Care Home: Waverley

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What the care home does well The home is in Mablethorpe and people can walk to the shops to do their own shopping and to the seaside.All the people we spoke with said they liked living there; one said it was a lovely place and another said ‘I love it here and I do lots of things’. Staff help people make plans for their holidays.There are regular meetings for the people where they can have a say in how the home is run.The staff know all about the people living at the home and how they like to be cared for. Staff talk to them about what they would like to do.The manager and senior staff work well as a team and have good training to help them look after people well.People are encouraged to make choices about what they want to do and how they wish to lead their lives.People sent us letters to tell us how well they thought the staff and the manager ran the home. One said ‘This has been my home for the last 9 years and I am very happy to be a part of it`. What has improved since the last inspection? Everyone now has a personal care plan. The manager talks with the day centre staff to ensure that everyone has up to date information about people. What the care home could do better: We could not find any serious concerns during our visit. It was recommended that a pharmacist visits to check that medication is safely stored and administered. Key inspection report Care homes for adults (18-65 years) Name: Address: Waverley 164 High Street Mablethorpe Lincs LN12 1EJ The quality rating for this care home is: two star good 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: Julie Western Date: 0 3 0 2 2 0 1 0 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. The first part of the review gives the overall quality rating for the care home:  3 stars – excellent  2 stars – good  1 star – adequate  0 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. 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 Care Homes for Adults (18-65 years) Page 2 of 26 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) Copyright © (2010) 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 Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Waverley 164 High Street Mablethorpe Lincs LN12 1EJ 01507473071 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) : waverley.res-home@virgin.net Mrs Sara Georgina Gibson care home 13 Number of places (if applicable): Under 65 Over 65 12 1 learning disability Additional conditions: Date of last inspection A bit about the care home The house is in Mablethorpe and is near to the shops and seaside. Care Homes for Adults (18-65 years) Page 4 of 26 13 people can live at Waverley. Everybody has their own room. The home has a car to take people to the day care centres and on trips out. The staff at the home help people make choices and do things they like doing. Fees are £411 weekly and other information is available from the manager. Care Homes for Adults (18-65 years) Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 26 How we did our inspection: This is what the inspector did when they were at the care home The quality rating for this service is two star. This means the people who use this service experience good quality outcomes. The Inspector talked to the people who live at the home. The Inspector saw some care plans and talked to the people and the staff about them. The Inspector also looked at some of the policies in the office. Policies are rules about how to do things. Care Homes for Adults (18-65 years) Page 7 of 26 What the care home does well The home is in Mablethorpe and people can walk to the shops to do their own shopping and to the seaside. All the people we spoke with said they liked living there; one said it was a lovely place and another said ‘I love it here and I do lots of things’. Staff help people make plans for their holidays. Care Homes for Adults (18-65 years) Page 8 of 26 There are regular meetings for the people where they can have a say in how the home is run. The staff know all about the people living at the home and how they like to be cared for. Staff talk to them about what they would like to do. The manager and senior staff work well as a team and have good training to help them look after people well. People are encouraged to make choices about what they want to do and how they wish to lead their lives. Care Homes for Adults (18-65 years) Page 9 of 26 People sent us letters to tell us how well they thought the staff and the manager ran the home. One said ‘This has been my home for the last 9 years and I am very happy to be a part of it. What has got better from the last inspection What the care home could do better We could not find any serious concerns during our visit. It was recommended that a pharmacist visits to check that medication is safely stored and administered. Care Homes for Adults (18-65 years) Page 10 of 26 If you want to read the full report of our inspection please ask the person in charge of the care home. gh If you want to speak to the inspector please contact Julie Western CPC1 Capital Park Fulbourn Cambridge Cambridgeshire CB21 5XE 01223771300 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 11 of 26 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 12 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from a thorough assessment and can be assured that their needs will be met. Evidence: We saw the statement of purpose and the service user guide. These were both clear, up to date and contained plenty of information about the home and what it can provide for people. The manager said he or a senior carer usually visited people in their own homes or in a care setting to make an initial assessment. The introduction to the home was over as long a period of time as it took until the person felt happy to stay permanently. People we spoke with said they had been able to choose the home and had visited before deciding to stay. All the people we spoke with said they had liked the home because it had a friendly feel to it and one compared it with a large family. Another said that everything they had wanted to happen when they first came to Waverley is happening. Care Homes for Adults (18-65 years) Page 13 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Detailed care plans help people to develop their independence, whilst risks are minimised. They are consulted about their daily lives, and supported in an individualised and respectful way. Evidence: We saw care plans for three people. They were very detailed and included needs such as communication, self-care and health care. The plans showed likes and dislikes and how people made their own choices or decisions. We saw risk management plans covering needs such as mental state, kitchen access, vulnerability and travel, although there was not an in depth assessment of mental capacity. Restrictions to choice or freedom were in place where there was a high risk to health or safety. Records we saw showed that care plans and risk assessments were reviewed every month, and at yearly intervals. Review records showed that relevant people were consulted about, and agreed to care plans. Surveys said that people had a good quality of life at the home. They also said that people are helped to maintain and develop their independence. Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: Staff we spoke with showed that they had a very clear understanding of the needs of each person. They were seen offering choices in whatever way the individual could understand, for example using objects of reference, pictures, gestures or verbally. They also responded to people in a respectful way, and offered gentle reassurances where necessary. Care Homes for Adults (18-65 years) Page 15 of 26 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. People benefit from a wide range of social and educational opportunities, which help them to develop their skills and live a fulfilling life. Evidence: People living in the home range from 34 to 74 years of age. Activities provided in the home were optional for all residents. Individual daily programmes, including evenings and weekends, clearly show leisure, educational and home management activity. Activities such as meal preparation, walks, art, paper rounds, music sessions, community based sports sessions, social clubs and meals out are offered. People said they liked to do things such as going horse riding, shopping and to the cinema. On the day of the inspection, two people were at a local heavy horse centre and five were at day centres in the area. Another five were on holiday in Blackpool with carers, paid for by the service. A variety of games and puzzles was available in the home. There were DVDs in bedrooms. Personal effects, photographs, individual records and surveys showed that people were supported to maintain their relationships with families and friends. Many Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: people had friends and relatives in the area who visited the home on a regular basis. One person we spoke with visited his family for weekends. Five people did voluntary work in charity shops and with the Salvation Army and another had a part time job as assistant in a shop in Louth. Records we saw showed that people were encouraged to prepare their own meals with assistance from carers. Several people said that they often went shopping for the meals they were going to eat. People said that they enjoyed their meals, and they said what their favourite foods were. These preferences were reflected in the menus, and the foods were always available in the home. Care Homes for Adults (18-65 years) Page 17 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good arrangements to make sure that the health needs of people are met, and they are protected by the medication policies and procedures. Evidence: We saw medical information about the health needs of each person, and this information linked with what people told us about the help they received. Records we saw showed when people had seen health professionals such as a GP, dentist or optician and they show that things such as weight were monitored. People have an allocated key worker so that they have a consistent support network. Staff we spoke with showed us that they knew the health needs of people very well. They also made sure that any personal support was provided in a private and dignified way, and they respected decisions about things like what time people got up in the morning. Records show that staff received training in how to administer medications in a safe way. There were no records of a pharmacist having visited recently and the manager said he would arrange for a visit immediately. Care Homes for Adults (18-65 years) Page 18 of 26 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. People are protected by clear procedures for handling complaints and allegations of abuse, and by the knowledge of staff who are well trained. Evidence: Since the last inspection there have been no safeguarding complaints about the home. Records we saw showed that there was one complaint made to the home concerning the behaviour of a resident and this was managed appropriately. There were policies and procedures for safeguarding people and these linked to the Local Authority policy. Staff we spoke with demonstrated a good knowledge of what abuse is and how to protect people. Records show that they received training in this subject. Any restrictions to choice or freedom were referred to in care plans. People we spoke with said they had no complaints but would go to the manager or their social worker if they did. Care Homes for Adults (18-65 years) Page 19 of 26 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. People enjoy a clean, comfortable and homely environment, which is well maintained. Evidence: We saw that internally and externally the home was well maintained. Bedrooms and communal areas we saw were decorated to a high standard and homely. One of the bathrooms showed signs of wear. The carpet in the ground floor corridor had a large bleach stain. People we spoke with said the home was friendly and homely and they liked living there. They were all involved in cleaning their own rooms and had keys to their rooms. The kitchens were inspected by an environmental health officer who awarded 3 stars, an excellent rating, for hygiene. Care Homes for Adults (18-65 years) Page 20 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A well-trained and supported staff team ensures that people are cared for safely. Evidence: The staff rota we saw showed that in addition to the manager, a senior carer and a carer were on duty for six people. Other carers were on holiday with five residents. We looked at records for three staff members. The recruitment records included criminal record bureau checks, application forms and two written references. They also contained identification and interview records. Records showed that residents were involved in the interviews for new staff. Staff said that they receive training in subjects such as fire safety, moving and handling, and medication administration. Training records we saw showed that other training included the Mental Capacity Act. We saw records showing that five staff members have the National Vocational Qualification, a nationally recognised qualification, at level 2 and 2 have level 3. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed, which means that people receive a good standard of care and support. The systems within the home protect their health, safety and welfare needs. Evidence: The owner is also the registered manager. She is a qualified social worker and has many years experience of working with adults with learning disabilities. An unregistered manager with appropriate qualifications including the registered managers award, is responsible for the day to day running of the home and the owner visits on a weekly basis. Staff said that they have good management support, with regular staff meetings, and minutes show that there are discussions about subjects such as student support issues, training, and health and safety. Returned surveys from staff were positive and staff said they could not think of a way the home could be better run. Quality monitoring arrangements include questionnaires given to all residents and families. They are also given to stakeholders such as staff working at the day centres attended by people. The results are discussed with the owner and residents and acted upon. Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: People we spoke with said they had a say in the running of the home and could make suggestions to improve their lives which were always listened to. We saw that things like accident and incident records are audited regularly. Records we saw showed that people had their own bank accounts and pocket money was managed by their main carers, known as key workers. Care Homes for Adults (18-65 years) Page 23 of 26 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 24 of 26 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 1 20 The home should receive regular visits from a pharmacist to ensure that medicines are kept and administered safely. Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 03000 616161 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 © (2010) 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. 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