Care Home: Victoria House

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What the care home does well MacIntyre Care, which owns and runs the home, has policies and procedures on the steps to be taken to help people move into the home. This includes ensuring the staff at the home have the skills necessary to meet people`s assessed needs. The essential lifestyle plans we saw during our visit showed that the care needs of the people living in the home have been assessed and that plans are in place to meet these needs. The people living in the home who we spoke with during the inspection said they, and staff from the home, put the plans together to make sure they get all the support they need in the way they prefer. Each person who lives at the home has a programme of regular weekly activities so they can carry on with their preferred lifestyles and staff help them to keep in touch with their families. On the day of our visit, the people living in the home were seen returning from various community based activities including day centres, shopping and college courses. We could see that staff are aware of the needs of each person who lives in the home and provide the level of support each person needs, such as help with personal care and making drinks, so they can live as independently as possible. People who live in the home are supported to make sure their healthcare needs are met so they stay well and healthy. This includes visits to their GP and outpatients appointments at hospital. Staff have received training on the administration of medication to the people living in the home so they can make sure people living in the home receive their medicines safely as prescribed. Copies of the complaints procedure are given to the people living in the home so they know what to do if they have any concerns. They told us they would speak to the staff and the manager if they had any concerns or worries. There is a safeguarding adults procedure in place at the home to make sure that the people living there are protected from abuse and harm. There are thorough recruitment procedures for staff to make sure they are suitable to work with the people who live at the home. They also have an induction programme and receive training on a range of areas that will help ensure they have the skills to care for the people living in the home. What has improved since the last inspection? Since our last inspection the weekly activity programmes for each of the people living in the home has been improved to make sure they have regular opportunities to go out into the community. Their essential lifestyle plans have been improved with the people living in the home more involved in developing the plans. MacIntyre Care has developed its recruitment procedures so that the people who live in the home are actively involved in appointing the staff who provide support for them.The complaints procedure for the people living in the home has been improved by providing a `Say Something` book so people can record their concerns. What the care home could do better: The staffing rota should be reviewed and monitored to make sure there are enough staff on duty to meet people`s needs at those times when all the people who live at Victoria House are at home. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Victoria House 63 Victoria Road Chester Cheshire CH2 2AX     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: Val Flannery     Date: 0 4 1 2 2 0 0 8 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. the things that people have said are important to them: They reflect 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 29 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.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Victoria House 63 Victoria Road Chester Cheshire CH2 2AX 01244382897 01244381773 will.parker@macintyrecharity.org Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr William Parker Type of registration: Number of places registered: MacIntyre Care care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: This home is registered for a maximum of 8 service users in the category LD (Learning disability) Date of last inspection Brief description of the care home Victoria House is a large two-storey detached building with a passenger lift to the first floor. The home supports six adults with a learning disability. Located in Chester the home is within walking distance of the city centre and other local amenities. All the people living in the home are physically able and can move about the home without mobility aids. The bedrooms are single; five of them are on the second floor of the main building. An adjacent building has been adapted to provide a self-contained flat for one of the people living in the home. Two of the bedrooms have en-suite toilet and bathing facilities. The home provides a communal bathroom and toilet on the ground floor and two toilets, a bathroom and shower on the second floor. Staff are on duty twenty-four hours a day to support the people living in the home. 6 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 29 Care Homes for Adults (18-65 years) Page 5 of 29 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: The overall quality rating for this service is 2 stars. This means the people who use the service experience good quality outcomes. This visit took place on the 2 and 4 December 2008 and took seven hours. It was carried out by one inspector. The report will refer throughout to we, as it is written on behalf of the Commission for Social Care Inspection. During the visit we spoke with the people living in the home, the manager and staff. We looked around the premises, joined people for a drink and looked at various records held by the home. Care Homes for Adults (18-65 years) Page 6 of 29 The visit was just one part of the inspection. Before the visit the home manager was asked to complete a questionnaire to provide up to date information about the home. CSCI questionnaires were made available to the people living in the home and staff so they could tell us what they think of the home. There were five people living in the home on the day of our visit. The last inspection of this service was completed on the 8 November 2006. What the care home does well: What has improved since the last inspection? Since our last inspection the weekly activity programmes for each of the people living in the home has been improved to make sure they have regular opportunities to go out into the community. Their essential lifestyle plans have been improved with the people living in the home more involved in developing the plans. MacIntyre Care has developed its recruitment procedures so that the people who live in the home are actively involved in appointing the staff who provide support for them. Care Homes for Adults (18-65 years) Page 8 of 29 The complaints procedure for the people living in the home has been improved by providing a Say Something book so people can record their concerns. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 29 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 10 of 29 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. People who are interested in moving into the home have their needs assessed to make sure the staff at the home can meet those needs. Evidence: The people currently living in the home have lived there for over two years. We saw a copy of the placement agreement for the home in the Essential Lifestyle Plan of one of the people living in the home. MacIntyre Care, which owns and runs the home, has comprehensive policies and procedures that include carrying out assessments of the needs of people who wish to live in the home, before they move in. Staff we spoke with during the inspection said meetings are being held between the manager, senior staff from MacIntyre Care and and healthcare and social care professionals. The purpose of the meetings is to plan a process for a person with complex needs to move in to the home. They told us that as part of the planning to ensure they have the capacity at the home to meet this persons needs, all staff have to undergo specialist training to make sure they have the knowledge and skills required. Care Homes for Adults (18-65 years) Page 11 of 29 Care Homes for Adults (18-65 years) Page 12 of 29 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. People who live in the home are involved in the planning of their care to make sure they are supported to make their own decisions and have control over their lives Evidence: We looked at the Essential Lifestyle Plans of two of the people living in the home. They were able to access their plans and talk about what was in them. They both said they know what is in their files, as staff ask them about things. Both files contained a lot of information about the person, their care needs and how they are to be met, their families, their daily routines and activities. One of people we spoke with told us they have made a decision, with support and assistance from staff, to move into independent living. The plans of care we saw show that meetings and consultations involving the person, their family, social services and staff from the home have been on going for some considerable time to plan this. The outcome of these meetings is that the person is to move to more independent living in the near future. Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: On the day of our visit, we saw people who live in the home returning from unescorted trips to the town, making drinks and performing a range of tasks independently. The records we saw showed risk assessments have been carried out to ensure that people are safe from unacceptable levels of risk when they are in the home and in the local community. Care Homes for Adults (18-65 years) Page 14 of 29 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The wishes of the people living in the home are recorded in their plans of care so that staff are aware of the level of support they require with daily living. Evidence: We looked at the Essential lifestyle plans (care plans) were seen for two of the people living in the home. These showed that the people who live in the home are supported to take part in a wide range of activities, in the home and in the local community. This included attendance at community based day centres, college courses, working as volunteers at charity shops, shopping, visiting local places places of interest and using local shops, pubs, restaurants and churches. Staff have helped the people who live in the home to make a pictorial plan to show what support they need and how they would prefer it to be provided. They told us about holidays they have been on and ones planned for the future. Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: The people living in the home who we spoke with during the visit were talking about Christmas shopping and where they were going to spend Christmas Day. They also said they regularly see members of their families and their friends. This can be in the home or visiting them with support from staff as needed. People living in the home told us staff help them but they also like to do things for themselves. We could see during our visit that support staff were aware of the the abilities of the people who live in the home. They were seen encouraging people to make drinks, help prepare the evening meal and make decisions about their daily routines. People told us they can choose what they have to eat. We saw one person choosing an alternative to the food offered for the evening meal. Care Homes for Adults (18-65 years) Page 16 of 29 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. Peoples choices on how they have their personal and healthcare needs met are recorded in their plans of care so that staff can ensure that the wishes of the people who live in the home are respected. Evidence: During our visit we saw staff providing support to the people who live in the home. This included help with using the telephone, making a drink, sorting out personal money and helping one of the people with their clothing. It was evident that staff were aware of the level of assistance needed by each of the people living there and the help was offered in a discreet and caring manner. Two of the people we spoke with said they usually do things for themselves and only ask staff for help if they cannot manage. They also said staff are very good and help them be independent. The two essential lifestyle plans we saw showed the level of help needed by each person with daily living routines such as personal care, using local shops and other services and managing their finances. The plans also included detailed information on the healthcare needs of the people Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: living in the home and how these needs were to be met. They showed that people are supported to keep doctors appointments and attend hospital outpatients appointments to make sure they get the treatment and advice they need to stay healthy. People living in the home told us staff take them to the doctors when they are poorly. One of the essential lifestyle plans we saw showed that the person is being monitored, as they are on a specific course of medication, to make sure this is effective. During the inspection staff were seen comforting a person who was feeling unwell and also giving them their prescribed medicines. We saw that correct procedures for administering medication were followed, including recording in the medication record book. MacIntyre Care has policies and procedures on the administration of medication to provide guidance for staff so they can make sure medicines are given safely as prescribed. We saw records that showed staff have access to training on medication awareness to make sure they are always up to date with correct guidance for the safe administration of medicines. Care Homes for Adults (18-65 years) Page 18 of 29 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. There is a clear complaints process so that people who live in the home know their concerns will be listened to and staff have received training so they know what to do to protect people living in the home from abuse. Evidence: We spoke with people during our visit about the complaints procedure for the home. They told us they would talk to the manager and staff if they had any worries or complaints. A copy of the complaints procedure was on display in the home and included details on how to contact the Commission for Social Care Inspection so people would know how to get in touch with us if they needed to. We looked at the complaints record kept at the home. One complaint had been made and had been dealt with satisfactorily. Two people who live in the home that we spoke with told us that staff listen to them and take action about any thing that may bother them. MacIntyre Care has a policy and procedure on safeguarding adults that includes the No Secrets guidance. One referral has been made to social services from the home in the twelve months before our visit and this was dealt with effectively to make sure that people living in the home were being safeguarded. We saw records that showed that all staff, including the manager, had received updated training on safeguarding adults during 2008. This is to make sure that they know what to do if they think people living in the home are being abused. Care Homes for Adults (18-65 years) Page 19 of 29 Care Homes for Adults (18-65 years) Page 20 of 29 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. The location and lay out of the home is suitable for the people who live there so they are able to maintain their Independence and contact with the local community. Evidence: On the day of our visit, the home was clean, tidy, well maintained and free from bad odours. The people living in the home all have single bedrooms, two of which have ensuite facilities. Bathing and toilet facilities are provided on both floors of the home. There is a large communal lounge, separate dining area and smaller relaxation area on the ground floor. There are gardens at the back and front of the home that the people who live there can use. We saw people who live in the home moving freely between their bedrooms and the communal areas and kitchen. The home is in keeping with the local neighbourhood and is close to Chester city centre and local facilities like pubs and churches. People who live in the home said they like living there, having their own rooms and being able to choose their own furniture and decor. One person was seen using their key to get into their bedroom. Staff training records showed that staff have received training on food hygiene and infection control so they know how to prepare and store food safely as well as being Care Homes for Adults (18-65 years) Page 21 of 29 Evidence: able to make sure that levels of hygiene are maintained. Care Homes for Adults (18-65 years) Page 22 of 29 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. The people living in the home take part in the process of recruiting new staff so they can have a say in who will be providing their support. Evidence: Two of the staff we spoke with during our visit confirmed that people who live in the home had been on the interview panel for recruiting new staff so they could have a say in who was appointed to work at the home. This is part of MacIntyre Cares inclusive recruitment procedure designed to make sure that people who use their services have a say in who is employed to provide their support. Staff told us that when they went through the recruitment process they had completed criminal record bureau checks, an application form for the job and provided two references. These checks are to make sure that the staff are suitable to work with the people who live at the home. We saw records that showed staff have received training including first aid, moving and handling, food hygiene, fire awareness training, safeguarding adults, and medication awareness. 50 of the staff have achieved an NVQ Level 2 or above. Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: Staff recruitment information is kept in the home as agreed between us, the commission, and MacIntyre Care, so that it is available to check that thorough recruitment procedures have been followed to make sure that the people who live in the home are protected from possible harm or poor practice. Two of the people who live in the home told us staff help them with, for example, shopping, going on holiday, preparing meals, doing the things they want to do. We saw people who live in the home approaching staff for guidance and help, including help with personal care. Staff responded in a sensitive and caring manner. It was evident that they were aware of the individual needs of the people living in the home. We spoke with the manager and staff about the current staff rota being used at the home and how there is normally only one person on duty at different times during the day. There are six staff working at the home, including the manager, and we were told this can cause difficulties in providing two members of staff on duty to meet peoples needs at those times when all the people living at Victoria House are at home. On the day of our visit there was one support staff on duty from 5 pm until 7am the following morning to care for the people living in the main building. A carer from an agency was supporting the person living in the flat. Care Homes for Adults (18-65 years) Page 24 of 29 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 home is well managed and the views of the people who live there are taken into account to make sure that it is run in their best interests. Evidence: The registered manager for the home worked for the organisation for over ten years in a senior capacity. He has nationally recognised management qualifications and the training records we saw showed that he had undertaken relevant additional training such as on safeguarding adults, moving and handling, medication awareness and first aid. The staff we spoke with during our visit said the home is well managed and the people who live thre are consulted about how it should be run. People living in the home told us they liked living there, they liked the staff and they were satisfied with the quality of support they received. MacIntyre Care has policies and procedures on maintaining health and safety in the home. This provides staff with up to date guidance on safe working practices so they can make sure that the people living in the home are not at risk. Regular health and Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: safety checks are carried out to make sure people living and working in the home are safe. For example, regular checks are carried out on the fire detection system including weekly tests, fire drills and a fire risk assessment for the home. The information about the home and the way it is run that the manager sent us before our visit identified that the people who live at Victoria House are asked to complete questionnaires about the quality of service offered, so they can have a say in how the home is run. Care Homes for Adults (18-65 years) Page 26 of 29 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 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 33 The number of staff on duty at times when all the people who live at Victoria House are at home should be reviewed to make sure that all their needs can be met at these times. Care Homes for Adults (18-65 years) Page 28 of 29 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). 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