Care Home: Wellroyd House

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What the care home does well The needs of people living in the home are appropriately assessed to make sure the service is able to meet them. People using the service are supported to be as independent as possible and involved well in decisions about their lives. The health and personal care of people using the service are met by staff who have been trained to make sure they can do their jobs and that they respect their dignity and protect them from harm. The concerns of people using the service are taken seriously by staff who have are properly recruited to make sure they are safe to work with them. Management systems are in place to make sure the health, safety and welfare of people living in the home is effectively promoted and protected. What has improved since the last inspection? A manager has been appointed make sure the home is effectively run and more staff provided to make sure there are enough of them available to meet the needs of people using the service. A lot of work has been carried out to improve the environment and make the home more comfortable. More training had been provided to make sure staff can do their jobs. What the care home could do better: The use of picture boards should be considered to help people using the services make decisions and choices about things and more epilepsy training should be provided to help staff to meet their needs better. Key inspection report Care homes for adults (18-65 years) Name: Address: Wellroyd House Roils Head Road Highroad Well Halifax West Yorkshire HX2 0LH     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: Rob Padwick     Date: 2 0 0 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 22 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) 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 Care Homes for Adults (18-65 years) Page 3 of 22 Information about the care home Name of care home: Address: Wellroyd House Roils Head Road Highroad Well Halifax West Yorkshire HX2 0LH 01422350109 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: lmacdonald@bridgewoodtrust.co.uk Bridgewood Trust Limited care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Wellroyd House is in the Highroad Well area of Halifax, about four miles outside the town centre. The home is on a bus route to the town centre. The home is owned and managed by the Bridgewood Trust since August 2006. The Trust is an organisation that specialises in providing a service for people with learning disabilities in the Calderdale and Kirklees areas. Wellroyd House is registered to provide accommodation for 12 people, both men and women, although the occupants have always been men. There is a large comfortable lounge and a second lounge with adjoining dining room on the ground floor, where the main kitchen and laundry are also located. Bedrooms are at ground and first floor levels. All of the bedrooms are single. Care Homes for Adults (18-65 years) Page 4 of 22 Over 65 1 11 Brief description of the care home The manager told us at the time of our visit the current weekly charge for living at the home is £ 456.95. this includes accommodation and all meals. People living at the home buy their own personal toiletries. Information about the home and the facilities is included in the Service User Guide, which is available on request from Wellroyd House. Care Homes for Adults (18-65 years) Page 5 of 22 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 peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. CSCI has reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. This inspection report is based on information received by us since its last key inspection, which took place on 2nd March 2007 and includes information gathered during a site visit to the home. As part of the inspection process, we send out a self assessment document that the Registered Person must complete and return to us. This helps us know how well the home is meeting regulations and national minimum Care Homes for Adults (18-65 years) Page 6 of 22 standards and what has been done to improve it and what still needs to be done. The self assessment was completed by the new manager for the service and information from this used as part of the inspection process. Other information used, included feedback from people living in the home and their relatives together with official notifications sent to us by the home. This information helps us to reach judgments about the service provided. The site visit took place on 20th February2009 and lasted for 5.5 hours. The provider was not told in advance when it would take place. The manager was available throughout the period of our site visit, and as well as speaking to him, we talked staff who were on duty and people living in the home. We looked round the building, including the bedrooms and shared areas of the home and we inspected the records of peoples care, staff files, health and safety documents and other records kept by the service. Although this report reflects findings of the Commission for Social Care Inspection, for reasons beyond it has been produced on a template for the Care Quality Commission. As from 1 April 2009 the duties of CSCI has been taken over by the Care Quality Commission, the new independent regulator of all health and adult social care in England. For more information please visit the Care Quality Commissions website at www.cqc.org.uk Care Homes for Adults (18-65 years) Page 7 of 22 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. 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 8 of 22 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 9 of 22 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. The needs of people living in the home are appropriately assessed to ensure it is able to meet them and information is available to help those thinking about using the service to make a decision about it. Evidence: Information was available in the services statement of purpose and service users guide to help those thinking about moving into the home to make an informed decision about it. The manager told us nobody had moved into the home since the last time we visited and the casefiles of those inspected contained Local Authority information about their assessed needs to help the manager make a decision about whether the service was appropriate for them. People living in the home told us they liked living in the home and were happy with the service they received and this was confirmed by visiting relatives we spoke to. Care Homes for Adults (18-65 years) Page 10 of 22 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. Staff support people living in the home to be as independent as possible and involve them well in decisions to ensure their wishes and feelings are met. Evidence: People living in the home told us they were able to make choices about their lives and staff were observed sensitively encouraging them to be as independent as possible and helping them take responsibility for making sensible decisions. The case files belonging to people using the service contained support plans developed from their individual assessments of need that detailed a range of their personal, health and emotional issues, together with good information on how they liked their support to be provided. The support plans were highly individualised with pictures and words, to help those living in the home understand them and there was good evidence of involvement with them and that they and their representatives participated in decisions and regular reviews of these to ensure they continue to be in agreement with them. Details about the management of risks to people living in the home were contained in the case files inspected together with information for staff on how to Care Homes for Adults (18-65 years) Page 11 of 22 Evidence: support them to lead as ordinary a life as possible. Since the last time we visited the staff team had been further developed with more training on person centred approaches to meeting needs and British Sign Language to assist them in working with people with communication difficulties. Care Homes for Adults (18-65 years) Page 12 of 22 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. People living in the home are appropriately supported to make choices and have a variety of opportunities to develop their lives. Evidence: Routines were observed to be flexible in nature to enable people using the service to have opportunities to pursue their own personal interests and have maximum choices about these. At the time of our visit, some people using the service were out attending college or on work placements, whilst others were observed listening to music and talking to staff and another was out with a relative who was visiting. Some of the people living in the home have more complex abilities and whilst we were told opportunities for them are rather more limited, we saw evidence staff worked hard to ensure they took part in appropriate leisure and and social activities. The case files and activity records showed evidence of key worker involvment with trips out to various leisure facilities, including swimming and dance classes, the local cinema and Care Homes for Adults (18-65 years) Page 13 of 22 Evidence: the library. The home works closely with the families of people using the service and we were told they are welcomed to visit and be involved in the life of the home. We observed staff supporting people using the service to take social responsibility for themselves with encouragement provided for light domestic tasks such as washing up and tidying their rooms. People using the service told us that they liked the food that was served and confirmed they were involved in making choices about these. The menus contained evidence that a variety of wholesome dishes were provided and the case files inspected contained appropriate monitoring of aspects of these. The last time we visited, the service was using pictorial menus to help people living in the home make choices about what to eat and whilst the manager told us he was planning to start using these again, a recommendation is made about this. Care Homes for Adults (18-65 years) Page 14 of 22 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. The health and personal care of people living in the home are met by staff have been trained to ensure their dignity is respected and they are protected from harm. Evidence: People living in the home told us their health and personal care needs were appropriately met and their case files contained details on how they liked staff to support them with these. Most of those using the service are largely independent of personal care and we observed staff supporting them in a sensitive way with a series of prompts and reminders to ensure their dignity was respected. All of the case files inspected contained OK Health Action plans together with regular staff monitoring of these and liaison with professionals in the Community to ensure health conditions were appropriately met. Medication policies were available together with best practice details to guide staff and there was evidence that appropriate training on the safe use and administering medication had been provided for them. Medication records were found to be accurate and well maintained and staff training had been given on a series of relevant health issues, however a recommendation is made that further epilepsy training is provided. Care Homes for Adults (18-65 years) Page 15 of 22 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The concerns of people living in the home are taken seriously and staff training is provided to ensure they can safeguard them from potential harm. Evidence: People using the service told us they liked living in the home and that they felt safe with the staff and that any concerns they had were taken seriously. A version of the homes complaints policy is available in a picture format to help people understand their rights and copies of this were contained in the case files inspected. Relatives we spoke to said they were generally happy with the service provided and confirmed improvements had been made to the home. Staff records confirmed training on the protection of vulnerable adults had been delivered and those on duty indicated they would take appropriate action should they have any concerns. A number of safeguarding referrals had appropriately been sent to the Local Authority for investigating and there was evidence the service had worked well with them to resolve these. We made check of the finances belonging to people living in the home and saw evidence that accurate records for these were kept. Care Homes for Adults (18-65 years) Page 16 of 22 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 using the service are provided with an homely environment that is comfortable and safe. Evidence: The work carried out to improve the environment for people living in the home when we last visited had been nearly completed and most of the bedrooms had now been upgraded and decorated to a good standard. Improved bathing facilities had been installed with a new shower room and assisted bath, giving people using the service greater privacy and choice. Furnishing and fittings were of a good quality and the atmosphere throughout the building was warm and homely. There was evidence of a good level of consultation with people using the service about the work to improve the facilities and discussion with relatives confirmed the environment had Very much improved. A new kitchen has been fitted as part of the work carried out to improve the building and we saw evidence the home had been recently awarded a four star rating from the Local Environmental Health Department. Staff files contained evidence of training on infection control measures and we observed the building to be comfortable and clean throughout. Care Homes for Adults (18-65 years) Page 17 of 22 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. People living in the home are supported by staff who are properly recruited to ensure they are safe to work with them and who have been trained to do their jobs. Evidence: Since the last time we visited additional staff support had been added at nights as was previously required and we observed these continue to be generally appropriate for meeting the needs of people living in the home during the day. Staff were observed to be approachable and friendly and from discussion with them it was clear they were committed to doing their jobs. The manager told us he was working with a training and development manager to develop the staff team the staff records showed evidence of good progress to ensure they are equipped with the right skills. There was evidence of mandatory and a range specialist training concerning the needs of people living in the home but as previously noted, a recommendation is made that epilepsy training is provided as some of those living in the home are affected by this condition. New staff undertake appropriate induction for the home and there was evidence they were receiving regular supervision. The people that run the home have very good recruitment procedures for checking staff are safe to work with people living in the home and the files of new staff contained evidence these were always followed. Care Homes for Adults (18-65 years) Page 18 of 22 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. Management systems are in place to ensure the health, safety and welfare of people living in the home is effectively promoted and protected. Evidence: Since the last time we visited a new manager had been appointed and registered to run the home and discussion with him confirmed he had recently obtained his Registered Managers Award. The manager has previously managed another home for people that run the service and there was evidence he takes his role seriously and works hard to make sure people living in the home are consulted and involved in decisions concerning them. People using the service told us how they had helped chose the decorations for their rooms and the quality assurance records contained questionnaires issued to them about reviews for them. We saw evidence of regular checks carried out to monitor the effectiveness of the home and the maintenance records were completed well and up to date. The self assessment for the home had been properly completed although more information would have helped tell us more about future plans for the service. Care Homes for Adults (18-65 years) Page 19 of 22 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 20 of 22 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 2 17 19 The Registered Person should develop the use of choice picture boards in the home. The Registered Person should ensure that staff receive epilepsy training to ensure the health needs of people living in the home are better met Care Homes for Adults (18-65 years) Page 21 of 22 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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