Care Home: Willow View

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What the care home does well People are assessed before they move into the home to ensure that their needs can be met and so that staff know the best way to care for them. They are encouraged to visit the home where able to help them decide whether or not it is the right place for them and also meet the staff. People living at the home and their relatives/ advocates where appropriate, are involved in planning their care and there is good information about how people should be supported. People are supported to take reasonable risks so that they can lead as independent a lifestyle as possible. The manager and staff are aware of their duties and responsibilities under the Mental Capacity Act 2005`s deprivation of liberty safeguards. People`s human rights are respected and their liberty only deprived when there are no other less restrictive ways of keeping them safe and well and giving them the care and / or treatment they need. The home is well managed by a qualified and experienced manager. What has improved since the last inspection? This is first inspection since the home was registered in April 2009. What the care home could do better: When taking medication out of the home the correct storage container must be used to ensure that the medication is kept safe. Key inspection report Care homes for adults (18-65 years) Name: Address: Willow View Willow View 938 Bradford Road East Bierley Bradford West Yorkshire BD4 6PA     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: Karen Summers     Date: 3 0 0 9 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 28 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 28 Information about the care home Name of care home: Address: Willow View Willow View 938 Bradford Road East Bierley Bradford West Yorkshire BD4 6PA 01274688246 01274688247 enquires@actionforcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Action For Care Limited Name of registered manager (if applicable) Mrs Nikky Suzann Smith Type of registration: Number of places registered: care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is 6 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 category: Learning disability Code LD. Date of last inspection Brief description of the care home Willow View is a care home providing accommodation and personal care for six people who have a learning disability and who may have severe challenging behaviours. The business is owned by Action for Care Limited and they are a registered charity. The accommodation is a large detached property which has recently been refurbished to a high standard. It provides 6 single en-suite bedrooms, 2 lounges, sensory room, Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 6 Brief description of the care home kitchen/dining area, meeting room/ activity room, house bathroom/ shower room, and an enclosed garden. The home is situated in a residential area and has easy access to the larger towns and cities of West and South Yorkshire. The provider informed the Care Quality Commission on 05/10/09 that fees range from £1800 to £2805 per week. Additional charges include hairdressing, private chiropody, toiletries, activities and holidays. Information about the home and the services provided are available from the home in the statement of purpose and service users guide. People can also see a copy of the inspection report at the home. Care Homes for Adults (18-65 years) Page 5 of 28 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: This report refers to an inspection, which included an unannounced visit by one inspector on the 30th September & 5th October 2009, and the length of the inspection was six hours. There were three people living at the home at the time of our visits. During our second visit there were two people in the home, however due to their disabilities we found it difficult to get feedback about how their needs were being met. As part of the inspection in order to provide information to help us form judgments about the quality of the service, the manager was asked to complete an annual quality assessment (AQAA) document. This she did, and the document provided the Care Quality Commission (CQC) with a lot of information about the way the home is run, and what they hope to achieve in the future. Care Homes for Adults (18-65 years) Page 6 of 28 To enable people who use the service to comment on the care it provides, we sent surveys to people living at the home, two of which were returned, ten to staff, six were returned, and other Social and Health care professionals involved with people living at the home, none of these were returned at the time of writing the report. The purpose of this inspection was to look at how the needs of people living in the home are being met and we focused on the outcomes of the key standards. Care Homes for Adults (18-65 years) Page 7 of 28 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 28 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 28 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. Peoples needs are assessed prior to them moving into the home and they are able to visit the home to decide whether or not it is the right place for them. Each person has a contract of terms and conditions with the home. Evidence: Information provided in the AQAA, suggests that the home is good at assessing peoples needs before they move in. It tells us that people and their family/ advocates are encouraged to visit the home and spend some time there so that they can decide whether or not is is the right place for them. This was also confirmed by the staff at the home. A survey that was completed with the assistance of a relative, confirmed that they received enough information about the home before they moved in so they could decide if it was the right place for them. The records for two people using the service were looked at and each contained detailed evidence that their needs had been assessed prior to them moving into the Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: home, including a Care Management Assessment. Care Homes for Adults (18-65 years) Page 11 of 28 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. People are involved in the care planning process, are supported to take reasonable risks and are able to make decisions about their lives with assistance as needed. Evidence: Two care plans/ support plans as referred to by the home, were looked at and each contained detailed information about how individuals needs should be met, the support needed and a record of who had been consulted as part of the care planning process. The information also included short and long term goals. In each of the records examined there was evidence that monthly reviews had taken place and who had attended was also recorded. There was also a copy of the care plan in the persons individual room to remind them of what had been agreed. The care plans were individual to the persons needs and where appropriate included risk assessment, behavior management plans, mental health assessments, physical care support and movement and handling plans etc. The daily record gave a full account of the persons day and reflected the identified needs. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: Staff were seen to interact with people positively and in a respectful manner. The surveys completed by people living at the home confirmed that they make decisions about what they do each day, and can choose how to spend their time. Comments include:They listen to me and help me make choices. They try to encourage my independence. A relative made the comment that the persons week is filled with activities and staff go out of their way to support the person and understand their needs. Staff comments in the surveys include: the home provides, Specialist care to promote independence and social and practical skills to ensure a good life style. Cares for each persons individual needs. Whenever possible people are supported in managing their own money and we saw individual records kept of all transactions. Care Homes for Adults (18-65 years) Page 13 of 28 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 take part in appropriate activities. They are part of the local community and are supported to maintain relationships with family and friends, and have a varied diet that takes into account their likes, dislikes and dietary needs. Evidence: The manager said that depending on the individual person, on a weekly basis they plan how they will spend their time. Two people have chosen to have a wall mounted planner, where with the assistance of staff they record what they will be involved in. The planner also acts as a reminder where they can go and check out what they will be doing on a daily basis. The activities that people are taking part in outside of the home varies between individuals and their needs, and also their ability to take part. The support plans gave clear guidance on how peoples needs in relation to their lifestyle are to be met. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: During the visit, staff were observed to support individuals to keep occupied by going on individual shopping trips and going out for lunch, and one person chose to spend time enjoying their own company and catching up on some television that they had taped. Contact with family and friends is encouraged and supported. A relative made the comment in a survey that was sent out by the home, that their relatives week is filled with activities and that staff go out of their way to support the person and understand their needs. They also said that the service gave excellent care. Another person made the comment in the CQC survey, They listen to me and let me make choices. They try to encourage my independence. Contact with family and friends is encouraged and supported. The menus were looked at and catered for specialised diets and the food preferences of people living their. Care Homes for Adults (18-65 years) Page 15 of 28 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. People receive personal support in the way they prefer and their physical and emotional care needs are met The home deals with peoples medication well overall however, when people go out of the home the correct medication storage container is not always used. Evidence: Two care records were looked at and there was evidence to suggest that people receive personal support in the way they prefer, are supported to have regular health screening and access a range of health services. There was also evidence to suggest that the information had been reviewed and updated. Records indicated a good level of contact with the primary health care team and a full range of medical services. There was evidence that staff who administer medication have had training, and the medication and records that were audited were correct. However, when people go out of the home and need to take medication with them, staff are not using the correct storage containers so that the medication is kept safe. This was discussed with staff and the manager at the time and the manager said that she would take steps to Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: ensure that the correct storage containers are used. Care Homes for Adults (18-65 years) Page 17 of 28 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. There are appropriate systems in place to make sure that peoples concerns/complaints are taken seriously and acted on and to make sure that people are protected from abuse. Evidence: The AQAA states that the home has a clear and effective complaints policy and that staff ensure people they support are aware of its existence and how to use it. The complaints procedure which is located in each persons room is also made accessible to their families and advocates. It is in large print, pictorial format and easy to follow. The survey that was completed with the assistance of a relative stated that they knew how to complain and who to speak to if they were not happy. Five out of six staff said that they knew the procedure to follow should someone have a concern about the home. There has been one concern received by the home since it opened in April this year, and records showed that appropriate action had been taken. The information from the provider also states that the home has a copy of the local authorities, Protection of Vulnerable Adults procedure (adult protection)and that staff induction includes knowledge of these procedures. This was confirmed by the staff at the time of the visit, and they were also aware of the homes Whistle blowing policy. Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: Care Homes for Adults (18-65 years) Page 19 of 28 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 live in a homely, comfortable and clean environment. Evidence: The atmosphere on the day of the visits was friendly and relaxed. As part of the inspection a tour of the home was conducted and this included the communal areas, a number of peoples bedrooms and the laundry. The decorative condition of the home was of a good standard, clean and well maintained. The information in the survey said that the home was fresh and clean. The information we received from the provider states that they provide people they support with their own personal space and that they are encouraged to add their own personal belongings that reflect their culture, beliefs and personalities. At the time of the visit people said that we could look in their bedrooms and there was evidence that they had begun to personalise their rooms. The manager said that as people settle into the home the communal areas will be decorated and pictures etc will be bought that reflect what people would like to have in their home. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: As a result of listening to what the people who use the service would like, individual activities boards have been put on the wall so that they are able to plan their week and have a reminder of their day to day commitments. Care Homes for Adults (18-65 years) Page 21 of 28 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 are supported by a competent, caring and supervised staff team, that have had all the necessary recruitment checks before working with people so that they are kept safe. Evidence: The duty rotas and training files were looked at and there was evidence to suggest that the staffing levels and skill mix were sufficient to meet the number and needs of people living at the home. Five staff who completed the survey said there are always enough staff on duty and one said that there is usually enough staff. The manager confirmed that there is always sufficient staff to care for the needs of people and that she is on call should they need to contact her. Six out of ten care staff have achieved a National Vocational Qualification (NVQ) level 2 or above in care, and a further three are currently working toward the qualification, which shows the providers commitment to ensure that staff are trained and competent to do their job. All six staff that completed a survey said that they are being given training that is relevant to their job and helps them to understand the needs of people living at the home. Staff were observed to have a positive and respectful relationships with people living Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: at the home. The person who completed a survey with assistance from their relative commented, They listen to me and let make choices. They do everything well. Three staff training records showed that they had received induction training, training in fire safety, movement and handling, infection control, first aid, medication, food hygiene, health and safety, adult protection and physical intervention etc. Three staff who were spoken with confirmed that they had received the training that had been recorded in their files. Recruitment records for three staff were looked at and each contained the required employment checks, references and Criminal Record Bureau checks. Evidence was also seen in the staff records and staff confirmed that they had regular supervision. The manager said that people living at the home are involved in the recruitment of new staff and they have an opportunity to sit on the interview panel and ask them questions and give their views and impressions. This was also confirmed by the staff at the home who gave positive feedback on their experiences. Care Homes for Adults (18-65 years) Page 23 of 28 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 by an experienced, competent manager, and the health, safety and welfare of people who live at the home are protected. Evidence: This is the first inspection since the home was registered in April 2009. The manager who is a Registered Nurse Learning Disabilities, has a NVQ level 4 in management, is an NVQ assessor and has a number of years experience in the care of people who have a learning disabilities. She presented as organised, competent and supportive to the staff and the people in her care. Staff who completed surveys told us that the home is well managed and one of the comments include: Willow view is a lovely place to work. I have learned so much. The manager and staff are aware of their duties and responsibilities under the Mental Capacity Act 2005s deprivation of liberty safeguards, and there was comprehensive information and documentation to reflect this in the records seen. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: As part of the inspection in order to provide information to help us form judgments about the quality of the service, the manager was asked to complete an annual quality assessment (AQAA) document. This she did, and the document provided the Care Quality Commission with a lot of information about the way the home is run and what they hope to achieve in the future. The AQAA indicated that the required maintenance and servicing of equipment is up to date, and a sample of records we looked at confirmed this. The manager said that quality monitoring surveys are due to be sent out to people living at the home, their relatives/ advocates and people who have an interest in the service, and they will be repeated approximately every four months. Comments from the surveys returned in July from relatives / advocates of two people living at the home include: ...is very happy and the care is excellent. All the staff are friendly and helpful. Generally the comments were very positive. Support meetings with people who live at the home take place approximately every month and minutes were seen. The minutes of the meeting showed that the views of the people were taken into account and also recorded, what the individuals wished to talk about for example, decoration of the home, the employment of new staff and any changes at the home. Staff meeting are held fortnightly and minutes were also seen. Care Homes for Adults (18-65 years) Page 25 of 28 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 26 of 28 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 20 When taking medication out of the home the correct storage container must be used to ensure that the medication is kept safe. Care Homes for Adults (18-65 years) Page 27 of 28 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). 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