Care Home: Walby Hill, 4

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What the care home does well Good information is available.People can plan their care.Good health is promotedPeople can voice their opinions.People have a choice about their lifestyle.People are involved in community activityThe home is comfortable.The home has been adapted. What has improved since the last inspection? The assessments are better so people are kept well and safe.Staff have had more training. What the care home could do better: There are no recommendations or requirements. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Walby Hill, 4 4 Walby Hill Rothbury Morpeth Northumberland NE65 7NT The quality rating for this care home is: three star excellent 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: Carole McKay Date: 1 8 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to:  Put the people who use social care first  Improve services and stamp out bad practice  Be an expert voice on social care  Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 35 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 35 Information about the care home Name of care home: Address: Walby Hill, 4 4 Walby Hill Rothbury Morpeth Northumberland NE65 7NT 01669620737 01670518118 linda.arkle@oakleatrust.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : The Oaklea Trust care home 6 Number of places (if applicable): Under 65 Over 65 2 4 learning disability Additional conditions: Date of last inspection 1 4 0 6 2 0 0 7 A bit about the care home 4 Walby Hill is a care home providing personal care and accommodation to six people with a Care Homes for Adults (18-65 years) Page 4 of 35 learning disability. Currently four people, male and female, live in the home. They are aged between 59 and 82. There are two vacancies. For the purposes of this inspection the home has been assessed against the standards for younger adults. The home is located on the fringe of the village in close proximity to shops and other amenities. The home is domestic in style and warm and comfortable in character. Care Homes for Adults (18-65 years) Page 5 of 35 The weekly fees are £245 per week. No additional charges are made. The home has a copy of the last inspection report and other information about the home is available. Care Homes for Adults (18-65 years) Page 6 of 35 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 Care Homes for Adults (18-65 years) Page 7 of 35 How we did our inspection: This is what the inspector did when they were at the care home The Visit: Unannounced visits took place on 9th and 18th June 2009. During the visits we talked with people who live at the home, some of the staff and the manager. We looked at information about the people who use the service and how well their needs are met. Care Homes for Adults (18-65 years) Page 8 of 35 Checked what improvements had been made since the last visit. We told the manager what we had found. What the care home does well Good information is available. Care Homes for Adults (18-65 years) Page 9 of 35 People can plan their care. Good health is promoted Care Homes for Adults (18-65 years) Page 10 of 35 People can voice their opinions. People have a choice about their lifestyle. People are involved in community activity Care Homes for Adults (18-65 years) Page 11 of 35 The home is comfortable. Care Homes for Adults (18-65 years) Page 12 of 35 The home has been adapted. What has got better from the last inspection The assessments are better so people are kept well and safe. Staff have had more training. Care Homes for Adults (18-65 years) Page 13 of 35 What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Carole McKay CQC North East PO Box 1255 Newcastle upon Tyne NE99 5AS TEL 030000 61 61 61 FAX 030000 61 61 71 Care Homes for Adults (18-65 years) Page 14 of 35 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 15 of 35 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and health care 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 16 of 35 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Service users are provided with clear and accessible information about the service and are fully involved in contributing to the assessment of their needs. Evidence: The Oaklea Trust has a comprehensive customer guide. The Trust has employed a customer co coordinator who has produced information about the service in varied, easy to read and easy to access materials. The guide covers the service description, its aims and objectives, staff team and contacts as well as clear admission criteria and a description of the caring process. No new long term admissions have been made to the home since the last inspection. The home has two vacancies. The Trust has also introduced a new comprehensive Customer Plan called My Life, My choices. This includes a full assessment of needs and a series of tools to assess and manage risk. The assessment process is comprehensive and covers all aspects of care, including some specialised risk assessment tools for good health. Through use of pictures and symbols the service users have been involved in producing personal futures plans that Care Homes for Adults (18-65 years) Page 17 of 35 Evidence: include their individual wishes and preferences. Care Homes for Adults (18-65 years) Page 18 of 35 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 service continues to support service users independence as their needs change. And it respects their choices and decisions by anticipating risks and managing these well. Evidence: Each person has a highly individualised service user plan. These take account of all aspects of need in each persons life, including their choices and preferences. These plans are drawn together with the involvement of each service user. They are produced in a format that makes the files accessible to each person. They are well organised and clear to follow. The ability of each service user to make decisions and to give consent is clearly described and supported in the plans. Some of the people who live at the service (the service users ) are becoming more physically dependent to varying degrees. And this is due to the aging process, rather than disability. The service recognises this in the way it assesses risk, at the same time as supporting the continued independence of each individual. Choices are respected. For example, each person is supported to take an annual holiday of their choice. Care Homes for Adults (18-65 years) Page 19 of 35 Evidence: The service users are involved in local community groups, such as the music society, the Church and the over 60s group. One service user likes to be involved in the running of the home and takes an active part in preparing meals. All service users are encouraged to participate in this and each has a planned day for doing so each week. Care Homes for Adults (18-65 years) Page 20 of 35 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 . Service user are involved in the decisions about their lives and play an active role in planning the care and support they need. Evidence: Each service user has an identified key worker on the staff team. They meet with their key worker once per month and an activity plan for the month is agreed. This meeting is an opportunity to identify new or changing decisions and wishes. House meetings take place and again these are an opportunity for service users to discuss things that affect the home and to contribute to decisions. For example the minutes of the meeting for May 2009 show that improvements to the garden were discussed and general plans for holidays. One service user was formally thanked at the meeting for their recent contribution to jobs around the house. The manager reported in the minutes that an advocacy group was going to be established. Care Homes for Adults (18-65 years) Page 21 of 35 Evidence: The service user plans show that care is provided in a person centred way. This includes supporting independence through risk assessment. And enabling service users to contribute to the plan by using pictures or photographs. One person had been supported to write part of the plan. Sections of the service user plans are entirely to do with lifestyle choices and identifying the support networks people have. All of the service users are past retirement age and their activity plans and choices reflect this. Some service users are members of the local Over 60s club. One person enjoys an annual holiday with the club. The service users are familiar with other local organisations, shops, cafes and churches. Regular contact is encouraged with friends and family members. Service users are supported to enjoy continued hobbies and pastimes and are also encouraged to take up new ones. There is evidence in the home that two service users are part of a local photography group. One person knits. Another person likes to use headphones to listen to music in the lounge without disturbing other people. There are opportunities for service users to take part in an arts and craft group. Some of the things that have been made in the group are displayed on the wall in the dining room. The home has a computer and it is installed with programmes that are suited to the abilities and interests of the service users. Menus are planned weekly by the service users with support from staff. A picture board showing staff on duty and the menu of the day is on display in the kitchen. A meal was not observed at this inspection. Since the last inspection the home introduced an assessment of service users nutritional needs. This led to more specific planning of meals for one of the service users. Care Homes for Adults (18-65 years) Page 22 of 35 Personal and health care support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The service users receive safe and effective personal and health care taking full account of their wishes and individual needs. Evidence: Service users are supported to attend to regular health checks, with their GP, dentist, optician and chiropodist. The outcomes and observations are very clearly recorded in each persons service user plan. Follow up appointments are properly followed through with service users and these things are also fully recorded. Some service users have needed additional support from other health professionals, such as speech and language therapists. Other people have needed to attend medical consultant clinics for exploratory examinations. These people have been fully supported in this and their on going health care has been very carefully recorded. A very positive survey was returned from a visiting health professional who included the comment- I am always impressed by the dignity and autonomy that is given to the people they care for. In their surveys the staff from the home responded that they are given up to date Care Homes for Adults (18-65 years) Page 23 of 35 Evidence: information about the needs of the people they care for and indicated that service users are involved in planning care:- As carers we take a pro-active role in developing customer care-plans and planning their daily lives together with the customers. The service user plans examined at the visit included the preferences of the service users. For example it was noted whether people preferred a bath or a shower and the time of day was indicated. Staff have undertaken training in age related health matters such as dementia. The service holds some medications on behalf of service users for safekeeping. The storage arrangements are safe and the records of administration are clear, up to date and complete. The records are individualised by the inclusion of a photograph of the service user and additional information about the reasons that medication has been prescribed. The staff have received training in the safe handling of medication. The manager assesses the competence of staff to continue with this responsibility. Care Homes for Adults (18-65 years) Page 24 of 35 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The policies procedures and quality of communication with service users all address service users concerns and keep them safe. Evidence: The service has written policies and procedures for receiving and investigating complaints. Copies of the complaints procedures are available to people in an easy read format. There is additional information, also in easy read, about how the service will respond to concerns. To help reinforce the openness of the service to receiving comments, information is made available to service users representatives by way of letter. One staff takes the lead in keeping representatives up to date and inviting comment. Also the monthly service user meetings have a standing agenda item for suggestions for improvement. The service users do raise concerns from time to time. These are recorded and the action taken is documented. The manager views concerns from service users as positive opportunities to acknowledge the rights of individuals and to make improvements to people’s lives. No complaints have been made to the service by other agencies. The Care Quality Commission has not received any complaints about the service. The home has written procedures for safeguarding vulnerable adults. These include what it is that staff are expected to do should they suspect a vulnerable adult is being abused. Care Homes for Adults (18-65 years) Page 25 of 35 Evidence: To supplement this information, the home has a copy of the Department of Health guidance, No Secrets, and a copy of the local authority procedures for safeguarding vulnerable adults. No safeguarding issues have occurred. Staff files show that all staff have received training in safeguarding within the last two years. The correct checks are taken up for new staff to make sure that service users are safe from people who should not be employed in care services. And for longer serving staff there are arrangements to update some of these checks. Since the last inspection staff have received training in The Mental Capacity Act and there is further training planned for this to be updated. This training will take account of new procedures for protecting the liberty of service users Care Homes for Adults (18-65 years) Page 26 of 35 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 building is a safe and comfortable home for the people who live there. Where it has posed restrictions these have been overcome by adaptation. Evidence: Routine maintenance and safety checks are carried out and recorded. The home does not employ domestic staff. The care staff follow written cleaning schedules to good effect. The home is clean and hygienic throughout Access at the rear of the home has been adapted to provide for a service user who needs to use a wheelchair when out of the home. The home is not ideally suited to the needs of people who are, or may become physically frail, as it has only one ground floor bedroom and no lift. This has been taken into account in the statement of purpose/aims and objectives review. And it provides people who are considering living at Walby Hill with clear information to help them make a decision. However all service users have their own room and these are spacious. There is a toilet and shower on the ground floor. On going decoration and replacement ensures that the home is attractive and comfortable. Cleaning schedules are followed by the care staff. These are pinned up in Care Homes for Adults (18-65 years) Page 27 of 35 Evidence: the kitchen and daily duties are also posted up in picture format so that service users who are involved in helping around the house can see precisely which tasks they can take part in. Part of the home was being cleaned during one of the visits. The furnishings are domestic in style and character. This all makes for a very comfortable home The wall near to the back door is damaged by damp and this needs to be repaired. The staff said that this matter had been reported for attention. Care Homes for Adults (18-65 years) Page 28 of 35 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 home provides and maintains a team of staff that can safely and competently meet the stated purpose of the home and the needs of the service users. Evidence: In surveys staff reported that they receive good induction training. And further training helps them keep up to date with new ways of working. The additional training is related to the needs of the service users, and examples were given: Equality and Diversity, Bereavement, Death and Dying, Autism. Staff are supported to undertake National Vocational Qualifications in care (NVQ) and all staff are qualified to at least level 2. The manager has a training schedule for updates in training in essential subjects, such as Health and Safety and First Aid and the staff files each hold a development plan for each person. In surveys staff confirmed that they receive regular one-to-one supervision with their manager and annual appraisal of performance. Recruitment of new staff is largely co ordinated by the Oaklea Trust Human Resources Department, but the file for the new staff showed that the proper checks and introductory training take place in a planned and comprehensive manner. The manager described these as sound. Care Homes for Adults (18-65 years) Page 29 of 35 Evidence: Staff turnover is low and so is staff sickness. There are arrangements in place to support staff returning from long term sick leave so that they are re introduced to the work place gradually. The manager said that additional supervision will also be offered in these circumstances. Staff cover is such that it can be flexibly used to provide cover at times to suit the needs of the service users. Two staff would be on duty through the day, as a minimum, with one staff sleeping over at night. On call arrangements are in place, though these are informal local arrangements. Care Homes for Adults (18-65 years) Page 30 of 35 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The competency of the manager and the internal quality assurance processes together ensure the well being of the service users. Evidence: The manager, Linda Arkle has been in post for most of the time the home has been open and has worked for three different providers. Linda has the registered managers’ award and has had additional training. Linda has formed productive relationships with the service users, the staff and service user representatives. In surveys staff said that they are supported and the manager was described as “excellent. The way the home is run shows an understanding of people’s needs in respect of age, gender, religion and disability. This is demonstrated by the way each person’s lifestyle choices are supported. There is strong evidence that the ethos of the home is open and transparent. Service users are supported to manage their money. All transactions are clearly accounted for in records. The manager is not acting as appointee, except in one Care Homes for Adults (18-65 years) Page 31 of 35 Evidence: circumstance where no other person is available. Legal processes are in place to protect service users interests where this is needed. Because the house does not have an office the small sitting room is used to store records and also as a staff sleep in room. Records are securely stored when not in use. But it can be difficult for the staff to access records, and at the same time respect the rights of the people who use the service. There is no designated space for meetings to be held in private and sometimes the dining room has to be used for this. The Oaklea Trust also has a process for auditing the quality of care and monitoring this on a monthly basis. The service uses the monthly meetings with the service users as an opportunity to support people to voice their views about the way the service is run. These meetings are given an agenda and are fully recorded. Staff are accountable for follow up action to points raised. The Trust expects the manager to produce a continuous improvement plan based on self assessment. An overall business plan is also devised The home has several house maintenance records files and processes. The upkeep of these is in parts delegated to individual staff. These records were examined and they were found to be up to date. Routine checks and safety instructions are being maintained to do with fire, water temperatures, food safety, electrical appliances, installations and gas installations. General maintenance checks are also made and there is a procedure for reporting faults. Training in Health and Safety is mandatory for staff. The home has had an emergency contingency plan in place for several years. Since the last inspection, due to the threat of flooding, the home had to be evacuated and the contingency plan was followed. CQC was notified of this and Linda reported that it worked well. Care Homes for Adults (18-65 years) Page 32 of 35 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 33 of 35 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 34 of 35 Helpline: Telephone: 03000 616161 or Textphone : or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 35 of 35 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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