on autism. In the AQAA, the manager told us, Guests bring in medications in original packaging with a signed consent form, all staff have accredited medication training and follow the policy and procedure for the administration of medication which is in place. Guests are asked if they wish to take control of their own medication and all guest have medication profiles, and risk assessment which identifies how they like to take their medication. All controlled drugs are stored in accordance with current regulation and guidance issued from the Royal Pharmaceutical Society. We record all controlled drugs in the controlled drug register. In the last two years, there have been seven errors with medication at the home. Noone has been harmed by the errors and proper action has been taken on each occasion. We discussed the errors with the manager who said that each time an error Care Homes for Adults (18-65 years) Page 21 of 35 Evidence: has occurred there has been a full review of the incident. This has invloved re-training for staff, adjustments to practice and the homes medication policy and the use of disciplinary measures for staff. We looked at medication records during our visit, we checked some medication administration records (MAR) sheets and found them to be in good order. Medication was also being stored correctly. There are facilities for people to store their own medicines safely in their rooms if they manage their own medication. Care Homes for Adults (18-65 years) Page 22 of 35 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 who use the service are able to express their concerns and are protected from abuse. Evidence: In the AQAA, the manager said, We have a comprehensive complaints procedure which is in different accessible formats. Every guest and their families are given a copy before they access the service. We make regular follow up calls with guests and their carers to provide them a chance to raise any concerns or give compliments on a one to one basis. In surveys returned to us most people said they knew how to complain, just one person said they didnt. We looked at complaints records in the home and saw that complaints have been recorded and investigated properly. In the AQAA, the manager also told us, All staff have safeguarding and abuse awareness training. They are made aware of their responsibilities if they suspect abuse and how to report and deal with it in accordance with the Trust polices. We record any suspected incidents of abuse in our protection from abuse log and incidents are reported to the Leeds safeguarding team and CQC (Care Quality Commission) via regulation 37 notification. Care Homes for Adults (18-65 years) Page 23 of 35 Evidence: There have been three safeguarding issues within the home since our last inspection. They have been dealt with properly, with appropriate action being taken. The manager and staff team are aware of how to report safeguarding issues, which means people are protected well. Records showed that staff have received training in safeguarding adults. They were able to say what action they would take if they suspected abuse or had an allegation of abuse made to them. They were also able to describe the different types of abuse. They were familiar with the whistle blowing procedure and said they would have no hesitation in using it if they thought they needed to raise concerns outside of the home or organisation. The manager told us that he is planning to make improvements to the service and that they want To develop guest training that give them abuse awareness and tells them what to do if they suspect that they or someone else is being abused. Records are kept of the finances of people who use the service and their monies are kept safe. This has recently been reviewed and more checks have been introduced to make the system safer for people. Care Homes for Adults (18-65 years) Page 24 of 35 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 environment is homely, comfortable and safe for people who live at the home. Evidence: In the AQAA, the manager said, This service is warm and friendly and many guests and carers have commeted on how homely the service feels. The service is cleaned to a high standard and there are infection control procedures in place. In the AQAA the manager also told us how the environment in the home had been improved. He said,We have moved the sensory room into the lounge. This has been a great benefit as it is being used more. We have turned the sensory room into a video and music room snug. All the bedrooms have been redecorated. The main living areas have also been redecorated. A tour of the home was carried out. Communal areas, bathrooms and bedrooms were visited. The home looked clean, homely and well maintained. There was original art work from people who use the service on the walls and around the home, which gave the home a particularly homely feel. People who use the service said, It is always well maintained. When people are staying at the home, their photograph is put on their bedroom door Care Homes for Adults (18-65 years) Page 25 of 35 Evidence: to help them orientate themselves and feel more settled. They are also encouraged to bring personal items in with them to help them feel more at home. The home is fully accessible to anyone using a wheelchair. There is specialist equipment such as tracking hoists and hi-lo beds, baths and showers which means they can meet peoples diverse needs. There is a lift to the second floor of the home for anyone who cannot manage stairs. People who use the service have full access to the kitchen and are encouraged to get involved in food preparation or help themselves to snacks and drinks when they want. The garden has been further developed since our last visit to the home. More planting has taken place and a poly tunnel has been introduced for people who use the service and staff to grow plants and vegetables. There are good systems in place to manage peoples laundry. A colour coding system has been introduced to make sure laundry does not get mixed up. A relative commented on this saying, She always comes home with the things she goes in with. People are also encouraged to do their own laundry if this is what they want. Clinical waste is properly managed. Staff have received training in infection control as part of their induction and were able to say what other infection control measures are in place. Hand washing and hand drying facilities were available in all areas of the home. Liquid soap or paper towels were available. This ensures good hygiene practice. Care Homes for Adults (18-65 years) Page 26 of 35 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. Staff are trained skilled and in sufficient numbers to support people who use the service. Evidence: People who use the service spoke highly of the staff and said staff always treat them well. Their comments included: The staff are great The managers and support staff are very caring and do their best in accommodating people with learning disabilities Staff are very understanding and take note of what I like to do. In the AQAA, the manager said, The staff team has really settled down of the past 12 months because we have focused on recruiting from the local area and developing the staff team through improved training. We now have lower staff turnover only 4 staff left within the last 12 months as opposed to 9 last year. The lower staff turnover and improved training has improved the morale of the service Care Homes for Adults (18-65 years) Page 27 of 35 Evidence: creating a more positive and proactive staff team focused on supporting guest needs and wishes. We looked at rotas, which are displayed as photographs so that people who use the service can recognise who is on duty. They showed that there are sufficient staff and that they work flexibly to meet the needs of the people who use the service. All the staff we spoke to said they felt they had enough staff to meet peoples needs properly. One staff member, in a returned survey said they wished they had more staff on at weekends. We looked at the recruitment records that are kept in the home. These take the form of a pro-forma showing that all the required recruitment checks have been carried out. This is then signed by the organisations human resources personnel and the homes manager. These showed that recruitment is properly managed by the home; interviews are held and CRB (Criminal Record Bureau) checks are obtained before staff start work and checks are made to make sure staff are eligible for work. Induction training is based on the Skills for Care common induction standards. Most staff said their induction had been good and prepared them well for their job. The manager said he was intending to make improvements to the service by Seniors to run staff induction days to improve the induction of new staff members. In the AQAA, the manager said, All staff go through mandatory training this includes LDQ (Learning Disability Qualification) 1/2, Moving and handling, Epilepsy and Medazolan training, Low arousal and CNB (Complex needs and behaviour management ) training, Infection control, NVQ (National Vocational Qualification) 2/3, Food hygiene, Fire training and first aid. 55 of our staff have an NVQ 2 or higher, 5 staff are currently working towards NVQ 2,3 and the rest are finishing their six month induction. All staff have equality and diversity training. Staff also go through specialist training to meet service users specific needs, this includes Makaton, Autism, Intensive Interaction, Gastronomy peg feeding and any other training we feel will help us support guest needs. We also looked at training records and these showed that most staffs training was up to date or if updates were needed, they were planned. The manager has excellent systems in place to monitor staffs training needs. Staff were pleased with their training. Comments included: Care Homes for Adults (18-65 years) Page 28 of 35 Evidence: Really enjoyed my training, given me good insight to the job Cant fault the Paceys, you always get what you ask for The Paceys offers a wide range of training and encourages staff to attend as much as possible. We looked at staffs supervision records and saw that regular one to one sessions are provided for staff to discuss their roles. Staff said they were happy with the support they get. One said, Good support, regular supervision, its great. Care Homes for Adults (18-65 years) Page 29 of 35 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is very well managed, the interests of the people who use the service are seen as important to the manager and staff and are properly safeguarded overall. Evidence: The manager has worked hard to develop and lead a staff team who feel confident in their ability to deliver the service. The manager is committed to developing the service as a short breaks service that is outcome focused for people and that they have a great time during their stays. He is well organised and monitors the service well. When asked how the service had improved, he said in the AQAA, We have introduced senior support workers who have become an essential part of the management team. They are the first line of management and work closely with the staff team and have been given supervision training. In the AQAA, he also said, The manager has developed a self managing team where staff are properly trained and feel comfortable challenging each other. They also are confident in managing the day to day running of the service. The manager believes strongly in an Open Door approach and of empowering service users and staff so Care Homes for Adults (18-65 years) Page 30 of 35 Evidence: that positive, innovative and creative outcomes are achieved. He has done this by empowering the staff team and encouraging them to try new ideas and rewarding their innovation. The staff and guest are encourage to share their ideas and input on how the service should be run. They are made aware that they all have a stake in the service and their views are important. Staff said they felt well supported and confident to take on any tasks delegated by the manager. They said, My manager and staff are very helpful and supportive I am new into support work and what I have seen is very good. I am very well supported in every aspect of my job He is really very approachable, feel able to make suggestions, have ideas We get good support from the management team, including the area manager Feel listened to. The manager has over 8 years experience working in management and over 8 years experience of working in care. He has completed his Registered Managers Award and NVQ 4 in care management. The assistant manager has over 13 years experience of working in care and has NVQ 2 and is currently working towards NVQ 4. At our visit, the manager told us he is about to be transferred from the home to work in another part of the organisation. We discussed the on-going management arrangements of the home with the manager and the organisations area manager. Until a new manager is in post, the current manager will maintain weekly contact with the service and staff will also be supported by the area manager. Records we looked at showed that regular health and safety checks are carried out. The manager also told us that they have recently introduced health and safety training for people who use the service. This has raised their awareness on issues such as road safety, fire safety and abuse. In the AQAA the manager said relevant health and safety policies and procedures were in place, and reviewed. He also said equipment has been serviced or tested as recommended by the manufacturer or regulatory body. Records showed that certificates on gas and electrical safety were up to date and the environment had been Care Homes for Adults (18-65 years) Page 31 of 35 Evidence: thoroughly risk assessed. The organisation provides a comprehensive manual of policies and procedures for staff to refer to. The manager has good systems in place to make sure staff read and understand the policies. He also makes sure any changes are communicated to staff. We looked at accident reporting and spoke to staff about this. Staff were clear on their responsibilites and how to report and record accidents or incidents. The organisation carries out a monthly analysis of accidents to see if there are any patterns or trends or ways of avoiding future accidents. The organisations area manager conducts monthly provider reports with requirements for improvement. The organisation also sends out annual questionnaires to people who use the service and their families or carers. This makes sure they are always looking at ways the service can be improved. In an analysis of the last surveys, the manager reported that 60 of people rated the service as excellent, 30 as good and 10 as OK. The manager said they are intending to extend the surveys to health and social care professionals so they can get feedback on how they think the service may improve. The manager receives regular supervision from the area manager to support him in his role. Care Homes for Adults (18-65 years) Page 32 of 35 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 33 of 35 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 34 of 35 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. Care Homes for Adults (18-65 years) Page 35 of 35 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!