Care Home: The Susan Hampshire House

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What the care home does well It was evident that staff focus on the individual needs of people who use the service and create a homely place for people to live. There is a commitment to provide a wide range of leisure and occupation. Individuals living in the home benefit from a consistent staff team. Staff spoken with enjoy their work. Staff described a supportive place to work with a good team morale. There is a good commitment to ensure that a competent and a trained workforce support the individuals living in the home. The majority of the staff have obtained a National Vocational Qualification. There is a good rolling programme of mandatory training. The responsible individual provides the manager and staff with good support and clear and helpful reports. The home is managed well and to the benefit of the people living in the home. What has improved since the last inspection? Newly admitted individuals are assured that there is a care plan in place which is generated by the home`s assessment, including risk assessments. What the care home could do better: Ensure individuals are protected by a robust medication procedure, which includes maintaining a record of all medication entering the home and updating medication profiles. Care planning processes could benefit from a review to ensure they are person centred. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Susan Hampshire House 103 Station Road Yate South Glos BS37 5AE     The quality rating for this care home is:   two star good 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: Paula Cordell     Date: 2 0 1 0 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 31 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 31 Information about the care home Name of care home: Address: The Susan Hampshire House 103 Station Road Yate South Glos BS37 5AE 01454327690 01275372151 susanhampshirehouse@freeways.trust.co.uk 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) : Freeways Trust Limited care home 16 Number of places (if applicable): Under 65 Over 65 0 16 dementia learning disability Additional conditions: 16 16 May accommodate up to 16 persons with learning difficulties aged 18 years and over Date of last inspection Brief description of the care home Susan Hampshire House is operated by Freeways Trust and registered to provide personal care and accommodation for up to 16 people who have a learning disability. Three of the beds are set aside to provide respite care. The home itself is residential in style and blends in well with the local community. It is situated opposite Yate town shopping centre and there are a number of shopping, leisure and community resources. Public transport is available. The cost of placement is between £613.83 - £892, the price dependent upon assessed need. Prospective residents can be provided with information about the home and this will detail the services and facilities available. Care Homes for Adults (18-65 years) Page 4 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced visit as part of a key inspection. The purpose of the visit was to review the requirements and recommendations from the key inspection in November 2007. In addition to monitoring the quality of the care service provided to the individuals living in Susan Hampshire House. There have been no additional visits between November 2007 and this visit. An Annual Service Review was completed in November 2008 and the judgement was that Susan Hampshire was still providing a good service to the people they support. There have been no complaints since the last visit. Care Homes for Adults (18-65 years) Page 5 of 31 There were no vacancies in the home. The home has an established group of people that stay at Susan Hampshire House for respite care. Three of the sixteen beds are for respite care. The inspection methods used included record checks, case tracking of four individuals that live in the home, a tour of the building and discussions with the manager, the deputy, the staff and the people living in the home. As part of the visit an expert by experience came along to Susan Hampshire House to speak with people living in the home. This person had a learning disability and has experience of using services. They comments are included in this report. The home has been sending us information in respect of regulation 37 notifications of events that effect the wellbeing of the people living in the home. These were used as a focus for the inspection, along with the annual quality assurance assessment completed by the manager and surveys from people who use the service (8), staff (3) and visiting professionals (2). The visit was conducted over a period of 7.5 hours and ended with structured feedback being given to the registered manager and the deputy. 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 7 of 31 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals have information about Susan Hampshire House to enable to them to make a decision to move to the home. Good assessments are in place to ensure that the home can meet the needs and aspirations of the individual. Evidence: The home has a statement of purpose and service user guide. These met with the National Minimum Standards. The service user guide was available in an accessible format. Information was available on what is and not included in the fees. Examples of additional fees include contributions towards the cost of holidays, transport, toiletries and personal items. There are two rates of contribution towards the cost of the transport dependent on whether individuals receive higher or lower rate disability allowance. One person rarely uses the homes vehicle and therefore does not contribute. The manager said that the transport contribution is more equitable than when we last visited. However, this must be reviewed where it is clear that the funding authority is already contributing to this. The manager has agreed to discuss at review meetings. Care Homes for Adults (18-65 years) Page 9 of 31 Evidence: Three peoples care files case tracked showed they had up to date contracts and the individual or their representative had signed them. Contracts included information about the fees. Good assessment records were seen to ensure peoples care needs are assessed prior to moving to Susan Hampshire House and this generates the homes care plan. Guidance is in place for both prospective individuals and staff on the assessment process. A number of people have moved into the home since the last visit and in the main this has been individuals that were known to both the care staff and the people who live in Susan Hampshire House as they had previously stayed for respite care. Two individuals were asked about their move to Susan Hampshire House both said they liked living there and the staff team. Both said they had been asked whether they wanted to live there. Relatives spoken with during the visit said the staff and the manager have been really helpful in settling their relative into the home. It was evident the family were being kept informed and were involved in the move to the home. Family members were assisting in making the individuals bedroom more personal. The home has responded to a requirement from the last visit to ensure that individuals have a care plan within five days of moving to the home as previously this was not completed until the six month review with staff relying on the placing authoritys care plan. From talking with staff, the manager, people who use the service and relatives it was evident that the home would ensure that the assessment was tailored to the individual. With a variety of visits to the home being made prior to making a decision including an overnight stay to enable the individual, people living in the home and the staff to get to know each other. As already mentioned most of the individuals had stayed in the home for respite prior to becoming a permanent resident. The home has three respite care beds. The expert by experience asked individuals how they felt about this. All appeared happy with the arrangement. One person said that they liked particular individuals and looked forward to them staying as it gave them someone new to talk too. Another person said to the expert that it really depended on who was staying. Care Homes for Adults (18-65 years) Page 10 of 31 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals can be assured that their care needs and aspirations are being met. The outcome for individuals is that they are supported in the way they choose. However, there are shortfalls in the care planning processes as these lack detail in how the person should be supported however there is a plan in place to address this. Good communication is in place between the staff which means that although some areas are not documented individuals are assured of a consistent approach. Evidence: A random selection of care files were seen to determine the quality of the service being provided to the individuals living at Susan Hampshire House. The manager said that they were in the process of introducing a more person centred approach to the planning of the care. The home operates a system where by the care review form forms part of the care plan. The review covers a wide range of areas including personal care, social, emotional, physical and psychological care needs. Key workers complete the review with the individuals on a monthly basis with a formal review being Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: completed annually. During the annual review the individual is supported to invite any relevant people including relatives and professionals who are involved in the care of the person. Care files could be better organised ensuring that information is filed in the appropriate section. The files did not flow to enable to get a true picture of the individual. It may be beneficial to have a pen picture about the person including how they liked to be supported, interests and some historical information at the start of the care file. The monthly review included aims and objectives for the individual which could be a social activity or a new skill to learn and build on. The statements were generally broad for example to go swimming or to be more involved in cooking. There was no clear guidance in respect of who will support them or the frequency. The lack of information could mean that the plan is not carried out and could be difficult to review the effectiveness. Some of the individuals consulted by the expert by experience were not aware that they had a person centred plan. Consideration should be taken for individuals to view what is written about them and for them to sign the documentation where relevant. In addition plans of care should be more accessible. Whilst there are some shortfalls in the documentation of the care needs of individuals it is evident that the people in the home are well supported and enjoy life in Susan Hampshire House. This was clearly evidenced in conversations with both the inspector and the expert by experience. Comments include I like living here with my friends, I can do what I like, the staff are good and listen and staff help us to sort out problems. People living in the home were fully involved in the planning of their care including the review process. It was evident that the service was planned around the individuals living in the home. Meetings are arranged on a monthly basis. The expert by experience was told that they talk at meetings about what they want to do. It was evident that menu planning, key policies, decoration of the home and staffing were common themes for discussion at the meetings. Risk assessments were seen and covered a wide range of activities both in the home and the local community. Individuals were evidently encouraged to lead full and active lifestyles based on choice. Risk assessments included the use of equipment for manual handling. The manager has attended a manual handling assessors course and all staff attend periodic updates in manual handling. Care Homes for Adults (18-65 years) Page 12 of 31 Evidence: Staff were knowledgeable about the care needs of the individuals. Regular staff meetings take place where care is discussed ensuring a consistent approach. Care Homes for Adults (18-65 years) Page 13 of 31 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. Individuals lead active and social lifestyles based on choice. Individuals are very much part of the home and the focus of the service being provided. There is an inclusive atmosphere. Individuals are encouraged to maintain contact with friends and family. A healthy diet is made available to people living in the home. Evidence: Individuals spoken with during the visit confirmed that they could do what they want and are supported to be active both in the home and the local community. Individuals said that they were regularly supported to go out in the community including shopping, attending church, playing skittles, going to the pub, going for walks to name a few. This was confirmed in completed surveys from individuals who said they could do what Care Homes for Adults (18-65 years) Page 14 of 31 Evidence: they want during the day, in the evenings and at weekends. Individuals are evidently offered a wide range of activities both in the home and the local community. Some of the individuals attend a day centre, some attend local colleges and some have employment in the local community. This was confirmed in daily records and the monthly key worker reports. Some of the individuals belong to local clubs including a golf club and social club for people with a learning disability. Two of the individuals living in the home expressed some concern that they day centre was closing. The manager said that the home would be organising activities for those individuals that will be effected. Work has commenced on developing activities with recruitment taken place for three new posts to support the individuals. The manager said that the individuals will be involved in the recruitment process and deciding on the activities they want to take part in. Social activities were many and organised at frequent intervals. Care records provided evidence that individuals are supported to go to places of interest, the theatre, football matches, meals out and pub trips the list was numerous. Regular entertainment is brought into the home including musical evenings, a magician and local singers. The expert by experience was told that there were lots of parties organised in the home and friends and relatives were invited to join in. Individuals are supported to have an annual holiday if they want. Holidays are tailored to the individual. Holidays this year have included a Caribbean cruise, trip to Burnham on Sea and Blackpool and a further cruise is being organised around the Canary Islands for three people. From talking with one individual it was evident that they enjoyed their holiday and another person was equally excited about going and described the planning involved. From talking with the individuals it was evident that they could chose the destination, who they went with, including the mode of transport. People who use the service have monthly meetings as confirmed in conversations with the individuals and staff. Notes of the meetings demonstrated that a wide range of topics were discussed demonstrating that individuals are involved in making decisions and very much part of Susan Hampshire House. Individuals spoken with said that they could invite friends for tea and relatives were encouraged to visit. From talking with the manager it was evident that relatives are invited to social functions and in the summer the home had a fete. Menus and conversations with individuals and staff provided evidence that there is a Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: wholesome, healthy and varied menu available. Individuals confirmed they could make choices on what to eat and that the food was good. From conversations it was evident that the individuals were involved in the menu planning. It was evident that individual preferences and special diets were catered for. The opportunity was taken to participate in the lunch time meal. Support was given sensitively and it was evident that meal times were very much a social time with the individuals and the staff all sat round the table chatting. Individuals confirmed they could help themselves to drinks and snacks and fruit was always available. Throughout the visit interactions between staff and individuals were positive and inclusive. Individuals were actively seeking out the company of each other and the staff in the dining area and it was evident that this was the hub of the home. Individuals were observed helping staff prepare both the lunch and the evening meal. Care Homes for Adults (18-65 years) Page 16 of 31 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. Individuals can be confident that their health and personal care needs are being met. The improved medication systems should better protect the people living in the home. Evidence: There is good health care monitoring in place for individuals. Good records are maintained that demonstrate that individuals have access to a GP, dentist, opticians and chiropodist and the outcome of the visit. Information was available to staff to guide them on how individuals should be supported with both their personal and health care needs. Health action plans were being developed for each person. As mentioned previously each person is allocated a key worker, a named member of staff. As part of the key workers role there is an expectation that they will review the care on a monthly basis. As part of the review the member of staff meets with the individual to plan new goals and aspirations and discuss progress made over the month. In addition the review contains pertinent information about the health of the person, a summary of appointments attended and the outcome. Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: The manager said that everyone if they wish has been asked go to the local surgery for a full health assessment and the plan is for this to further develop the health action plans. Letters were seen confirming appointments over the next few months. Surveys from visiting professionals said that individuals are treated in a respectful manner, the staff support the person to lead the life they choose and have in the main the skills to support the individuals. One visiting professional raised concerns about the medication administration systems as a cause for concern including staffs knowledge and how they check medication entering the home. Since the last visit two regulation 37 notifications have been forwarded to the Care Quality Commission in respect of medication not being received by the home and not being checked by the staff consequently an error has occurred. The system in the home has been reviewed and procedures have been improved relating to the receipt of medication from the pharmacist where by two staff check the records ensuring that there has been no changes to the prescribed medication by looking at previous medication records and the new ones sent to the home. However, there was no record for the medication recently received although there was for the previous month and only the homes record of what was ordered. The home must maintain a record of all medication entering the home and it would be good practice to retain a copy of the white part of the prescription as this contains what was prescribed by the GP and the quantity. This will enable the home to track errors back to either the staff ordering the medication, the pharmacist or the surgery. Records were maintained of administration. These are checked by a second member of staff on a daily basis. The deputy manager has the responsibility to check the competence of all staff and provide training where appropriate. This has recently been completed for all staff. Only staff that have been assessed as competent can administer medication. Staff attend medication training as part of their induction. Medication profiles are in place. However it was noted that some were not up to date. Information in the care planning file did not contain an up to date record of medication that individuals are taking which could be misleading. The home has a medication policy and this has recently been reviewed and further information included to guide staff on their responsibility in the event of an error. The organisation has a policy to guide staff in the event of a death occurring in the home. From talking with staff and individuals it is evident that some have experienced Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: bereavement due to death of two of the individuals who lived in the home. Whilst it was evident that there is a good support network in the home it may be beneficial for some staff to attend bereavement and loss training. It was evident from conversations that the manager and the staff had responded sensitively to the dying person and the people living in the home. The home has access to a Chaplin that has visited the home to chat with both staff and the people living in the home. Care Homes for Adults (18-65 years) Page 19 of 31 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. Individuals can be confident that they are protected from abuse and their concerns are listened too and acted upon. Evidence: There is an organisational complaints policy which has recently been reviewed. This includes what people can expect when a complaint is made and the timescales that it will be responded too. Completed surveys from individuals in the home provided evidence that they knew how to complain. Copies of the complaint procedure are included in the statement of purpose and the service user guide. Individuals have monthly opportunities to discuss on a one to one basis concerns with their key worker and during monthly house meetings. Individuals spoken with during this visit clearly said if they were unhappy they would speak to the staff on duty or to the manager. It was evident that their views were actively sought about improvements that can be made to the home. The home has recently reviewed how complaints are recorded and a standardised form has been developed enabling the complaint, the action taken to address the concern and the outcome to be clearly documented. An opportunity was taken to review the complaints that have been made since the last visit. These were generally about concerns about interpersonal relationships within the home and no different from those Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: you would normally find when a group of people live together. It was evident that individuals were empowered to raise concerns and the staff and the manager are active in trying to resolve them. Policies and procedures were in place relating to safeguarding as seen at the last visit, including an accessible one for people who live in the home. All staff have recently attended an update on safeguarding in April 2009. Records were seen confirming this. Safeguarding is covered during staff induction as part of the Learning Disability Qualification. The manager stated that all staff have completed this. Staff spoken with, were aware what constitutes abuse and the policies in place to guide them if an allegation is made. There is a whistle blowing policy as seen at previous visits. Finances were checked and found to be correct for a random selection of people receiving a care service. Individuals have their own bank accounts and these are kept in the home. The administrator said that where individuals are unable to sign their cheques then a signature is obtained from a senior manager at Freeways Head Office. This person acts as their appointee. Some of the individuals have relatives who act as their appointee and one person in the home has capacity to act for themselves. Good systems were in place to protect the finances of the individuals, including a record of all money entering and leaving the home supported by two staff signatures and a receipt. Financial audits are completed by the Finance department periodically and during monthly provider visits in respect of regulation 26. The expert by experience asked individuals how they felt about their money being looked after by the staff at the home. One person said they could have money whenever they wanted it and that they are supported to go to the bank and sign a form. Financial support varied depending on the ability of the individual. Each person has a care plan detailing the support that is required. The manager stated that training has been given to all staff on supporting individuals that challenge during the spring of this year. Records were seen confirming this. The manager stated at the last visit that they were the trainer in this particular topic for Freeways and attend annual updates with an accredited trainer to enable them to officially deliver this training. Care files contained evidence that individuals have a positive strategy to support them if they become angry or upset. All staff and the manager have attended training in the new legislation regarding mental capacity and deprivation of liberty. The manager described how this training has generally had an impact on the service provided and how decisions are made on behalf of individuals. It is evident that the home would seek guidance and support from placing authorities and work with other professionals in seeking some clarity Care Homes for Adults (18-65 years) Page 21 of 31 Evidence: where the person lacks capacity or where decision may cause conflict. This is good practice. Care Homes for Adults (18-65 years) Page 22 of 31 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. Susan Hampshire is purpose built and provides a safe, homely place for the people living there. Great attention has been paid to make it homely and appealing both for the people living there and their visitors. High standards of cleanliness are in place. Evidence: Susan Hampshire House is purpose built and in keeping with the local neighbourhood. It is situated opposite Yate Shopping Centre and has many local amenities, which include places of worship, sports facilities, pubs, shops and good transport links. All bedrooms are single with many having ensuite facilities (a toilet and sink). There are four bathrooms and toilets situated throughout the home. All bedrooms seen were personalised and decorated and furnished to high standard and reflected the interest of the individuals. The home provides respite care to individuals living in the community and separate facilities are available for these individuals including a small kitchen and lounge. However, as noted at the last visit it was evident that many of the individuals who receive respite often enjoy being part of the home and prefer to spend time downstairs with the others. Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: The home has a loop system for the benefit of people who are hearing impaired, including light sensors in the event of a fire. Sensory equipment had been fitted in the bathrooms and was said to be appreciated by the people living in the home. The home was purpose built and is accessible to those that may be physically disabled including handrails throughout, a lift to the first floor and a variety of manual handling aids including hoists and bathing aids. Great attention has been made to ensure that all parts of the home are homely with ornaments, plants and domestic style furniture. All areas were clean and free from odour. Individuals have access to three lounges and a dining area. It was noted that the two sofas in the conservatory could benefit from being replaced. The springs had gone in one which may make it difficult for an older person to get up. Staff said that the sofas had been there since the home opened ten years ago. There is an enclosed outside garden with seating and mature shrubs. The home has a number of pets including three cats and fish. Individuals said they were actively involved in caring for the animals. The staff and the individuals living in the home are responsible for keeping the home tidy. Staff support individuals as part of their weekly life skills day to clean their bedrooms and change their bedding. In addition individuals were observed helping with the washing up, generally cleaning the kitchen and dining area and doing their laundry. It was evident that individuals felt valued and part of the home. The home was inspected in June 2009 by Environmental Health and achieved a five star rating. A good standard of cleanliness was observed in the kitchen with safety measures being taken to ensure that individuals are protected. Care Homes for Adults (18-65 years) Page 24 of 31 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. Individuals benefit from a competent and stable staff team. Good support mechanisms are in place ensuring a consistent approach. Evidence: There is an established team working at Susan Hampshire House which offers the individuals consistency. From talking with staff it was evident that they enjoyed working in the home and supporting the individuals. Staff were knowledgeable about the needs of the people living in the home. The statement of purpose states that there should be a minimum of four staff working during the day with one waking and one sleeping in member of staff to cover the nights. This was confirmed by staff and the duty rota for the current month. Recruitment information was not seen on this occasion. The last member of staff to be employed was over 12 months ago. The Care Quality Commission has recently inspected Freeways Trusts recruitment processes at their main head quarters. Good recruitment practices are in place including obtaining references, a full completed application and a check for any criminal record. The manager has the responsibility for completing interviews and individuals living in the home participate in the process. Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: On the day of the visit interviews were being held for the activity coordinator and one of the individuals was assisting in the interview process. Individuals living in the home have attended training on interviewing skills enabling them to assist as noted at the last visit to the home. There was a good rolling programme of training including annual updates in first aid, manual handling and fire training. Other training seen included dementia, epilepsy, communication, supporting individuals that challenge, diabetes, medication and more recently training on the mental capacity act. From talking with the manager and the staff it was evident that there was a commitment for staff to attend appropriate training based on the care needs of the people living in the home. The manager has agreed to explore training on mental health as this was an area that staff had not covered. The home has exceeded the government target of achieving 50 of the workforce having a National Vocational Award. Out of the eighteen staff thirteen have an National Vocational Award and a further three staff are completing. All staff have completed the Learning Disability Qualification as part of their induction. Good communication mechanisms are in place including regular meetings, supervision and annual appraisals. Documentation was in place confirming this. Staff spoken with and the completed staff surveys confirmed that they were supported in their roles. Care Homes for Adults (18-65 years) Page 26 of 31 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. Individuals can be assured that the service is managed well and that there are good quality initiatives in place. Health and safety is paramount and Susan Hampshire provides a safe place to live. Evidence: There is a stable management team working in Susan Hampshire House. Both the registered manager and the deputy have worked in the home since it opened. Mr Jeremy Venton is the registered manager. He has worked for the organisation supporting individuals with a learning disability for many years. Evidence was provided to demonstrate that Mr Venton continues to attend training enhancing his skills and experience. There are good quality assurance initiatives in place to ensure that the quality of the care and the service provided is regularly being monitored and improved. This includes questionnaires being completed by individuals living in the home and their relatives. It was evident that where suggestions are made for improvement this is listened too and Care Homes for Adults (18-65 years) Page 27 of 31 Evidence: acted upon. The home has drawn up a business plan for the forth coming year identifying areas for improvement based on the comments made by individuals living in the home. Other areas where audits are completed include care reviews, medication, staff training, sickness and absence and the environment. The provider completes monthly visits in respect of regulation 26 and copies of the reports are held in the home. They continue to be well presented and gave a good insight into the service covering key aspects of the running of the home. It was evident that the provider had a key role in reviewing the quality of the service provided. The home completed the Annual Quality Assurance Assessment as part of this inspection process. The AQAA offers the provider an opportunity to say where the service is doing well and what could improve. It was evident that the service continues to develop ensuring that the needs of the individuals are being met. Good systems were in place relating to health and safety including ongoing training, policies and procedures, routine checks on the environment and the equipment. There was a good standard of record keeping being maintained relating to fire risk assessments, fire checks including fire training and drills and general risk assessments. These had been kept under review. The home has been inspected by Environmental Health and has been given a five star rating. Care Homes for Adults (18-65 years) Page 28 of 31 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 29 of 31 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 1 20 13 Ensure there is a record of medication entering the home. Which will better safeguard individuals in relation to the medication administration. 02/11/2009 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 2 6 20 Develop the present care planning processes to ensure that they are person centred and accessible to the individual. Ensure that medication profiles are current offering staff and the individuals information about the prescribed medication its use and side effects. For staff to attend bereavement and loss training. 3 21 Care Homes for Adults (18-65 years) Page 30 of 31 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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