Care Home: Westminster Croft

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Annual service review Name of Service: Westminster Croft The quality rating for this care home is: The rating was made on: two star good 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 review of the service. We call this review a ‘key’ inspection We do an annual service review when there has been no key inspection of the service in the last 12 months. It does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection or annual service review.   Has this annual service review changed our opinion of the service?   No You should read the last key inspection report for this service to get a full picture of how well outcomes for the people using the service are being met. The date by which we will do a key inspection: Name of inspector: Rajshree Mistry Date of this annual service review: 0 4 1 2 2 0 0 9 Annual Service Review Page 1 of 10 Information about the service Address of service: 3 Westminster Croft Brackley Northants NN13 7ED 01280705348 01280840049 Telephone number: Fax number: Email address: Provider web address:   www.livability.org.uk Livability Name of registered provider(s): Conditions of registration: Category(ies) : learning disability Conditions of registration: Number of places (if applicable): Under 65 Over 65 3 0 A maximum of three (3) service users in the category of LD may be accomodated in the home at any time. No one in the category of LD may be admitted to the home when three (3) service users in this category are already registered. Have there been any changes in the ownership, management or the Yes service’s registration details in the last 12 months? If yes, what have they been: Date of last key inspection: Date of last annual service review (if applicable): Brief description of the service Westminster Croft is a care home, which is registered to provide personal care and accommodation for three people with a learning disability. Westminster Croft is one of six homes in the area. These are owned by Livability and are known as The Brackley Residential Project. Westminster Croft is a detached four bedroomed property situated in a residential area of Brackley in Northamptonshire. It is within walking distance of Brackley town centre. There are good local community amenities that include shops, pubs, restaurants, Annual Service Review Page 2 of 10 New Registered Manager gymnasium and a public swimming pool. The accommodation consists of bedrooms on the first floor; the smallest of the bedrooms is used as the staff office and sleep in room for the night support worker. There are adequate number of bathrooms and toilet facilities and communal areas that include the lounge, kitchen and a dining room. There is a well-maintained garden with a single driveway to the front with a garage. There is a raised garden with flower borders and patio area to the rear of the property. The Registered Manager is also the Registered Manager for the sister homes: Hawkins Close, Holly Close, Remus Gate, Tudor Way and Hanover Drive, where the main office is based. The range of fees for 2009/10 are not known. People who are interested in using Westminster Croft should contact the Registered Manager or the home directly for the range of fees. Further information about Westminster Croft can be obtained from the home in the form of a Service User Guide and a Statement of Purpose. The latest Inspection Report is available at the home or can be accessed via the Care Quality Commission (CQC) website: www.cqc.org.uk Annual Service Review Page 3 of 10 Service update since the last key inspection or annual service review: What did we do for this annual service review? We looked at all the information that we have received or asked for since the last Key Inspection of the service. This included the Annual Quality Assurance Assessment (AQAA) that was sent to us by the service. This AQAA is a self-assessment that focuses on how well outcomes are being met for the people using the service. It also gave us some numerical information about the service. We assessed the information we have about the service and how the complaints received are managed. We looked at what the service told us with regards to the things that have happened in the service. These are called notifications and are a legal requirements. We looked at the last Key Inspection Report dated 6th December 2007, the last Annual Service Review dated 28th November 2008 and any other visits that we have made to the service in the last 12 months. We looked at the relevant information from other organisations and what other people have told us about the service. We sent out surveys to the people who use the service and surveys to the staff to gather their views about Westminster Croft. What has this told us about the service? Westminster Croft sent us their Annual Quality Assurance Assessment (AQAA) when we asked for it. It was clear and gave us all the information we asked for. We looked at the information in the AQAA and our judgement is that the service is still providing a good service. Westminster Croft has demonstrated how it continues to maintain the standards to benefit the people who use the service. The AQAA was completed by the Assistant Manager that provided us with details of what the service does well and the evidence to support the practice. There were details about the new developments and practice in place to improve the quality of service people experience. This showed the service recognises the need to continuously adapt and improve in response to needs, concerns, changes in best practice and legislation. The AQAA demonstrated that people considering using the service are given information about Westminster Croft in the form of a Service User Guide and the Statement of Purpose. This information is available in written and pictorial format to suit peoples preferred form of communication and understanding. These documents have details about the range of services and facilities available to meet individual needs and aspirations. Both documents are reviewed annually. Annual Service Review Page 4 of 10 The AQAA showed that there is a comprehensive pre-admission assessment process to ensure the service is able to meet the individual needs. The assessment process takes into account individual needs, preferences, routines and aspirations, which may involve other professionals and organisations. People considering using Westminster Croft are encouraged to visit several times and have overnight stays. This enables people to decide if this is the right place for them and ensures a planned move to the home. The people who live at Westminster Croft are given a contract of stay that has the agreed fee, terms and conditions. This contract has been developed in a pictorial format to suit individual needs. People who use the service are supported by key workers and use a person centred approach of care. Care plans are developed with individuals taking into account their choices, interests, health and personal are needs and social aspirations. Assessments of risks are completed to ensure peoples independence is promoted safely and continue to receive support as individual needs change. The AQAA states staff have supported people to do a My Year file, which contains photographs and written information about what they do each month. This will be used as part of the annual review, recognising accomplishments and identifying new goals and aspirations. The AQAA states people using the service take control of their life and make decisions about their daily routines and lifestyle. People are encouraged to choose their own bedroom furnishing and colour scheme. People have a day-off with the support of staff to pursue their own interests and meet friends for coffee or lunch. There are house meetings, which helps people to decide the weekly menu plan and take responsibility for keeping home clean and doing the house-work. People help with the weekly food shopping and plan the menu. People are encouraged to help staff prepare the meals. Individual likes and dislikes of meals are recorded and known to the staff, which promotes their health and well-being. The AQAA states people are supported to manage their own money where possible. Individual financial records are kept for people that prefer to have their money held in safe-keeping. There are plans to support people to manage their individual budgets in the future. The AQAA states people who use the service have at least one holiday a year with staff. Individual holiday diaries are kept for people to share with their family. People keep in contact with their family and friends and can also invite people to the home for meals and parties. People using the service have the right to form appropriate personal relationships who are supported by staff, if necessary. The people who use the service all attend the local day centre, where they have the opportunity to take part in peer and cultural activities. The Link Worker from the day centre meets with the people who use the service and staff to review individual needs, support and aspirations. Westminster Croft has an Activities Co-ordinator who supports people using the service with their individual interests and social aspirations. Annual Service Review Page 5 of 10 The AQAA states the people who use the service are supported to be as independent as possible with regard to receiving support with their personal care needs. People are registered with the local General Practitioner (GP) surgery. They also have regular visits to the dentist, optician, podiatrists and the opportunity to have annual health checks. Some people have support from specialist health services such as the Psychiatrist and the Occupational Therapist. This shows individual needs are met by respective health professionals. The improvements made include the life skills assessments carried out by the Community Team and the annual health checks carried out by the GP with regards to promoting their health and well-being. Westminster Croft has a good system for the management, storage and administration of medication. The staff have accredited medication training and are responsible for administering medication to people. The AQAA states the complaints procedure is provided to everyone using the service in a booklet form, which is available in pictorial format. The complaints procedure is also detailed in the Service User Guide and the Statement of Purpose that is provided to people when they move to the home. People who use the service are supported to express their concerns and are supported throughout the complaints procedure. Staff are aware that some people do not always know their rights and are supported through the process of making a complaint. There are fortnightly house meetings and care meetings, where people may express any concerns they may have. Any concerns received by Westminster Croft are recorded and addressed. Copies of the concerns or complaints are also sent to the Care Quality Commission, the Ordinary Living Team and to the Operations Manager at head office. Westminster Croft received 1 complaint, which was resolved promptly. The Care Quality Commission received no expressions of concerns or complaints about Westminster Croft. The Care Quality Commission has received timely notifications with regards to events or incidents affecting the well-being of people who use the service. These are known as Regulation 37 and are a legal requirement. The AQAA states the staff have received training in safeguarding of vulnerable adults (sova) and have supporting policies and procedures in place. Safeguarding means promoting and protecting vulnerable people who use the service from harm, risk and abuse. All staff are aware of their role and responsibility with regards to safeguarding adults. The staff have received training in Mental Capacity Act 2005 and the Deprivation of Libertys to help staff have a better understanding of liberties and capacity. The AQAA states the monthly monitoring visits carried out by the Operations Manager also looks at any complaints, concerns and safeguarding matters that affects the wellbeing of people who use the service. The feedback from the Annual Quality Surveys also help the service to continue to develop and improve the quality of service people experience. Annual Service Review Page 6 of 10 Westminster Croft is a well-maintained detached property that blends in with the other private residential properties. People who use the service choose the bedroom furniture and decor to reflect their interest and personality. People have a responsibility to keep their bedroom and the home clean and tidy. People have the opportunity to raise issues at the house meeting with regards to health and safety matters. The monthly monitoring visits carried out by the Operations Manager also monitors and assesses the home environment with regards to health and safety. Westminster Croft has secured funding to change the shower room into a wet room to benefit the people who use the service. Westminster Croft had an Environment Health Inspection and were awarded 5 star rating. The AQAA demonstrated that staff recruitment process is robust, whereby the people who use the service are involved in the recruitment of staff. Pre-employment checks are carried out and maintained on file. These include two satisfactory references, criminal records bureau (crb) and protection of vulnerable adults (pova) checks. These checks are to assess the suitability of applicants to work with vulnerable people. The service also uses agency staff who undergo the same pre-employment checks, to ensure they are suitable to work with vulnerable people. The AQAA states all staff complete a 6 to 8 week induction programme and are expected to complete the Learning Disability Qualification (LDQ) within 6 months of employment. The agency staff are required to complete an induction before they can work alone. All staff receive mandatory training and updates. The numerical information in the AQAA states there are no staff that have attained National Vocational Qualification (NVQ) level 2 or above in care. The AQAA states all staff including agency staff receive supervision and an annual performance review. There are monthly staff meetings, which include standard agenda items such as safeguarding adults, health and safety, care standards and sharing information with regards to the things that have happened in the service and the people who use the service. The AQAA states the Registered Manager is experience in managing a care home and working with people with a learning disability. She has attained the NVQ level 4 and the Registered Managers Award. The management of the service includes the Assistant Manager, who is currently working towards the NVQ 3, a full time support worker and a part-time support worker. In addition the service regularly uses agency staff. The management of the service meets the needs of the people who use the service through staff recruitment, training and staff deployment. We have been informed that there will be changes to the management team whilst the Registered Manager has a sabbatical leave for 3 months, returning in February 2010. They have sent us information with regards to the personnel that will be managing the service, the support systems and gave assurance that people who use the service will not be affected. The AQAA states the policies and procedures are reviewed regularly and some were last updated in July 2009. Annual Service Review Page 7 of 10 The AQAA details the range of quality assurance and monitoring systems in place. These include the Operations Managers monthly monitoring visits, known as Regulation 26 visits and are a legal requirement. There are fortnightly house meetings whereby the people who use the service are consulted and informed about any changes that may affect or influence the quality of life they experience. There are also annual reviews conducted with the people who use the service, which are carried out by the organisation that financially supports the individuals, such as the Local Authority. People also have the opportunity to express their views and opinions about Westminster Croft through the annual quality assurance surveys. We sent out 3 surveys to the people who use the service in easy read/pictorial format to suit their needs. All 3 surveys were returned, which people completed with the support of the staff. All the responses indicated people were given information about the home and were asked if they wanted to move to the home. All the responses indicated people made decisions about what they do each day, in the evenings and at weekends. All the responses indicated people know who to speak with if they are not happy or have a complaint. All the responses indicated the home is fresh and clean. All the responses indicated staff treat people well, listen and act on what they say. We received the following comments with regards to what the service does well: Always clean Cooking Helping us We sent out 3 staff surveys, of which 2 were returned. All the responses indicated staff receive up to date information about the people that use the service, their care and support needs. The responses indicated that they were appointed with satisfactory preemployment checks and received induction and training that covered their job role. The responses received indicated staff felt they had the right skills, knowledge and experience to look after the people who use the service. The responses received indicated staff were confident to respond to concerns and complaints from the people who use the service and/or their relatives. The responses received indicated that staff receive support, supervision from the manager and have meetings to discuss work issues. The additional comments received in the staff surveys with regards to what the service does well included: Service users help plan the weekly menu and can choose what they would like to eat, not necessarily the same as the other service users Access to lifestyle choices, means that service users can now go out and about in the evenings and at weekends, even when the other service users do not want to go out Although the home is not fully staffed so we have to use agency staff, we try to book regular agency staff to provide consistency for the service users Provides a homely environment for the people we support and care for Annual Service Review Page 8 of 10 We concluded from the responses in the surveys that peoples experience of the service is consistent with the practice detailed in the self-assessment. Westminster Croft continues to let us know about the things that have happened since our last Key Inspection. They have shown that they have managed issues. They work well with us and have shown that the service continues to provide good quality outcomes for the people who use it. What are we going to do as a result of this annual service review? The next inspection of this service will be based on the Fees and Frequency Regulations 2007 and the assessment of risk of the service. Further clarity will become evident as the new registration and inspection system under the Health and Social Care Act 2008 is confirmed. Annual Service Review Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Annual service review CQC General Public 0870 240 7535 (national contact centre) Our duty to regulate social care services is set out in the Care Standards Act 2000. The content of which can be found on our website. Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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