Care Home: The Whinnies

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Whinnies Gateshead Road Sunnyside Newcastle upon Tyne NE16 5LG three star excellent service The quality rating for this care home is: 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: Carole McKay Date: 0 7 0 1 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. They reflect the things that people have said are important to them: 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. 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. Internet address www.csci.org.uk Information about the care home Name of care home: Address: The Whinnies Gateshead Road Sunnyside Newcastle upon Tyne NE16 5LG 01914960418 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): thewhinnies@c-I-c.co.uk Community Integrated Care Name of registered manager (if applicable) Brenda Cawton Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 3 0 care home 3 learning disability Additional conditions: The registered person may provide the following category of service only: Care Home - 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, maximum number of places: 3 The maximum number of service users who can be accommodated is: 3 Date of last inspection 0 1 0 2 2 0 0 8 A bit about the care home The Whinnies is registered to provide 24 hour care for three people with moderate to severe learning disabilities. The home is close to local transport services. There is also a car available. 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 How we did our inspection: This is what the inspector did when they were at the care home We sent out surveys. And we visited the people at the home. What the care home does well It provides clear information about the home. The people who live at the home enjoy a good lifestyle The service provides an attractive, safe and comfortable home. The home has plenty of staff to support service users. What has got better from the last inspection The care plans have improved and they are easier for people to read. The arrangements for helping people with medicines are safer. New windows and blinds have been fitted. Other parts of the home have been improved. There is more information for the people who live at the home about how to complain and how to stay safe. Staff have had more training. What the care home could do better Talk to other people who know the people who live there about important decisions. Think about how staff training affects the lives of the people who live at the home. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Carole McKay St Nicholas Building St Nicholas Street Newcastle upon Tyne NE1 1NB 0191 2333300 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 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 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 . Suitable information about the service will be available for people who are considering coming to live at the home. Introductions will usually be gradual and involve a full assessment of an individuals needs. Evidence: The home has information about the service it provides that is designed to be easily read. The home has one vacant place and the registered manager described how a possible future admission was being planned for. Records to do with this showed that the person, and their representatives, have been consulted and encouraged to make introductory visits to the home. The home has obtained information about the persons needs in advance of these visits, so that a full assessment can be carried out. Staff feel supported in their work from having clear, up to date information about service users needs. 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 who use the service are supported to make decisions and to direct their care in the way that they prefer. At times this may include taking managed risks. Evidence: People who live at the service each have an individual service user plan. These describe, in an individualised way, their care needs, preferences, lifestyle and the support they require to meet their personal goals. They are detailed and well organised documents. And they include pictures, photographs and symbols so that the people at the home can understand them and be part of making them. In surveys the staff confirmed that they have up to date information about how to support service users. This was one of a few comments on the matter: care plans are kept up to date on a very regular basis. And another - We are always receiving information about the people we care for. And- I am always kept up to date about the service users I support. Through this process the people who live at the service are supported to make decisions. Advocates are involved with the service and each person has a keyworker on the staff team. Keyworkers have special responsibilities for assisting the person they represent. During the visit the staff encouraged the people who live at the home to be involved in planning the day and to participate in the inspection. For example, one person was asked if he would like to show us his room and was supported to do so by the staff. The home has recently helped a service user to obtain a new special armchair. This decision was not shared with the funding authoritys representative or another third party involved in the care of the individual. It would be good practice to Evidence: do so. The service user plans include clear information about the potential risks to the people who live at the home And information about the way risks should be managed, so that people can maintain a maximum level of independence. 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 . Service users are supported to take part in a variety of leisure and community based activities, and as a result live an interesting and valued lifestyle. There is a positive effort made to include community groups in the lives of service users and vice versa. The food is wholesome, well presented and meets the dietary needs of people who live at the service. Evidence: The differing individual social needs of the people who live at the home are recognised. Each person has a weekly activity plan, that is flexible and responsive to changes in the weather or changes in preferences. But at the same time the plan offers social structure to peoples lives. People use local public transport and the home has a car. The terms of use for the car are clearly set out. The records show that people enjoy regular social outings, breaks and holidays. One person was able to enthusiastically tell us about this at the visit, with support from staff and by using a photograph album. Photographic records of social events are dotted around the home, as reminders and conversation points. The manager, staff and service users discussed an exciting gardening project that the home has developed over the past few years. The project is referred to as the Social Inclusion Gardening Network (SIGN) and has developed from the interest of one service user from another home requesting to use one of the allotments situated in the area of land that is owned by CIC and surrounds the bungalow. At the time much of Evidence: this land was overgrown but as a result of the home offering community activity to the Youth Offending Team much of the land has now been cultivated to provide four separate allotments that other community groups will use. Separate access to the allotments has been arranged to protect the privacy of the people who live at the service. And the manager reported that friendships have developed between the people who live at the home and some of the people who use the allotments. 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 . The people who live at the service will have their personal and health care needs met in a flexible but consistent manner. Medication is being managed safely. Evidence: The people who live at the home are supported to register with and attend local health-care practices in the community. Visits to the GP, dentists, opticians and other health professionals are recorded in individual care files, with the outcome of each visit. The people who live at the home are in good health and good spirits. Their physical and emotional needs are clearly recorded in individual care files and records show that positive relationships have been developed with health care professionals. The care plans are specific and detailed. They address such things as food intake, sight impairment, blood pressure checks and treatment for specific short term problems. Since the last inspection the staff have undertaken some specialist health related training. Both the people who live at the home require support with taking medication and the associated risks are clearly assessed. Action plans to manage identified risks are in place. In response to a recent random inspection of the service, following two errors in medication, the service has revised its medication procedures and staff have undertaken additional CIC training. The completed work books from this training are in the home. The records to do with administration of medication were up to date and clearly signed off with no unexplained omissions or errors. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Appropriate arrangements are in place that protect service users from abuse and seriously addresses complaints and concerns about the service. Evidence: Staff confirmed that they have received awareness training regarding abuse and adult protection, as well as training in relation to handling verbal and aggressive behaviour. Staff were able to appropriately describe what action to take in a situation where they witnessed abuse or an allegation of abuse was reported to them. A senior member of staff confirmed that staff have received training in relation to the local authoritys POVA (Protection of Vulnerable Adults) procedures, a copy of which is available within the home. Easy to read guidance has been provided for the people who live at the home to do with abuse and the procedures for making a complaint or raising a concern. These are available on audio tape also. Entries in the Complaints Book confirmed that complaints and concerns are taken seriously, recorded and satisfactorily addressed. There have been no complaints recorded since the last inspection. The complaints procedures are in picture format and all service users and staff were aware of whom to speak to if they were unhappy about something. 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 home is homely, comfortable, and clean and provides service users with adequate private and communal space in which to live. Evidence: The home is well maintained, clean and tidy reflecting effective cleaning routines. The individual tastes and personalities of the service users are demonstrated throughout the home with colours and small furnishings reflecting their preferences. A service user to the home was also delighted to show their newly decorated and refurbished room and confirmed that they had chosen the colour. Since the last inspection various improvements have been made to the premises. New windows and window blinds have been installed throughout. A new carpet has been laid in the main hall and corridor. A new dining suite has been purchased. And a large attractive fish tank has been purchased to replace a smaller one in the lounge. This is an eye catching point of interest. All service users confirmed that are consulted in any changes that are to take place in the home. The records of service users meetings confirmed this. The home accommodates service users in individual bedrooms with en-suite facilities as well as a lounge/dining room and a small conservatory, kitchen and bathrooms. Rails around the walls of the home allow for independent mobilising. Other adapted facilities are also available in bathrooms and toilets. These have been provided to meet the needs of individual people. 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 . Robust recruitment and selection procedures and regular training opportunities ensure that the people who live at the home are appropriately supported and protected by a competent and qualified staff team. Evidence: There was an adequate number of staff on duty to effectively address the needs of the people who use the service. In surveys staff confirmed that the staffing levels are good. The manager has a creative approach in relation to having an effective number of staff to support service users with their preferred activities. At the time of the inspection one social work trainee was an additional resource, available to support service users with their chosen activities. The manager and staff felt that the extra resources allowed more activity to take place and gave quality time to service users. This should be objectively monitored, in line with the national minimum standards for care homes for adults. This will ensure that the people who live at the service do not feel overwhelmed by the numbers of people in the home at any one time. There is a well-documented and appropriate training programme in the home that includes each member of staff. A training matrix identifies individual training needs and when mandatory training needs to be reviewed. Staff confirmed that they receive appropriate training to carry out their roles. One member of staff commented, These training days have increased my knowledge and have given me a better understanding of the service users I work with. This means that service users are constantly supported by well trained staff. Every new member of staff participates in an induction course and has to achieve elements within set timescales. The programme is comprehensive and shows how to support service users in an appropriate way. So that all staff understand issues Evidence: surrounding learning disabilities the staff have also carried out the LDAF (Learning Disabilities Award Framework) training award. Computer based learning has been introduced to affirm induction training. The manager said that she has not yet carried out an assessment of how staff training directly affects the outcomes for the people who live at the home. But staff have been enrolled onto a training course about equality and diversity, to take place in the near future. This may provide a useful opportunity to examine the impact that training has on the lives of the people who use the service. The company provide new members of staff with a filofax type folder that includes information about the home and explains training requirements and opportunities. Staff are employed via robust recruitment procedures. A sample of staff files demonstrated that the necessary documents were in place, for example an application form, two written references and a satisfactory CRB check. This ensures that the staff who apply to work at the home are suitable to work with vulnerable people. Two of the files examined included those of staff that had recently been employed. Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The manager, who is well supported by her senior staff and care staff teams, provides good leadership and runs a service that has effective monitoring systems that are focused on the best interests of the service users. Evidence: The manager of this service is a fully qualified registered manager. She has achieved the Registered Managers Award and NVQ4 in Care and states that she is up to date with mandatory training and attends training courses in relation to her role. Recent training includes issues relating to welfare benefits, learning skills to be a facilitator for challenging behaviours and knowledge and skills relating to supervision and appraisal. Both service users and staff confirmed that they felt valued by the manager and the Company and feel that their opinions matter.This has created an atmosphere of openness and respect, that reflects on the quality of care received by, and the quality of life experienced by service users. This service has a quality assurance system in place that monitors and records all aspects of the service delivered in the best interests of the service users. The Commission for Social Care Inspection CSCI, receives regular copies of the Annual Review from the Company. The fire records and accident book were examined and records were satisfactory. The health and safety files were examined. Health and Safety procedures are in place and routine safety and maintenance checks also. Risks that were highlighted at the last inspection have been considered and the manager is of the view that these are adequately managed through additional security measures. Evidence: Are there any outstanding requirements from the last inspection? Yes  No  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 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 Description 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 Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 7 Decisions that affect the well being of individual service users and involve managing finances or behaviour should be shared with other interested parties or specialist teams or individuals who also support the person. The manager should ensure that trainees make up less than 20 of the total care hours and there should be no more than one trainee on duty at a time. This is in line with the National Minimum Standards for Care Homes for Adults. The manager should carry out an assessment of training provided to staff to determine the impact this has on the outcomes for the people who live at the home. 2 33 3 35 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web:www.csci.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. - 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!