Care service inspection report

Transcription

1 Care service inspection report Full inspection Leonard Cheshire - Newhaven Road Care Home Service Newhaven Road Edinburgh Inspection completed on 05 May 2015

2 Service provided by: Leonard Cheshire Disability Service provider number: SP Care service number: CS Inspection Visit Type: Unannounced Care services in Scotland cannot operate unless they are registered with the Care Inspectorate. We inspect, award grades and set out improvements that must be made. We also investigate complaints about care services and take action when things aren't good enough. Please get in touch with us if you would like more information or have any concerns about a care service. Contact Us Care Inspectorate Compass House 11 Riverside Drive Dundee DD1 4NY enquiries@careinspectorate.com page 2 of 24

3 Summary This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change after this inspection following other regulatory activity. For example, if we have to take enforcement action to make the service improve, or if we investigate and agree with a complaint someone makes about the service. We gave the service these grades Quality of care and support 5 Quality of environment 5 Quality of staffing 5 Quality of management and leadership 5 Very Good Very Good Very Good Very Good What the service does well Individuals are involved in all aspect of their lives and the running of this care home. What the service could do better At the time of the inspection the service had several staff vacancies amounting to approximately 100 hours. This is being covered mostly by existing team members. This limits activities for service users at certain times including when they are all at home. What the service has done since the last inspection All service users now have Person Centred Health Passports in place. Conclusion The care and support in this service is of a very high standard. page 3 of 24

4 1 About the service we inspected Inspection report Newhaven Road was registered as a care home with the Care Commission in April 2002 to provide care and support for up to seven adults with learning disabilities. The home is owned and managed by Leonard Cheshire Disability. Newhaven Road has been registered with Social Care Social Work Improvement Scotland (SCSWIS) which is to be commonly known as the " Care Inspectorate". The service supports seven adults with physical and / or sensory disabilities. Six people stay in the main house and one person in the lodge which is adjacent. The properties are both fully accessible and meet the needs of everyone staying in these settings. The service is close to all local amenities and regular public transport links are nearby. Recommendations A recommendation is a statement that sets out actions that a care service provider should take to improve or develop the quality of the service, but where failure to do so would not directly result in enforcement. Recommendations are based on the National Care Standards, SSSC codes of practice and recognised good practice. These must also be outcomes-based and if the provider meets the recommendation this would improve outcomes for people receiving the service. Requirements A requirement is a statement which sets out what a care service must do to improve outcomes for people who use services and must be linked to a breach in the Public Services Reform (Scotland) Act 2010 (the "Act"), its regulations, or orders made under the Act, or a condition of registration. Requirements are enforceable in law. We make requirements where (a) there is evidence of poor outcomes for people page 4 of 24

5 using the service or (b) there is the potential for poor outcomes which would affect people's health, safety or welfare. Based on the findings of this inspection this service has been awarded the following grades: Quality of care and support - Grade 5 - Very Good Quality of environment - Grade 5 - Very Good Quality of staffing - Grade 5 - Very Good Quality of management and leadership - Grade 5 - Very Good Inspection report This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change following other regulatory activity. You can find the most up-to-date grades for this service by visiting our website or by calling us on or visiting one of our offices. page 5 of 24

6 2 How we inspected this service The level of inspection we carried out In this service we carried out a low intensity inspection. We carry out these inspections when we are satisfied that services are working hard to provide consistently high standards of care. What we did during the inspection We carried out an unannounced inspection at Newhaven Road on 5th May During this inspection time was spent with five service users, the service manager and four support workers. Documents that were observed included support plans, risk assessments, minutes of meetings,incident reports, and staff files and their training records. The environment was observed during the visit. Grading the service against quality themes and statements We inspect and grade elements of care that we call 'quality themes'. For example, one of the quality themes we might look at is 'Quality of care and support'. Under each quality theme are 'quality statements' which describe what a service should be doing well for that theme. We grade how the service performs against the quality themes and statements. Details of what we found are in Section 3: The inspection Inspection Focus Areas (IFAs) In any year we may decide on specific aspects of care to focus on during our inspections. These are extra checks we make on top of all the normal ones we make during inspection. We do this to gather information about the quality of these aspects of care on a national basis. Where we have examined an inspection focus area we will clearly identify it under the relevant quality statement. page 6 of 24

7 Fire safety issues Inspection report We do not regulate fire safety. Local fire and rescue services are responsible for checking services. However, where significant fire safety issues become apparent, we will alert the relevant fire and rescue services so they may consider what action to take. You can find out more about care services' responsibilities for fire safety at page 7 of 24

8 The annual return Every year all care services must complete an 'annual return' form to make sure the information we hold is up to date. We also use annual returns to decide how we will inspect the service. Annual Return Received: Yes - Electronic Comments on Self Assessment Every year all care services must complete a 'self assessment' form telling us how their service is performing. We check to make sure this assessment is accurate. We received a fully completed self assessment document from the provider. They told us about their strengths within the service and some areas that they had identified for improvement. Taking the views of people using the care service into account All service users were very happy with the support at Newhaven Road. They liked the staff and had fun with them and were able to do many activities of their choice. Taking carers' views into account No relatives were spoken to as part of this inspection. page 8 of 24

9 3 The inspection We looked at how the service performs against the following quality themes and statements. Here are the details of what we found. Quality Theme 1: Quality of Care and Support Grade awarded for this theme: 5 - Very Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the care and support provided by the service. Service Strengths The provider has a detailed Involvement Policy. The service have regular informal talks, keyworker meetings and review discussions with service users looking at their care and support. They are fully involved all their meetings and in reviews they invite relatives or friends of their choice to attend. Service user meetings are held on a regular basis and minutes observed showed that they talked about a variety of things. This included Christmas arrangements, family visits, holidays, activities, issues to do with the house, having a barbeque and a memorial garden for two service users that had died recently. Decoration to people's own rooms or public areas has been discussed with everyone and this was recorded in the minutes of meetings and individuals talked to us about making choices. Individuals have had opportunities to be involved in interviews for staff when there is a vacancy at Newhaven Road. page 9 of 24

10 People have the choice to be involved in the Service User Support Team (SUST) which is a provider service allowing them to give their views on the organisation. They have not ben involved in this recently. Areas for improvement The staff and service users should look at all aspects of the service to maximise their involvement and understanding about the care service. Grade 5 - Very Good Number of requirements - 0 Number of recommendations - 0 Statement 5 We respond to service users' care and support needs using person centered values. Service Strengths This year we are using an Inspection Focus Area (IFA) to identify excellence and to promote and support improvement in care homes and combined housing support and care at home services. We have asked providers to complete a self assessment as well as answering a number of specific questions during the inspection which explore health outcomes for people with a learning disability. The IFA also provides a focus on Human Rights, Safety, Supporting communication and the wider recommendations from the Keys to Life and Winterbourne View findings. Information gathered from our inspection activity in will provide valuable intelligence at all levels, including a national overview. These are our findings : Support plans were observed for four people staying at this care home. They were comprehensive in their details and well laid out. They were seen to include all aspects of support required, risk assessments, reviews and recordings showed outcomes for individuals. page 10 of 24

11 People in this service are supported to access many community services for activities or health purposes and this was evidenced in support plans and daily recordings. Holidays, shopping, visits to family or social occasions were occurring for all people who wished this and in respect of their choices. People access many community resources. Health issues were being followed up with doctors or specialist community health services in respect of several service users. Outcomes generally are good with support being provided when required. Podiatry can be difficult to access and also getting physiotherapy on an ongoing basis. Dental input is good with most people attending local dentist while one person accesses specialist clinic for support in this. All service users have individual person centred passports which can go with them to hospitals or appointments if required, which clearly explain their support needs. Communication needs are clearly identified in support plans and staff were observed talking to people in a way which supported individuals well. They obviously knew people well and able to understand their needs whether this was through verbally or non-verbal ways. Positive relationships and understanding was evident throughout the inspection. People are supported to maintained contact with their relative and friends. Some people have regular volunteers that visit them or take them out to activities of their choice. Family and friends contact is a big part of this service and this was clearly supported well by the staff team. All staff have disability equality, whistle-blowing and adult protection training. Staff spoken to were clear on what actions to take if concerns about individuals care. Also the Team Leader and Senior Support Worker work alongside staff and observe practice on a regular basis. page 11 of 24

12 The service provider has all the necessary policies and procedures in place in relation to the safety of individuals staying at Newhaven Road and staff members as part of their induction. Areas for improvement This service has major strengths in this area which should be able to be maintained on an ongoing basis. Grade 6 - Excellent Number of requirements - 0 Number of recommendations - 0 page 12 of 24

13 Quality Theme 2: Quality of Environment Grade awarded for this theme: 5 - Very Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the environment within the service. Service Strengths It has been decided that during this inspection this participation statement will be considered within Quality Theme 1 - Care and Support - statement 1.1. The grade for participation statement (1.1) in Quality Theme 1 - Care and Support will be accepted as the grade for this statement. The service has lots of strengths in relation to involving service users / carers and evidence of this was seen at the time of the inspection and detailed previously in this report. Areas for improvement This level of involvement should be sustained in this service and any opportunities to increase participation should be explored. This will looked at in future inspections. Grade 5 - Very Good Number of requirements - 0 Number of recommendations - 0 Statement 3 The environment allows service users to have as positive a quality of life as possible. page 13 of 24

14 Service Strengths The home is fully accessible and meets all service users physical needs. All bedrooms are personalised and people have been fully involved in all decoration choices. Inspection report The communal areas and garden are used well by most of the service users for socialising or relaxing with the people they are staying with and staff members. On a daily basis and through service user meetings people will comment on the house. One person when asked by us what she thought of the place stated what she likes it and said wanted to change in her room which was acknowledged by staff and another person said that they had chosen their colour scheme. All rooms that have been decorated and furnishings purchased have had involvement from the people staying at Newhaven Road. Two people spoke of their involvement while service users meetings recorded discussions about the house. People all have their individual likes and dislikes and things that they like to do in the house and make choices about socialisingknown in the community. The house on going around it appears clean and well organised and free from any risks to people moving around in their wheelchairs independent of staff, which several of the people are able to do. Individuals can complete an annual survey with assistance of relatives / volunteers and can also make suggestions / complaints through using the Have Your say leaflet. Areas for improvement The house has lots of strengths which gives people a safe and good lifestyle staying there. page 14 of 24

15 Grade 6 - Excellent Number of requirements - 0 Number of recommendations - 0 page 15 of 24

16 Quality Theme 3: Quality of Staffing Grade awarded for this theme: 5 - Very Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of staffing in the service. Service Strengths It has been decided that during this inspection this participation statement will be considered within Quality Theme 1 - Care and Support - statement 1.1. The grade for participation statement (1.1) in Quality Theme 1 - Care and Support will be accepted as the grade for this statement. The service has lots of strengths in relation to involving service users / carers and evidence of this was seen at the time of the inspection and detailed previously in this report. Areas for improvement This level of involvement should be sustained in this service and any opportunities to increase participation should be explored. This will looked at in future inspections. Grade 5 - Very Good Number of requirements - 0 Number of recommendations - 0 Statement 4 We ensure that everyone working in the service has an ethos of respect towards service users and each other. page 16 of 24

17 Service Strengths The service provider has all the necessary policies in place in relation to staff conduct and comprehensive induction is provided by Leonard Cheshire in respect of good practice in care and support. The staff are aware of the National Care Standards which have been discussed in the past at team meetings. The service has a copy of the Keys to Life and summary of recommendations. All teams within Leonard Cheshire have had the strategy on their Team meeting agenda's to discuss. All staff are issued with the Scottish Social Services Council Codes of Practice when they start with the provider and expected to adhere to them in their working role. Staff members have all completed adult protection, whistleblowing and disability equality training and were able to say what they would do in the event of an issue that concerned them and stated they found management easy to approach. Records were well maintained in an organised manner in this service. This including daily recording, handover information, incident recordings, communication books and up-to-date support plans. The Team Leader works alongside staff and is able to observe practice and lead by example. Staff stated that the manager was a good support and would always make herself available to support an individual service user or make time for staff. Several service users were able to tell us about how they were treated by staff and all we very happy with the support they were getting and had no issues. Annual questionnaires are available to people with families or volunteers helping to complete these. Inspection report page 17 of 24

18 Areas for improvement It was found that this area of support was of a high standard that has been maintained over several inspections. Grade 6 - Excellent Number of requirements - 0 Number of recommendations - 0 Inspection report page 18 of 24

19 Quality Theme 4: Quality of Management and Leadership Grade awarded for this theme: 5 - Very Good Statement 1 We ensure that service users and carers participate in assessing and improving the quality of the management and leadership of the service. Service Strengths It has been decided that during this inspection this participation statement will be considered within Quality Theme 1 - Care and Support - statement 1.1. The grade for participation statement (1.1) in Quality Theme 1 - Care and Support will be accepted as the grade for this statement. The service has lots of strengths in relation to involving service users / carers and evidence of this was seen at the time of the inspection and detailed previously in this report. Areas for improvement This level of involvement should be sustained in this service and any opportunities to increase participation should be explored. This will looked at in future inspections. Grade 5 - Very Good Number of requirements - 0 Number of recommendations - 0 Statement 3 page 19 of 24

20 To encourage good quality care, we promote leadership values throughout the workforce. Service Strengths All staff will have keyworker responsibilities with the care home and this will be support by the manager informally and through regular supervision. Currently in this service one of the support workers is acting - up into the Team Leader post and is being provided with training and support in this role. In the absence of the Team Leader a support worker is identified on the rota to be the responsible person on shift. This role expects people to organise the shift, be responsible for medication and monies and is rotated around all the staff team. Senior roles within the organisation are advertised to all staff. Staff members will take on different roles within the service and will have extra responsibility. They told us that they were provided with the necessary support from colleagues and management. All staff through their annual appraisal can identify along with their line manager their development needs which may be a wish for extra responsibility or to go for a promoted post within the organisation. All Team Leaders have SVQ4 which covers aspects of management / leaderships. While SVQ2 has been achieved by most support staff and some SVQ3. Areas for improvement Consideration for staff to progress to SVQ3 and the benefits to the service and provider should occur. The process for opportunities to advance in training was not clear to staff members spoken to. Grade 5 - Very Good Inspection report page 20 of 24

21 Number of requirements - 0 Number of recommendations What the service has done to meet any requirements we made at our last inspection Previous requirements There are no outstanding requirements. 6 What the service has done to meet any recommendations we made at our last inspection Previous recommendations There are no outstanding recommendations. 7 Complaints No complaints have been upheld, or partially upheld, since the last inspection. 8 Enforcements We have taken no enforcement action against this care service since the last inspection. page 21 of 24

22 9 Additional Information Inspection report 10 Inspection and grading history Date Type Gradings 1 May 2014 Unannounced Care and support 5 - Very Good Environment 5 - Very Good Staffing 4 - Good Management and Leadership 5 - Very Good 24 Apr 2013 Unannounced Care and support 5 - Very Good Environment 5 - Very Good Staffing 5 - Very Good Management and Leadership 5 - Very Good 20 Apr 2012 Unannounced Care and support 5 - Very Good Environment 5 - Very Good Staffing 5 - Very Good Management and Leadership 5 - Very Good 3 Nov 2010 Unannounced Care and support 5 - Very Good Environment Not Assessed Staffing Not Assessed Management and Leadership Not Assessed 16 Jun 2010 Announced Care and support 5 - Very Good Environment Not Assessed Staffing Not Assessed Management and Leadership 4 - Good 11 Feb 2010 Unannounced Care and support 5 - Very Good Environment Not Assessed Staffing 4 - Good Management and Leadership Not Assessed page 22 of 24

23 8 Sep 2009 Announced Care and support 5 - Very Good Environment 5 - Very Good Staffing 2 - Weak Management and Leadership 4 - Good 5 Mar 2009 Unannounced Care and support Not Assessed Environment Not Assessed Staffing 2 - Weak Management and Leadership 5 - Very Good 18 Nov 2008 Announced Care and support 5 - Very Good Environment 5 - Very Good Staffing 4 - Good Management and Leadership 5 - Very Good page 23 of 24

24 To find out more This inspection report is published by the Care Inspectorate. You can download this report and others from our website. You can also read more about our work online. Contact Us Care Inspectorate Compass House 11 Riverside Drive Dundee DD1 4NY Other languages and formats This report is available in other languages and formats on request. Inspection report Tha am foillseachadh seo ri fhaighinn ann an cruthannan is c?nain eile ma nithear iarrtas. page 24 of 24