Care Home: Victoria House Residential Home

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What the care home does well Each person who lives at the home has had their needs assessed to make sure the home can give them the care and support they need. All of the people have care plans which give information to staff about how to support them and meet their needs. Care is planned with the people in a way that they prefer and in a sensitive manner. The staff team at the home recognise the differing needs of the people who live there and make sure that they are aware of each person`s preferences. They treat the people as individuals and support them to live the life they choose as much as possible, so they will have new experiences and know that their opinions are valued. People who live at the home experience a variety of activities. This gives them choice, as well as building their self-esteem and confidence. The staff team make sure that the home is clean, warm and adequately furnished so the people who live at the home have a comfortable place to live. Staff support the people to use local services so they are part of the community. The staff make sure the people`s health care needs are met so they remain in good health. All of the people who live at the home have plans of care and risk assessments. This is so staff have the information they need to support each person and keep them safe. The home has procedures for staff and service users for the administration and recording of medication, which is adhered to. This is to make sure the people who live at the home receive their medication when they need it and at the correct times. The home has procedures for dealing with complaints and protecting the people who live there from abuse. This means that the people who live at the home feel safe, know they can talk to the staff and that their views are listened to. What has improved since the last inspection? The provider has continued to make lots of improvements to the environment; several areas throughout the home have been completely refurbished, these include several bedrooms, one of the two kitchens, and a new call alarm system has been installed. What the care home could do better: No requirements or recommendations were identified. Key inspection report Care homes for adults (18-65 years) Name: Address: Victoria House Residential Home Victoria House 30 - 31 Victoria Embankment Darlington Durham DL1 5JR     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Jim Lamb     Date: 1 2 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 28 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Victoria House Residential Home Victoria House 30 - 31 Victoria Embankment Darlington Durham DL1 5JR 01325244960 01325244961 amandaatkins@castlebeck.com www.castlebeck.com Castlebeck Care (Teesdale) Limited Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Amanda Atkins Type of registration: Number of places registered: care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 6 The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Learning disability Code LD, maximum number of places: 6 Date of last inspection Brief description of the care home Victoria House is owned by Castlebeck Care (Teesdale Limited) Group. The home is registered to provide residential accommodation for six people with a learning disability. From the outside the home looks like two terraced houses but inside alterations have Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 6 Brief description of the care home taken place that connect the two houses so that they are as one home. Victoria House is located in a residential area that is within walking distance of the town centre and all local transport links. The home has it?s own transport which can be used for social outings. Inside the house there are six single bedrooms, each bedroom has a wash hand basin. There are also two lounges, two kitchen diners, three toilets, one shower and one bathroom and a staff bedroom. Outside there are small paved gardens to the front of the house and a yard area at the back of the house. The fees for the home do not include hairdressing, chiropody and some social activities and personal items. A full list of current charges can be obtained from the manager. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The quality rating for this service is 3 stars. This means that the people who use the service experience excellent quality outcomes. How the inspection was carried out. Before the visit we looked at information we have received since the last visit, how the service dealt with any complaints and concerns since the last visit, any changes to how the home is run, the providers view of how well they care for people, and the views of Care Homes for Adults (18-65 years) Page 6 of 28 people who use the service, staff and other professionals. During the visit we talked with people who use the service, staff, and the manager, looked at information about the people who use the service and how well their needs are met, looked at other records which must be kept, checked that staff had the knowledge, skills and training to meet the needs of the people they care for, looked around the building/parts of the building to make sure it was clean, safe and comfortable, and checked what improvements had been made since the last visit. We told the manager/provider what we found. Care Homes for Adults (18-65 years) Page 7 of 28 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. Care Homes for Adults (18-65 years) Page 8 of 28 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 9 of 28 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 28 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. Service users are provided with enough information about the home prior to admission, and their needs are fully assessed. This ensures that the home can meet the persons needs appropriately. Evidence: The home has a Statement of Purpose and Service Users Guide that gives clear information about the service. These include good details of the accommodation for the people who have moved here. There is comprehensive assessment process that includes the input of the prospective service user, their relatives, social worker, care manager and, where appropriate, psychology, and psychiatry services. This ensures that the needs of each prospective service user are fully assessed before a decision is made about whether the service can meet their individual needs. The pre-assessment information in the home gives very clear details of service users specific needs. Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: All the people who live here have contracts that outline their rights and responsibilities whilst living here. These are kept in their care files which they can access, with support if necessary. The contracts also include details of the individual fees for each service user and their contribution. Care Homes for Adults (18-65 years) Page 12 of 28 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. The care planning system is clear enough to ensure that staff have the information they need to meet the assessed needs of the service users. Evidence: Each persons assessed needs are met in an appropriate range of systems. All have clear and detailed care plans. Other assessed needs are met using appropriate formats. For example, the nutritional needs of individuals, their monthly weight is recorded, and their specific health needs. The care/goal plans are looked at closely in regularly monthly reviews, and they are updated as necessary. All plans are person centred and holistic in content. The staff on duty are always given up to date information about the service users and their current needs. The service users said that they make decisions about what they do each day, and that they can do what they want to do during the day, evenings and at weekends. Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: The people living in the home have a wide range of opportunities for choice. These include meals and cooking, activities, trips out, what to wear, and toiletries. Holidays are negotiated individually with each person, and they can choose where to go, when, and who with. The interactions between staff and the people who live in the home were observed to be based on mutual respect and affection. Risk assessments are carried out, and staff ensure that service users understand there content. Assessments seen were comprehensive and appropriately detailed. They are reviewed regularly and updated as necessary. The homes policy is to accept that risk is part of the normal experience of daily living, and is properly managed. Care Homes for Adults (18-65 years) Page 14 of 28 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. The service users are offered a good quality lifestyle, which includes varied social contact and activities. Evidence: There is a relaxed, informal and friendly atmosphere in the home. Routines are flexible and allow the people living at the home to make decisions about everyday things such as when to rise and retire to bed. Care plans and conversation with service users showed how people are encouraged and supported to be as independent as possible, subject to their individual plan and risk assessments. Meals are served at set times although there is a great deal of flexibility to suit individual needs and wishes. Records of food served show a varied and balanced diet is provided with alternatives always being available. People living in the home said the food is very good. Service users are always consulted about menus, they help with the Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: weekly food shopping, and also help to prepare meals. People living in the home are encouraged and supported to lead meaningful and stimulating lives and are offered a range of activities: bingo. board games, film nights, handicrafts, gardening, trips out e.g. shopping and visits to local places of interests. Each person enjoys two holidays annually, one of these is financed by the organisation, this is good practice. All are supported to maintain contact with their relatives and friends. Some service users have home leave with their relatives. The views of people living in the home are sought on a daily basis through informal conversation and at regular service users meetings, during which people are consulted about the general running of the home, and suggestions for improvements are sought. Service users told the inspector they are happy living here, and a friendly and homely atmosphere was very apparent during the inspection. Two made many very positive comments about the staff and said they were always helpful and kind. Care Homes for Adults (18-65 years) Page 16 of 28 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Detailed health care records are in place, and service users receive regular health care checks. Evidence: People using the service are given sensitive personal support by the staff to promote each individuals independence, dignity, privacy and choice. Each person has an individual assessment of his or her personal needs, and has a care/goal plan in place to meet those needs. Plans are person-centred, sensitive and thoughtful. They stress the strengths of the individual, and are positive in terms of seeking to develop the skills and abilities of the person. Privacy is given a high priority. Plans are reviewed every month, and amended as necessary, to reflect the progress made by the individual. Each person has his or her own Personal Health Information file. This contains professional health assessments, correspondence, records of contacts with health professionals. It demonstrated that all aspects of a persons physical and mental health are taken seriously and are properly met. Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: Medicines practices are good, all service users are supported to self administer their own medication. There are policies and procedures in place to minimise any risk of a medication error. The Medication Administration Records (MAR) was checked. This was found to completed properly, with no gaps. Staff do a daily audit of the prescribed and non-prescribed (homely medicines) medications. Medicines are safely stored. All staff have had training on how to use the medication system. They have also had external Safe Handling of Medicines training. Care Homes for Adults (18-65 years) Page 18 of 28 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. The complaints management is good, and always addressed effectively, resulting in service users being adequately safeguarded. Evidence: Appropriate procedures are in place for dealing with concerns/complaints. Since the last inspection visit there have been no complaints received. There was evidence that staff receive regular safegaurding training. Each service user has a copy of the complaints procedures. Care Homes for Adults (18-65 years) Page 19 of 28 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 home provides a safe, very comfortable, and well-maintained environment for service users to live. Evidence: The premises maintain a very pleasant and homely atmosphere. All parts of the building seen were very clean and suitably equipped. The communal areas have been decorated with attractive wallpaper, chosen by the service users. and this makes these areas appear more homely and attractive. There is an ongoing programme of decoration and refurbishment and several bedrooms have been refurbished to a high standard. One of the two kitchens has also been refurbished to a high standard. A new call alarm system has also been installed. The rear courtyard provides an attractive outside space, and is used regularly by service users. A number of service users spoke positively about their bedrooms and the accommodation in general. All bedrooms are highly personalised and furnished to a very good standard. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: Overall, this is a very attractive, homely environment that provides a very comfortable and safe place for service users. The home has policies and procedures on hygiene and control of infection. Staff receive infection control training. There is suitable hand washing facilities throughout the building. Arrangements are in place to dispose of clinical waste. Care Homes for Adults (18-65 years) Page 21 of 28 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. There is enough staff employed to meet the needs of service users and safeguard their welfare. All are properly recruited and trained to enable them to meet the holistic needs of the service users. Evidence: The staff confirmed that there are enough staff on duty across the day to meet the holistic needs of the service users. There are 3 support staff during the day, 1 night staff, with 1 person sleeping in. The personnel records of two staff were examined. Both had completed application forms, the dates of employment were clear, making it easy to follow a clear employment audit trail. The manager also completes an audit check list and this ensures that all the necessary checks have been completed prior to commencing employment. All had the required two work references, (crb) criminal record bureau check, documentary evidence of identity, induction and training and development information. Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: The organisation employs a training and development officer, and all staff have an annual training matrix drawn up, this covers all mandatory training needs, and other core training needs, such as control of infection and Adult Protection. Individual staff members have his or her individual training needs analysis on their personal file. These have recently been revised to cover developmental as well as mandatory and core training. The staff have undertaken mental capacity and deprivation of liberty training. All staff have achieved NVQ level 2/3, and this has been linked to the learning disability framework. Care Homes for Adults (18-65 years) Page 23 of 28 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 is supported by the organisation in providing good leadership throughout the home, with staff demonstrating an awareness of their roles and responsibilities. Evidence: The manager is very experienced and has the Registered Managers Award at National Vocational Qualification (NVQ) level 4. She confirmed that all staff are regularly supervised (bimonthly) and have an annual appraisal. Good accounting procedures are followed, with receipts and signatures being obtained for all financial transactions involving service users personal monies, such as pocket monies, clear individual accounts and records are maintained. Service users have ready access to their money, even at short notice. It was confirmed that there are good health and safety policies and practices that promote the health, safety and welfare of service users and staff. All relevant staff members do refresher training in Health and Safety, such as moving and handling, fire safety and food hygiene. This Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: helps reinforce the registered providers written policies on Health and Safety. Health and Safety issues are also discussed at staff meetings. Service users and staff expressed satisfaction with the way the home was run and the good standards that were evident in many instances. Service users said they enjoyed living at the home and believed the home was safe and run in their best interests. The manager said she will routinely invite comments and suggestions for improvements from both service users and visitors to the home, via regular meetings, surveys and consultations. An annual develpoment plan was seen to be completed. Care Homes for Adults (18-65 years) Page 25 of 28 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 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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