Care Home: The Steppes Residential Care Home

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Annual service review Name of Service: The Steppes Residential Care Home The quality rating for this care home is: The rating was made on: two star good service 2 6 1 1 2 0 0 8 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 We do an annual service review when there has been no key inspection of the service in the last 12 months. It does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection or annual service review.   Has this annual service review changed our opinion of the service?   No You should read the last key inspection report for this service to get a full picture of how well outcomes for the people using the service are being met. The date by which we will do a key inspection: Name of inspector: Janice Patrick1 Date of this annual service review: 2 5 1 1 2 0 0 9 Annual Service Review Page 1 of 7 Information about the service Address of service: Cossack Square Nailsworth Glos GL6 0DB 01453832406 Telephone number: Fax number: Email address: Provider web address:   steppescare@aol.com Name of registered provider(s): Conditions of registration: Category(ies) : old age, not falling within any other category The Steppes Care Limited Number of places (if applicable): Under 65 Over 65 0 21 Have there been any changes in the ownership, management or the No service’s registration details in the last 12 months? If yes, what have they been: Date of last key inspection: Date of last annual service review (if applicable): Brief description of the service The Steppes is a care home registered to provide personal care for twenty-one older people in total. The home is an older style property that has been extended over time and adapted for its current purpose. Adjacent to the main house is a smaller and more recently constructed house with six service users accommodated there. Both parts of the home provide a domestic style environment and easy access with a stair lift in the small house and a shaft lift in the main house. The main house has a small communal lounge and dining room on the ground floor. Service users accommodation is provided on the ground and first floor. All service users accommodation is provided in single rooms, most have en-suite facilities. A communal bathroom providing an assisted bathing facility is situated in each house. The amenities of the local town are in close proximity. The current fees can be obtained from the service; hairdressing, newspapers and chiropody are extra to these. Annual Service Review Page 2 of 7 2 6 1 1 2 0 0 8 The home has an information file in the main reception that contains the homes Statement of Purpose and Service Users Guide. Annual Service Review Page 3 of 7 Service update since the last key inspection or annual service review: What did we do for this annual service review? We looked at all the information that we have received, or asked for, since the last key inspection or annual service review. This included the current Annual Quality Assurance Assessment, AQAA that was sent to us by the service. The AQAA is a self assessment completed annually by the service. It tells how well the service feels it is meeting peoples needs. It also tells us of improvements made to the quality of the services provided and the plans the service has for the next twelve months. It also gives us some numerical information about the service. The views of those who use the service and of those who work for the service. Information we have about how the service has managed any complaints. What the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. The previous key inspection report and any outstanding requirements. What has this told us about the service? The last inspection which involved a visit to the service was in November 2008 when the service was assessed as providing good outcomes for people who use it. There were four requirements made as a result of this; these included ensuring that care plans were kept up to date and detailed, that guidance regarding resuscitation was appropriately sought, that medication administration records were dated and signed correctly and that any medication prescribed to be given on an as required basis is accompanied by a care plan. We received eight service user questionnaires back. The AQAA tells us that the service has not received any complaints, although arrangements are in place for peoples complaints or concerns to be received and addressed. The Commission has not received any complaints or concerns about this service. Six service user questionnaires confirmed that people were aware of how to make a complaint; two indicated that they were not aware. The AQAA also tells us that the views of those living at the service are paramount to how the service operates and what improvements are made. It tells us that the service is looking at further ways of getting feedback from interested parties. As a result of feedback so far, improvements have been made to simple signage within the service, alterations to the activities being provided and development of picture books to include various meals so as to help with communication and peoples ability to make choices. Seven service user questionnaires confirmed that staff always listened to what people in the home had to say. The AQAA also tells us that the service has arrangements in place to ensure peoples Annual Service Review Page 4 of 7 equality and diversity needs are recognised, acknowledged and met. It tells us that staff are trained in this as well as the Mental Capacity Act 2005 and Deprivation of Liberty Guidance. The service aims to improve how it considers these areas by also accessing further training for staff in dementia care. The service have experienced some difficulties in finding training for staff that work at night or who have young families but are being proactive in addressing this. The AQAA tells us that peoples health care needs are met with the support of external health care specialists. It tells us that appropriate assessments are carried out; followed by comprehensive care planning of peoples needs along with the service users involvement. The AQAA explains the plans to further improve the care planning and tells us that a high standard of care is maintained. It tells us that this is partly due to a low turnover of staff, hence the team is experienced and by taking advantage of external health care professionals support. Seven service user questionnaires confirmed that staff were always available and that they always receive appropriate care and support. One returned questionnaire said the care was very good and staff are kind. Another said the standard of care was excellent. One visitor commented that they were always kept well informed of their relatives condition. The AQAA tells us that additional improvements have taken place to help improve peoples health and welfare and include the provision of a cold water dispenser, which is accessible to those who live in the home, further Infection Control training for staff and more detailed care plans. The AQAA tells us that a varied activities programme is provided, which includes regular trips out of the home. It tells us that one of the care staff has attended accredited training in the provision of activities in a care setting. It does not tell us how many hours are dedicated to this but descriptions given in the AQAA imply these are varied. It tells us that people also take part and belong to groups within the local community. The AQAA tells us that the service would like to see more involvement with the local community and that it is proactive in trying to achieve this. Five service user questionnaires confirmed that activities are always provided and three said they are usually provided. One comment from a relative felt there could be more stimulation for those with short term memory problems and another questionnaire said more exercise would be appreciated. The AQAA tells us that there are policies and procedures in place to help protect people from harm and abuse. It tells us that staff are trained in safeguarding adult processes and further training has been accessed on the Deprivation of Liberty Guidance. It says that senior staff have a more in depth understanding of these issues and ensure peoples protection by ensuring that additional practices are carried out thoroughly, such as recruitment. The service also plan to increase how many staff become dementia link workers. The AQAA tells us that the environment is kept clean and in a good state of repair with peoples safety being uppermost. It tells us that various improvements have been made to ensure this and that individual and environmental risk assessments are in place. Comments from service user questionnaires confirm that the home is kept clean. One specific comment from a service user confirms that the person is very happy with their bedroom. Annual Service Review Page 5 of 7 The AQAA tells us that many staff have worked in the home for significant lengths of time and that this means that many staff can concentrate on improving their existing skills and knowledge. One service user questionnaire tells us that staff are very caring and that many are excellent and long serving. The AQAA tells us that arrangements are in place to ensure all staff receive appropriate training and supervision in all aspects of their work. It tells us that over fifty percent of the staff have obtained the National Vocational Qualification (NVQ) in care at levels 2 and 3. The service sources training through the Skills for Care which helps to ensure staff are being up dated correctly. It tells us that the Registered Manager is the safe moving and handling trainer for the service. The AQAA tells us that the management team has remained unchanged for several years and that this has helped the service to run smoothly and contributes to the low turn over of staff. It also tells us that there is an established quality assurance system in place, which includes obtaining the views of those who live in the service and those of other interested parties. It explains that the annual completion of the AQAA has also acted as a valuable self audit. It tells us that the service is not stuck in its ways and that the aim is to embrace new ideas and initiatives if they benefit the service users. One specific comment from a service user questionnaire tells us that the service gives personal attention and that it is not like an institution. What are we going to do as a result of this annual service review? We are not going to change our inspection plans based on the current information. We will continue to monitor all information given to us. Subject to any changes in registration and inspection practice following implementation of the Health and Social Care Act 2008, our current plan is to do a key inspection by 26th November 2010. Annual Service Review Page 6 of 7 Reader Information Document Purpose: Author: Audience: Further copies from: Annual service review CQC General Public 0870 240 7535 (national contact centre) Our duty to regulate social care services is set out in the Care Standards Act 2000. The content of which can be found on our website. 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 copy of the findings 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. 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