Care Home: Watermill House

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What the care home does well The manager completed and returned the AQAA to the CQC and ensures that incidents are reported as necessary.The AQAA recorded that the policies and procedures in the home are updated. There is a formal quality assurance system in place that seeks the views of the people who live in the home. We looked at the maintenance certificates held within the home these reflected that the electrical, and gas systems in the home had received maintenance checks and were safe. Records are kept of any accidents in the home and what to do if someone is harmed. The managers make sure that staff employed are safe to work with the people that live in the home and they are protected from harm. The staff are very caring and treat people with respect and dignity. Each person is seen as an individual, staff recognise their qualities, strengths and personalities, rather than focus on their complex behaviours. People are supported to keep in touch with their families and friends. Students and their families are given enough information that is easy to read so that they know what they will get from the home. New people are able to visit the home and where possible (dependent on individual need)stay overnight to help them to decide if the home is right for them or not. Relatives are very involved in the home and are made to feel welcome, making sure that family can keep in contact. People are helped to eat a healthy diet. Peoples medicines are looked after well and staff assist them to take their medicines safely. Everybody`s concerns are listened to and staff make sure they take action to sort problems out quickly. The staff and managers know that they need to make sure people are protected from harm and what to do if someone is harmed. The staff are very caring and treat people with respect and dignity. What the care home could do better: A regular plan of maintainance needs to be made available within the home with specific timescales, to ensure that the environment is maintained to a good standard despite the heavy wear and tear it is exposed to. The home needs to have access to a maintainance team at regular times throughout the year, a minimum of at least every three months. This will ensure that all redecoration and minor repairs are completed in a timely mannner.All work identified within the maintenance plan should be completed within three months to ensure that people living in the home are provided with a well maintained comfortable environment. Random inspection report Care homes for adults (18-65 years) Name: Address: Watermill House Common Road Wressle North Lincolnshire DN20 0DH three star excellent service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Wilma Crawford Date: 0 4 0 5 2 0 1 0 Information about the care home Name of care home: Address: Watermill House Common Road Wressle North Lincolnshire DN20 0DH 01652652147 F/P01652655766 helenh@roxbyhouse.co.uk www.optionsgroup.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Helen Elizabeth Horsewood Type of registration: Number of places registered: Conditions of registration: Category(ies) : Wider Options Ltd care home 10 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 10 The maximum number of service users who may be accommodated is: 10 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 categories: Learning Disability-Code LD Date of last inspection Brief description of the care home Watermill House provides accommodation for up to nine service users who have Autism Spectrum disorders and associated challenging behaviours. The accommodation includes extensive grounds for the service users to access and horses are stabled on the premises. The service users also access services available at Care Homes for Adults (18-65 years) Page 2 of 13 Brief description of the care home Watermills sister home Roxby House. Similar services are have been developed at Watermill. This includes therapeutic areas including a gym and a water spa. The current fees for the home can be obtained through the managment of the service. There are no other fees incurred by the people that live at the home. The fees include a weekly allowance to support individuas to budgetl service for food, personal hygiene needs and activities. Care Homes for Adults (18-65 years) Page 3 of 13 What we found: The random visit was completed on 4th May 2010 and lasted 5 hours. The service had not been informed in advance when the visit would take place. The home Manager was available for the duration of the visit. All of the people living in the home were spoken with in varying levels and five staff members. The main method of inspection used was called case tracking which involved selecting three people living in the home and tracking the care that they receive through the checking of their records, discussion with them where possible, the care staff and observation of care practices. The premises were looked at, the medication system and a sample of other documents required to be maintained by the home. We looked at the care files for three of the people living in the home. Each of the files contained information about individuals social, emotional, communication and details of how independence skills are developed and maintained. These may include things such as; activities, promoting independence, and travel. Care plans were found to be detailed and comprehensive and had been developed to cover all aspects of the individuals assessed needs. The people living in the home have additional complex needs, clear detailed information including risk assessments and behaviour management plans were also in place for staff to follow and support people effectively and safely. Care plans are regularly reviewed and updated on a minimum of a monthly basis, sooner if the need arises. Peoples care plans also contained information about their health needs and the support that they require to be able to maintain their needs. Care plans showed evidence of regular input from a range of professionals including G.Ps, Consultants, Dentists, Opticians, Epilepsy Liaison Nurses and District Nurses. The staffing levels are provided in line with individual need ranging from a level of one person to one staff member, to two staff to one individual. Staffing levels are regularly monitored and reviewed in line with individual need. Each person has their own key worker who works closely with people, supporting them and encouraging them to be involved in the development of their care plans. The home also has a range of facilities that people can use on site including a sports hall, snoezelen room, activity centre which is near to completion and a hydro pool. People can also use additional facilities at the sister home Roxby House and have mobility cars and other vehicles for use to access the local community. AALPS has educational options for AQAs which provide recognition of achievements in potentially any area of individual development and NVQs, within IT, rural studies, and craft, catering and hospitality courses. Watermill House provides an individual service to the people living there, to ensure that all their needs are met. All the individuals residents have Autism, learning difficulties, behaviour that challenges and a range of other complex needs. They also have difficulties Care Homes for Adults (18-65 years) Page 4 of 13 in communicating effectively so it is very difficult to ascertain their views, so staff have to work very closely with parents and families, social workers, health care professionals and previous placements who have a good knowledge of the individual. Each individual has a key worker and a Deputy Manager or Team Leader who is responsible for them. All the staff work with each of the people living in the home and they actively advocate the needs and possible views of the individual at a quarterly Person Centered Planning meeting to promote the individual. Careful observation and communication within the team ensures that knowledge is shared and maintained up to date. People living in the home, families and professionals are all involved in the Quality Assurance systems in place in the home. Results from surveys and any action plans developed to resolve or develop areas identified are shared, so people are aware of what action is to be taken and expected timescales. Recently three people have moved from Roxby House and the staff team have worked closely worked closely with their staff from Roxby to ensure that a smooth transition was made for these people, between the two servvices. Staff also work closely with parents to ensure that contact and access is supported and maintained. Each individual has a structured activity plan which is available in pictorial as well as written format. This is also based on individual assessments and preferences. Each individual is registered with local GPs, Dentist, and Optician. Staff support them to access these professionals. Records of such visits are recorded and documented within the care plan. Medication records and storage were looked at in the home; this was found to be stored in a locked cupboard within a locked room. Facilities are available on site to store and dispense controlled drugs appropriately. All medication was found to be appropriately stored and records well maintained. Records are kept of the signatures of staff who are authorised to administer medicines, this allows for a clear audit trail and photographs are in place to in the medication records for each person, to help ensure that errors do not occur. Staff spoken to confirmed that they had received training in the safe administration of medicines. There is a policy in place to support people should they wish to raise a concern with the home. A copy of this policy in an easy read version, is also available. We looked at the records of complaints received; these include the details of the actions taken and the outcome. People living in the home and staff also have a concerns form which they can use if they have any concerns or worries about practice etc they may wish to share. Copies of these were maintained with records of the action taken as a result of the concern being raised. People living in the home also have access to advocacy services. Care Homes for Adults (18-65 years) Page 5 of 13 A copy of the Local Authoritys policy, The Protection of Vulnerable Adults is available in the home alongside the organisational policy on how to support people with allegations of harm should they arise. When we spoke to members of staff they were clear on the actions that they would take should an allegation of harm occur and the manager told us at the visit and in the AQAA that staff have received training in this subject. We looked at the systems in place for supporting people to manage their money and the manager told us that this system has not altered since the last visit to the home. The majority of people have a court of protection order to manage their finances, or their family act as their representative. A tour of the building was completed and some of the accommodation was looked at. The home was clean, comfortable and odour free throughout. Peoples individual accommodation was personalised and maintained to a variable standards, some very good whilst others in need or total refurbishment (dependant on individuals needs). However there were areas where furnishings needed updating/replacement, carpets and flooring needed replacing and areas where there had been considerable wear and tear. When this was raised with the Manager she produced a document identifying that the home had been visited on 29th April and a list of work that she had identified to be carried out. Although individuals had been identified to carry out work, time scales were not in place. Progress with this was at different levels. The inspector contacted the facilities manager who agreed that the identified work would be completed within three months. New furnishings would be ordered later in the week and contractors had submitted quotes for work to be carried out. In addition to this an agreement was made that a maintenance team would be available every quarter to ensure that redecoration could be maintained to a good standard. Requirements were made in respect of the work being completed within three months. Work required to be undertaken included; fitting a doorbell, repainting of corridors walls and woodwork, cleaning or replacement of hydrotherapy pool and identified en suites, replacement of worktops in the kitchen, replacement of office carpet, replacement of hall way, replacement repair of damaged wall in hallway, removal of skip from log cabin garden, total refurbishment of identified individuals bedroom and redecoration of the main hall and stairs area to the four bedrooms of people living in the home. There have been difficulties in maintaining the environment, due to the high wear and tear presented by the people living in the home. Additionally contractors need to work flexibly for example during the night, so people are not upset by changes in routines or unfamiliar faces in their environment. General day to day maintenance and replacement of equipment is completed promptly. A small internal maintenance team maintains the environment, while contractors are brought in for more specialist work. A fobbed door locking system is used in the home to promote a safe living environment for the people living there. All staff are inducted via the LDQ framework and have specific Autism training that is regularly updated and refreshed. They all have job descriptions, trained in PRICE and are working towards NVQ qualifications. 62 of the staff team have an NVQ level 2 or above. Care Homes for Adults (18-65 years) Page 6 of 13 Staff are supervised regularly and have annual appraisals to monitor and develop performance. Records for staff seen were found to be complete. others examined were found to be complete. Staff personnel files are well maintained and regular checks completed to ensure that references are taken up and CRB checks are in place prior to commencement of employment. There is a 6 month probationary review for all staff, to look at their suitability to the job role and their performance within that role. All staff have individual training records, where the staff development department produce accurate training matrix and highlight shortfall/updates that are required. Staff are paid to attend training that is scheduled on their days off. Managers have just completed distance team Diversity Equality training. The introduction of the 5 day rolling programme has just come to the end of its first year and this has enabled staff to pick and book through out the year, when they want to do their five days of Mandatory training. It seems to have been very productive and feed back was staff liked that they could pick the days they wanted which fitted in well to their personal lives. The Registered Manager has completed the registered managers award and NVQ 4 in care. She also has completed a Certificate in Education, City and Guilds 7307 stage 1 and 2 and is up to date with all her mandatory training including First aid and moving and handling. Since the last inspection the manager of the home has also successfully completed a fit person interview with the Commission. The deputy manager of the home has completed NVQ 2 and 3 in care and NVQ 4 in management. She is also a qualified NVQ assessor. The standard for the management continues to be exceeded. Staff and professionals visitors to the home confirmed to the inspector that the manager has an open door policy and the external managers of the home were also accessible and were very approachable. Internal and external lines of accountability are clear and the management and staff that were interviewed were clear of their own and others responsibilities. Job descriptions and personal specifications were available on all of the care staffs personnel files that were seen by the inspector. This supported the evidence that they are provided with the correct information in relation to their employment and responsibilities at the home. The manager completed and returned the AQAA to the CQC and ensures that incidents are reported as necessary. The AQAA recorded that the policies and procedures in the home are updated. We looked at the maintenance certificates held within the home these reflected that the electrical, and gas systems in the home had received maintenance checks and were safe. Records are kept of any accidents in the home. What the care home does well: The manager completed and returned the AQAA to the CQC and ensures that incidents are reported as necessary. Care Homes for Adults (18-65 years) Page 7 of 13 The AQAA recorded that the policies and procedures in the home are updated. There is a formal quality assurance system in place that seeks the views of the people who live in the home. We looked at the maintenance certificates held within the home these reflected that the electrical, and gas systems in the home had received maintenance checks and were safe. Records are kept of any accidents in the home and what to do if someone is harmed. The managers make sure that staff employed are safe to work with the people that live in the home and they are protected from harm. The staff are very caring and treat people with respect and dignity. Each person is seen as an individual, staff recognise their qualities, strengths and personalities, rather than focus on their complex behaviours. People are supported to keep in touch with their families and friends. Students and their families are given enough information that is easy to read so that they know what they will get from the home. New people are able to visit the home and where possible (dependent on individual need)stay overnight to help them to decide if the home is right for them or not. Relatives are very involved in the home and are made to feel welcome, making sure that family can keep in contact. People are helped to eat a healthy diet. Peoples medicines are looked after well and staff assist them to take their medicines safely. Everybodys concerns are listened to and staff make sure they take action to sort problems out quickly. The staff and managers know that they need to make sure people are protected from harm and what to do if someone is harmed. The staff are very caring and treat people with respect and dignity. What they could do better: A regular plan of maintainance needs to be made available within the home with specific timescales, to ensure that the environment is maintained to a good standard despite the heavy wear and tear it is exposed to. The home needs to have access to a maintainance team at regular times throughout the year, a minimum of at least every three months. This will ensure that all redecoration and minor repairs are completed in a timely mannner. Care Homes for Adults (18-65 years) Page 8 of 13 All work identified within the maintenance plan should be completed within three months to ensure that people living in the home are provided with a well maintained comfortable environment. 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 2. Care Homes for Adults (18-65 years) Page 9 of 13 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 10 of 13 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, 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 1 24 23 23(2)b The Registered 19/08/2010 person must ensure that all equipment provided at the care home for use by service users or persons who work at the care home are maintained in good working order. People living in the home would benefit from a well maintained, comfortable environment. 2 24 23 Regulation23(2)b. the 19/08/2010 Registered person must ensure that the premises is kept in a good state of repair externally and internally. all areas identiied within the report must be repaired/refurbished.maintai ned People living in the home would benefit from a well maintained, comfortable environment. Care Homes for Adults (18-65 years) Page 11 of 13 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 24 The Registered person should consider how they can ensurethat maintainance is provided within the home on a regular basis in order to keep up with the required redecoration and refurbishment of the premises, in order that it is well maintained for the people living there. Care Homes for Adults (18-65 years) Page 12 of 13 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got 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 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial 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. 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