Care Home: Vulcan Square

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What the care home does well The home continues to effectively ensure that the people who use this service are supported appropriately in all aspects of their day-to-day living. This includes providing the necessary support to enable each person to be a part of the wider community and to have aspirations, expectations and goals. This includes encouraging and supporting the people who use the service to maintain family relationships / friendships and develop social and life skills. The ethos of the home is clearly aimed at working with people in a way that acknowledges and respects their rights as human beings. The home benefits from having a committed staff team who are clear about the purpose and function of the service and their responsibility to maximise the life opportunities of the people who live here. What has improved since the last inspection? Care plans, risk assessments and responses to personal needs have all been improved upon. The physical environment of the home is much improved as too is the internal and external management arrangements. What the care home could do better: Vulcan SquareDS0000010308.V378168.R01.S.doc Version 5.3 No requirements or recommendations have arisen as a result of this inspection. This is a positive development as the home has had a period of historical difficulty and work has clearly been carried out to change that situation and to put things on a more stable footing. Key inspection report CARE HOME ADULTS 18-65 Vulcan Square 32-33 Vulcan Square Westferry Road Isle Of Dogs London E14 3RJ Lead Inspector James Pitts Key Unannounced Inspection 29th October and 5th November 2009 12:20 Vulcan Square DS0000010308.V378168.R01.S.doc Version 5.3 Page 1 This report is a review of the 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. 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 home adults 18-65 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. Vulcan Square DS0000010308.V378168.R01.S.doc Version 5.3 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) 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. www.cqc.org.uk Internet address Vulcan Square DS0000010308.V378168.R01.S.doc Version 5.3 Page 3 SERVICE INFORMATION Name of service Vulcan Square Address 32-33 Vulcan Square Westferry Road Isle Of Dogs London E14 3RJ 020 7537 0411 020 7987 3917 h3053@mencap.org.uk www.mencap.org.uk Royal Mencap Society Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Orland Clarke Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Vulcan Square DS0000010308.V378168.R01.S.doc Version 5.3 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd July 2008 Brief Description of the Service: Vulcan Square comprises two adjoining houses set in a small square of similar residential properties. Each house has lounge, kitchen diner and a ground floor wc and hand basin. On the first floor there are three service users bedrooms in each house and a small box room that accommodates the staff sleepover room in one house and the staff office in the other. The two houses have the same layout and are connected by a shared garden. Three female service users reside in one house and three male service users in the other. The buildings are owned and maintained by East Living. The home is staffed and managed by Mencap. The home is set in the heart of Docklands on the Isle of Dogs. There are local shops and amenities nearby. Behind the development there is access to the River Thames. Vulcan Square DS0000010308.V378168.R01.S.doc Version 5.3 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means people who use this service experience good quality outcomes. This visit took place during the daytime, over the course of two visits and most of the people who use the service were at home at different points. Almost all of the people who live at Vulcan Square are able to hold conversations and verbally express their views. Two of these people spoke about what they usually did during the day and one person kindly gave us a tour of their home. Staff were also observed interacting with everyone appropriately. Conversations were held with the manager, staff on duty, and records were also examined. All of the people who live here have been sent questionnaires by the Commission. Although none had been received at the time of this inspection we will consider any comments that may be made at a later date. What the service does well: What has improved since the last inspection? What they could do better: Vulcan Square DS0000010308.V378168.R01.S.doc Version 5.3 Page 6 No requirements or recommendations have arisen as a result of this inspection. This is a positive development as the home has had a period of historical difficulty and work has clearly been carried out to change that situation and to put things on a more stable footing. 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. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Vulcan Square DS0000010308.V378168.R01.S.doc Version 5.3 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Vulcan Square DS0000010308.V378168.R01.S.doc Version 5.3 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 1 & 2 were assessed at this inspection. The people who use this service and others are told what the home does and how it will do it. The service user guide is written in a clear way so that everyone can understand it. The people who use the service can feel confident that the home will only care for people that the staff are trained and able to care for. EVIDENCE: A Statement of Purpose and Service Users Guide have been developed, which include information about the aims and values of the service, the facilities available, how privacy and dignity will be maintained, how to make a complaint and details of the registered persons. The manager told us that one person had been admitted to the home since the previous key standards inspection. We looked at this person’s care plan file and found that a good initial assessment was completed prior to the decision being taken about whether a service could be offered. This is an improvement on what was found at the previous inspection. Vulcan Square DS0000010308.V378168.R01.S.doc Version 5.3 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 6, 7, 9 & 10 were assessed at this inspection. The people who use this service can feel confident that staff know what they need. They can also be assured that the staff will make sure that each person who lives at the home is allowed to live the sort of life that they can meaningfully choose to. EVIDENCE: We looked at the care plans for three of the people who use the service and found that they continue to address a range of health, social and personal care needs. For each person there was evidence of the home including life story Vulcan Square DS0000010308.V378168.R01.S.doc Version 5.3 Page 10 work in the plans. These plans were also person centred. It was noted at the previous inspection that challenging behaviours that had been exhibited increasingly for one person had not been evidenced. It is noted that clear guidelines and procedures for staff response in these circumstances has now been developed and is being implemented appropriately. Discussion with people who use the service, with the manager and with staff evidenced that each person has their own bank account. All receive support in managing their finances, and with their agreement monies are held in the staff office and withdrawn as required. Each service user has an individual locked box that contains their money. A separate log detailing the date and nature of any withdrawal or deposit is recorded and signed by staff. We looked at the risk assessments for all of the people who use the service. At the previous inspection it was noted that whilst some risk assessments relating to the care plan were available, some gaps were identified. This is not now the case and risk assessments have been improved upon and are currently being updated at appropriate intervals. The previous inspection noted that the relocation of a PC and staff mail slots to the service user’s lounge raised issues of confidentiality. The issues of how confidential information that might be displayed on screen in a public area, or put in an unattended staff mail slot, would be protected have now been resolved with clearer staff guidance on confidentiality. Vulcan Square DS0000010308.V378168.R01.S.doc Version 5.3 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): This is what people staying in this care home experience: People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 11, 12, 13, 14, 15, 16 & 17 were assessed at this inspection. The people who use this service can continue to feel confident that the staff of the home will provide opportunities for everyone to develop their personal and social skills. This includes active support for each person to participate in the community both in terms of the activities of daily life and leisure interests. The opportunity for each to develop and maintain personal and family relations continues to be encouraged and is actively supported by the staff team. EVIDENCE: The people who come to live here stay for a very long time, although sometimes people might move somewhere else if they want or need to, Vulcan Square DS0000010308.V378168.R01.S.doc Version 5.3 Page 12 although this would rarely happen. Each of the people who live here is supported by the staff to be as independent as possible and to make as many choices as they knowingly can. The staff continue to be very good at helping each person to learn new things and to obtain new skills. All of the people who live here goes to day centres, college class’s community projects or work experience placements. The staff at the home still keep everyone up to date with what is going on in the community. There is a car that people can use to go out but the home is very close to bus stops and Docklands light rail. The staff team continues to encourage the people who live here to keep in contact with their families and friends, even when the may live overseas. Family and Friends are made very welcome when they visit the home and many go to visit their families, often staying for weekends. There are not many rules at this home. The most important one is that no one is allowed to smoke in the house. All of the people who live here are allowed to use the entire house, except other people’s bedrooms or the office if a meeting is happening. Each of the people who live at this home is allowed to make choices about what they want to eat. The staff continue to be good at making sure that healthy food is always on offer. There is a rolling five week menu plan that service users choose and better recording of alternative meals taken is now in place. Vulcan Square DS0000010308.V378168.R01.S.doc Version 5.3 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 18, 19 & 20 were assessed at this inspection. The people who use this service can continue to feel confident that they will get the right support to take care of their personal and healthcare needs. Anyone who needs to take medicine regularly to help them stay well will get the proper support from staff to make sure that this happens. EVIDENCE: The staff that were on duty during this inspection showed that they are very aware of what each person needs and they are sensitive about how they should meet those needs. None of those who live here requires specialist technical aids or equipment to help them to be independent. Individual care plans tell the staff in great detail the way that each person wants to be physically cared for and supported, this also includes details of personal preferences. Vulcan Square DS0000010308.V378168.R01.S.doc Version 5.3 Page 14 All of the people who live here usually go to see a local GP if they are not feeling well. They can see any local GP but most see the same one that they all know well. The staff are still very good at writing down anything that happens if anyone becomes unwell. If anyone has an illness or something else is wrong with them then the staff do know what this is and how to help them to get the treatment that they need. Some of the people who live here need to take medicine every day and the staff are very good at making sure that this happens so that they can stay well. The staff are also good at making sure that no one can get hold of any medicine that they should not have and so they keep medicines locked away in a cabinet that each person has in their own bedroom. Each person also has a health action plan that outlines any current healthcare needs as well as a range of standard annual health checks. Vulcan Square DS0000010308.V378168.R01.S.doc Version 5.3 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 22 & 23 were assessed at this inspection. The people who use this service can continue to feel confident that the staff team at the home know what to do if there are complaints or concerns about abuse. The home has clear guidance for staff about the procedures to be followed in either of these circumstances. EVIDENCE: The people who live here, and others, are given clear information about how to complain and what happens when they make a complaint. The Mencap complaints and safeguarding police and protocol are is use. Two complaints have been made since the previous key standards inspection and each was resolved satisfactorily. There is also clear written information for staff about what to do if they think that anyone who lives here is being hurt or abused by another person, or if an allegation is made. One concern had been reported earlier this year. This matter was subsequently resolved. Vulcan Square DS0000010308.V378168.R01.S.doc Version 5.3 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 24 & 30 were assessed at this inspection. The people who use this service can continue to feel confident that they are living in a well maintained, clean and pleasant home. EVIDENCE: The home is located in two four-bedroom houses in a residential location in Tower Hamlets. One house accommodates male residents, and the other female. The houses have a shared rear garden and staff and service users move between the two houses using patio doors onto the garden from each lounge. Vulcan Square DS0000010308.V378168.R01.S.doc Version 5.3 Page 17 The houses are similarly laid out with lounge dining areas and separate kitchens. Each house has a ground floor WC and access to the first floor and all bedrooms is via a staircase. In the women’s house the fourth bedroom is used as an office and in men’s house this room is used as a staff sleep in room. The houses are well maintained, and are comfortable and homely. Pictures of people who use the service decorate the communal areas, and each is able to personalise their own bedrooms with pictures and other items. One person kindly gave us a guided tour of their home and a few people showed us their bedroom. Each had been supported to personalise their room so that it reflected their personalities and important life events. Several minor repairs identified at the previous inspection and these have now been attended to. The previous inspection noted that the open areas underneath the stairs were being used for storage of some bulky items including flat pack furniture boxes and unused office materials, which was unsightly. This does not now occur. An odour problem was also identified at that inspection and this too has now been resolved. Vulcan Square DS0000010308.V378168.R01.S.doc Version 5.3 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 32, 34, 35 & 36 were assessed at this inspection. The people who use this service can feel confident that the home carries out the proper pre-employment background checks on new staff and trains and supports staff to do their job properly. EVIDENCE: The home keeps records that say what training courses staff have done, and when they did them. Staff attend regular training updates, and just over 50 are qualified at NVQ level 2 or higher. The manager stated that other staff are to commence this qualification over the coming months. The registered provider continues to carry out the necessary background checks on staff, and all of these checks were verified at this inspection. These checks include things like asking the Criminal Records Bureaux if a new member of staff has ever been found guilty of a crime or is unsuitable to work Vulcan Square DS0000010308.V378168.R01.S.doc Version 5.3 Page 19 with vulnerable adults, and asking people who used to employ them if their work was good and if they are the right sort of person to work with the people who use this service and to support them. We looked at the supervision records for two members of staff and the supervision matrix for the whole team (this outlines the dates that supervision meetings have taken place). These evidenced that all were receiving at least six one to one supervisions sessions each year, and some even more than this as the service aims for a monthly staff supervision programme. Vulcan Square DS0000010308.V378168.R01.S.doc Version 5.3 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Standards 37, 39 & 42 were assessed at this inspection. The people who use this service can feel confident that they are living in a home that has good internal management. EVIDENCE: A new manager was appointed to the home in March 2008. They have since successfully achieved their registration with the Commission. The manager told us that they had commenced their NVQ level 4 studies but have to change to a Vulcan Square DS0000010308.V378168.R01.S.doc Version 5.3 Page 21 new course provider and will be applying again shortly. This person does, however, already hold the certificate in social care and a HNC in caring studies. Monthly performance monitoring visits to the home (known as a Regulation 26 visit) are occurring but there was a gap noted in March 2009. The registered provider is reminded that these must be carried out each month, although this will not attract a requirement on this occasion it will do if failure is identified again. The standard of regulation 26 visit procedures and reports does show that the proper areas are being considered. The home is good at making sure that the people who live and work here are kept safe from fire and other hazards. Fire alarms are now sounded regularly and there are periodic fire drills. All of the necessary health and safety checks have been completed in the last year and all are currently within the necessary date of completion, whether this be annual or more frequently. Vulcan Square DS0000010308.V378168.R01.S.doc Version 5.3 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 x Version 5.3 Page 23 Vulcan Square DS0000010308.V378168.R01.S.doc No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Vulcan Square DS0000010308.V378168.R01.S.doc Version 5.3 Page 24 Care Quality Commission Care Quality Commission Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: 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. 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