Inspection on 08/09/08 for Bamburgh Crescent, 10

This is the latest available inspection report for this service, carried out on 8th September 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Bamburgh Crescent, 10 20/12/05

Bamburgh Crescent, 10 26/05/05

Bamburgh Crescent, 10 21/12/04

Bamburgh Crescent, 10 21/06/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

Extracts from inspection reports are licensed from CQC, this page was updated on 19/12/2008.

CARE HOME ADULTS 18-65 Bamburgh Crescent, 10 10 Bamburgh Crescent Shiremoor Newcastle upon Tyne Tyne & Wear NE27 0NX Lead Inspector Key Unannounced Inspection 8 & 12 September & 6 October 2008 10:00 Bamburgh Crescent, 10 DS0000033083.V371740.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Bamburgh Crescent, 10 DS0000033083.V371740.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Bamburgh Crescent, 10 DS0000033083.V371740.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bamburgh Crescent, 10 Address 10 Bamburgh Crescent Shiremoor Newcastle upon Tyne Tyne & Wear NE27 0NX 0191 200 8625 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) susan.redpath@northtyneside.gov.uk North Tyneside Council Mr Andrew Robinson Vacant Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Bamburgh Crescent, 10 DS0000033083.V371740.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. It is recognised that a percentage of the service users may also display physical disabilities 11th September 2006 Date of last inspection Brief Description of the Service: Bamburgh Crescent is situated in a residential street in the Shiremoor area of North Tyneside. It is a single storey building, which has been designed to meet the needs of adults with learning and physical disabilities. Since the last inspection of Bamburgh Crescent, there has been a change in the services provided at the home. Bamburgh Crescent now has two separate units one of which provides a short stay residential placement. The other unit provides two longer-term residential placements. Nursing care is not provided. A bus route, pub and local shops are within easy walking distance. Each unit has its own kitchen, laundry facilities, lounge, dining area and assisted bathrooms. There are gardens to the rear and front of the home. Street parking is available. The current charge for a residential place at Bamburgh Crescent is £4065.00. The Council charges £11.62 per night for respite care. There are no additional charges. Copies of the Commission’s most recent inspection reports are available on request. Bamburgh Crescent, 10 DS0000033083.V371740.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. We have 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 that 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. Since the last inspection, the home has closed and re-opened with a different remit. A new manager has also been appointed and registered. Because of all the changes that have occurred with the service, some of the requirements set in the last inspection report are no longer appropriate. This applies to the second part of requirement 4 and requirements 1, 6 & 7. Also, requirements 5 & 6, and the second part of requirement 10, have been changed to recommendations and repeated in this report. How the inspection was carried out: Before the visit: We looked at: • • • • Information we have received since the last key inspection visit on the 11 September 2006; How the service dealt with any complaints and concerns since the last visit; Any changes to how the home is run; The manager’s view of how well they care for people. The views of relatives, other professionals and staff. The Visit: An unannounced visit was made on the 08 September 2008. inspection we: • • During the Talked with the manager; Looked at information about the people who use the service and how well their needs are met. People using the service were unable to participate in an interview but we did interview three staff and observed people being cared for; DS0000033083.V371740.R01.S.doc Version 5.2 Page 6 Bamburgh Crescent, 10 • • • • Looked at other records which must be kept; Checked that staff have the knowledge, skills and training to meet the needs of the people they care for; Looked around the building to make sure it was clean, safe and comfortable; Checked what improvements had been made since the last visit. What the service does well: What has improved since the last inspection? Bamburgh Crescent, 10 DS0000033083.V371740.R01.S.doc Version 5.2 Page 7 Following the re-opening of the service: • • The rear garden areas have been refurbished to create safe areas that can be used by people using the service; Staffing levels have been increased to provide people with the level of support they need to live lives that are more independent. A new manager has been appointed. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Bamburgh Crescent, 10 DS0000033083.V371740.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Bamburgh Crescent, 10 DS0000033083.V371740.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 Quality in this outcome area good. This judgement has been made using available evidence including a visit to this service. There are suitable arrangements for making sure that people’s needs are assessed before they use the service. This will help ensure that staff are able to meet people’s needs on admission. EVIDENCE: Bamburgh Crescent has a service user guide and statement of purpose. However, these need to be reviewed and updated to reflect the home’s new role. The new manager said that this work will be undertaken shortly and the required information will be made available in a range of formats. People’s needs are assessed before admission to ensure that the placement offered is appropriate. Relevant professionals are involved in the preadmission assessment process. Staff reported that the manager had arranged for them to meet with the professionals caring for a potential resident and carry out an assessment of their needs. They also said that they had been able to work with hospital staff to gain a better understanding of the person’s needs. The home had obtained copies of various reports prepared by Bamburgh Crescent, 10 DS0000033083.V371740.R01.S.doc Version 5.2 Page 10 occupational therapy and speech and language staff. As part of preparing for the most recent longer term admission, the manager arranged for his staff team to participate in two training days specifically aimed at helping them find successful ways of working with the individual concerned. The manager confirmed that the service does not presently have a standardised pre-admission assessment proforma that can be used when assessing the needs of people who may wish to use the service. None of the people using the service at the time of the inspection were able to comment on the quality of the information they received before admission or whether they were satisfied with the way in which their needs assessment was carried out. Bamburgh Crescent, 10 DS0000033083.V371740.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements are in place to help support people using the service to contribute to the decisions made by staff about how they should be cared for. This helps people to retain greater control over their lives and how they are supported to be more independent. EVIDENCE: Staff understand the importance of people being supported to take control of their own lives. Staff are skilled in developing and implementing strategies that provide people with opportunities to make their own decisions and choices and to develop behaviours that will help keep them safe and independent. For example: Bamburgh Crescent, 10 DS0000033083.V371740.R01.S.doc Version 5.2 Page 12 • • Staff are currently implementing behaviour management strategies devised by other professionals to help them support a person with challenging behaviours to access local community and health care facilities; Staff involve the person currently living in the long-term residential unit in shift handovers so that they are aware of what is going on in their own home and the reasons for this. People’s care records contain information about their preferred styles of communication. For example, staff are using a visual timetable to help one person make choices about what they do each day and to help them understand what is planned and where an activity or event will take place. Staff had been provided with information about the benefits of using a visual timetable as an aid to establishing better communication and greater independence. The service plan for a person using the respite care service included information about the specialist communication system they use to make their needs known. Arrangements have been put in place to ensure good communication between the home and staff at the various day care services attended by people using Bamburgh Crescent. Staff at the home complete a daily record which provides day centre staff with information about the person’s well being whilst they have been at Bamburgh Crescent. The service plans of two people accommodated at the time of the inspection were looked at. A detailed service plan was in place for a person using the respite care service. This was person centred and written in plain English. It provided staff with clear guidance about how to meet the person’s needs in a range of areas such as communication and personal hygiene. The service plan had been signed by the person’s representative to confirm their agreement with the contents. However, the plan did not contain any information about desired outcomes and the description of the person’s needs was not clear. The second person using the service at the time of the inspection has only recently moved into Bamburgh Crescent. Their key worker is working with them and her colleagues to devise a service plan to meet their assessed needs. The key worker said that once prepared the service plan would reflect the views of the key professionals involved with the person. Staff have access to the ‘Essential Lifestyles’ statements devised by the person’s social worker. This provides staff with important information about the person’s known likes and dislikes and preferred routines whilst they get to know them. The person’s care records did not contain an assessment of their capacity to make decisions, for example, in the area of managing their own finances. Neither of the service plans included reference to equality and diversity issues. Service plans are not currently available in a format that might be more easily understood by the people using the service. Bamburgh Crescent, 10 DS0000033083.V371740.R01.S.doc Version 5.2 Page 13 The manager has arranged for staff to undertake person centred planning training. This will help staff to devise more effective support plans. People’s care records include comprehensive risk assessment information. The home has obtained specialist risk assessment information devised by other relevant professionals such as specialist mental health risk assessments. In addition, a detailed behavioural risk assessment and behavioural strategies advice has been obtained for one person to help staff minimise the risks associated with their placement at Bamburgh Crescent. An assessment of the risks posed by one person’s epilepsy has been carried out and guidance provided to staff to help keep them safe. General risk assessments covering such areas as road safety and using the kitchen have also been devised. Moving and handling risk assessments and management plans will be carried out by occupational and physiotherapy staff in conjunction with Bamburgh Crescent staff. Risk assessments are used as ‘live’ working tools. For example, staff are updating one person’s behavioural risk assessments on a daily basis to reflect changes to the way in which they are working with them. To help protect one of the people using the service, the front door is being locked. The manager agreed to update the assessment to reflect the home’s changed practice in this area. A relevant risk assessment has been devised to protect staff and people using the service because of needing to the lock the residential unit front door. Advice is also being taken from the local fire and rescue service. Bamburgh Crescent, 10 DS0000033083.V371740.R01.S.doc Version 5.2 Page 14 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are supported to make choices and decisions and they receive the level of staff support that suits them. This means that people are able to lead fulfilling lives. EVIDENCE: Staff are committed to enabling people to develop and maintain their skills, including social, emotional, communication and independent living skills. A member of staff said that people’s needs are assessed in areas ranging from keeping them safe to developing skills that will help them to be more independent. Bamburgh Crescent, 10 DS0000033083.V371740.R01.S.doc Version 5.2 Page 15 Staff support people to communicate their wishes and to participate in everyday household tasks. Staff are prepared to work flexibly and have changed their working routines to fit in with the needs of people living at the home. Where appropriate, people are provided with opportunities to maintain important personal and family relationships. One person’s service plan refers to the importance of their family and contains guidance about how the person develops relationships. For another person, the home has set up safe visiting arrangements and has acted in a supportive capacity to both the service user and their relative. Arrangements are in place to support people to access advocacy services. This means that someone independent of Bamburgh Crescent supports people using the service to express their views and opinions. The service is committed to the principles of inclusion and promotes and fosters good relationships with the local community. Every effort is made to involve people using the service in meaningful daytime activities of their own choice and according to their individual interests, diverse needs and capabilities. For example, an activity timetable has been devised for a person who has recently moved into the long-term residential unit. During the inspection, staff supported the person to visit an arts and crafts café and local shops, using local transport links. Where possible, people are encouraged to be involved in the planning and preparation of meals. Where people are unable to participate in this process, staff take into account known food likes and dislikes when planning menus. For the person using the long-term residential unit, meals are planned daily and there is no set menu. Staff have adopted this approach as it better fits the needs of the person concerned. Staff tried a variety of approaches to help the person concerned make positive choices about the food they want to eat such as pictorial menus. A record of the food eaten by this person is kept. Information about their food preferences was obtained before they moved into Bamburgh Crescent. Staff actively encourage healthy eating. None of the people using the service at the time of the inspection required assistance with eating or drinking. It was not possible to ask people using the service if they like the food served at Bamburgh Crescent. However, the person using the respite care unit arrived home from their day care placement and immediately indicated to staff that they wanted something to eat. A more experienced member of staff immediately knew what the person wanted and this was prepared. The person was able to eat their snack in their bedroom, which was what they wanted to do. The senior member of staff provided positive guidance to a new carer about how best to meet people’s nutritional needs. Kitchens are kept clean, Bamburgh Crescent, 10 DS0000033083.V371740.R01.S.doc Version 5.2 Page 16 tidy and hygienic. People using the service are provided with suitable eating aids. This helps them to eat and drink more independently. Bamburgh Crescent, 10 DS0000033083.V371740.R01.S.doc Version 5.2 Page 17 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People receive good personal and health care support that meets their assessed needs. Staff promote people’s health and well being which helps them to lead healthy lifestyles. EVIDENCE: Staff provide support in a patient, thoughtful, gentle, kind and considerate manner. Service plans address people’s needs for support with personal care and contain information about their preferred personal routines. Staff rotas take account of the need to ensure that female staff are rostered on duty when female service users require assistance with intimate personal care. A range of aids and adaptations are available and staff said that they have the equipment they need to meet people’s physical care needs. Bamburgh Crescent, 10 DS0000033083.V371740.R01.S.doc Version 5.2 Page 18 Bamburgh Crescent now provides longer-term care and will have a greater role to play in ensuring that people’s health care needs are met. There is at present only one person living in the residential unit. Before this person was admitted into the home, staff obtained information about their health care needs and how they should be met. Staff have obtained a copy of the person’s Health Action Plan and this provides staff with good information about their past and current health care needs. Staff consult with relevant health care professionals on the person’s behalf when necessary. Medication records are fully completed, contain required entries, and are signed by appropriate staff. The manager carries out regular checks of medication storage arrangements and medication records. This helps to ensure that day-to-day medication practices are in line with the provider’s medication policies and procedures. People receive the support they need to take their medication. Lockable facilities are provided to ensure that people taking their own medication can do so safely. The home has a good history of handling medications in a safe manner. All staff have recently completed accredited medication training. Although there are written records confirming that staff have been deemed competent to administer emergency epilepsy medications, a general assessment of staff’s competency to handle, record and administer medication has not been carried out. In addition, some staff’s training in administering emergency epilepsy medication had not been reviewed and updated during the previous 12 months. All medication is safely locked away and only trained staff administer medication. Bamburgh Crescent, 10 DS0000033083.V371740.R01.S.doc Version 5.2 Page 19 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are good arrangements for keeping people safe and for ensuring that complaints are responded to appropriately. This means that people can be confident that they will be protected from harm, and that their views will be listened to and their concerns acted upon. EVIDENCE: The service has a complaints procedure that is clearly written and easy to understand. It is available on request in large print and a pictorial format. The complaints procedure is supplied to everyone living at or visiting the home. Neither the home nor the Commission have received any complaints during the last 12 months. Staff are clear about how they are expected to handle complaints. People using the service at the time of the inspection were unable to comment on whether they are satisfied with the way in which complaints are managed. The home has an adult protection policy that complies with the relevant guidance and legislation. There have been no adult protection concerns raised with either the Commission or the home since the last inspection. The majority of staff have completed safeguarding training. Staff are clear about how to keep people safe and handle complaints. Bamburgh Crescent, 10 DS0000033083.V371740.R01.S.doc Version 5.2 Page 20 Bamburgh Crescent, 10 DS0000033083.V371740.R01.S.doc Version 5.2 Page 21 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well maintained and has been satisfactorily adapted to meet the needs of the people using the service. EVIDENCE: Bamburgh Crescent is homely, comfortable and provides a safe environment. No health and safety concerns were identified during the inspection. People using the service have access to safe and pleasant garden areas to the rear of the building. Significant improvements have been made to the rear garden areas. For example, fencing has been fitted in both gardens to give more privacy and provide more security. However, the front garden has an unkempt appearance and would benefit from the same sort of attention that has been given to the rear gardens. The bedroom accommodation, communal rooms, bathing and kitchen areas are clean, tidy and well maintained. The home is Bamburgh Crescent, 10 DS0000033083.V371740.R01.S.doc Version 5.2 Page 22 bright, cheerful, airy and free from offensive odours. The standard of decoration, fixtures and fittings is good. A range of specialist aids and adaptations has been provided and this not only promotes people’s independence but also helps staff provide safe care. For example, grab rails and hoisting equipment have been fitted in the bathing areas. Each unit has an easy access shower. Bamburgh Crescent, 10 DS0000033083.V371740.R01.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People are protected by the provider’s recruitment policies and practices and are supported by a competent staff team. EVIDENCE: There are rotas that show which staff are on duty and at what times. The staff team consists of a full time manager and 13 residential care officers. The rotas show that, for three service users, there is always a minimum of two staff on duty between 7 am and 10 pm. In addition, there are extra staff on duty during busier times of the day, to support people participating in community based activities or to attend staff meetings. Staff are responsible for carrying out all ancillary tasks such as cooking and laundry, where people using the service are unable to do so. One member of staff ‘sleeps over’ in the building each night. The manager’s hours have not been included on the staff rotas. Waking night staff are provided when the needs of people using the respite care service require this. Bamburgh Crescent, 10 DS0000033083.V371740.R01.S.doc Version 5.2 Page 24 The majority of the staff have either obtained a National Vocational Qualification at Level 3 or a recognised qualification in social work. A further three staff are in the process of completing a relevant qualification. Staff did not receive supervision at the frequency stipulated in the National Minimum Standards during the previous 12 months. However, since the new manager took over and the home re-opened, staff have been receiving structured supervision on a more regular basis. To date, Mr Robinson has also carried out at least 50 of the required staff appraisals. He has also put arrangements in place to ensure that regular staff meetings are held. Finding time for carers to attend staff meetings has not been easy and great care has been taken to ensure that people continue to receive consistent care whilst permanent staff are out of the building. A range of pre-employment checks is carried out before staff can commence work at the service. For example, with regards to staff employed after the introduction of the National Minimum Standards, it was identified that: • • • Staff are required to complete an application form and attend a selection interview. The manager said that gaps in employment are always verified; Each person’s identity is checked and verified; All staff undergo a Criminal Records Bureau Disclosure check. However, it was identified that a Testimonial rather than a reference had been accepted for one member of staff. There are opportunities for staff to complete and update their training in key areas. For example, in the sample of staff files examined, all three staff had completed training in first aid and moving and handling. However, documentary evidence was not available for some staff confirming that they had completed training in health and safety, fire safety, infection control or food hygiene awareness. The new manager has identified who has completed what training and when this next needs updating. Arrangements are being made for staff to update their training where necessary. This training was designed to help staff care for the person in question and was delivered by members of the multi-disciplinary team. Staff also receive opportunities to complete training that is more relevant to the needs of people with learning disabilities. For example, all staff have completed training in the use of physical intervention. Some staff have undertaken training in equality and diversity and using the Mental Capacity Act. In addition, before one person moved into the residential unit all staff received two days training that was specific to the needs of this person. Bamburgh Crescent, 10 DS0000033083.V371740.R01.S.doc Version 5.2 Page 25 One member of staff spoke about the challenges they face caring for a person who is very challenging to look after. They said they valued the management and peer support they received but would welcome more training to help them develop skills and competencies in managing behaviours which challenge. Bamburgh Crescent, 10 DS0000033083.V371740.R01.S.doc Version 5.2 Page 26 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and run in the best interests of the people using the service. This means that people can feel confident that their health, welfare and safety will be promoted and protected. EVIDENCE: A new manager has been appointed and registered with the Commission since the last inspection. Mr Robinson has considerable experience in working with people with learning and physical disabilities in a residential setting. The manager has obtained a recognised qualification in social care and is due shortly to commence the Registered Manager’s Award. Bamburgh Crescent, 10 DS0000033083.V371740.R01.S.doc Version 5.2 Page 27 Mr Robinson has clear ideas about the standards of care he wants staff to achieve at Bamburgh Crescent. He has an open style of leadership, encourages staff to participate in the running of the home, and consults them about decisions that need to be made. Although staff have undergone a significant period of change over the last 12 months, they remain positive about the support they deliver to the people in their care. Following the re-opening of the service, arrangements are being put in place to monitor the quality of care and facilities offered. For example: • A quality questionnaire is being developed which will ask people using the service and their families, and professionals involved with the service, to comment on how well Bamburgh Crescent is performing; • Annual service reviews will be held and people using the service will be invited to attend and express their views about the care they are receiving; • The provider carries out monthly unannounced monitoring visits to ensure that the service is being run in the best interests of the people using the service; • The provider is in the process of preparing a business plan that they have agreed to forward to the Commission upon completion. The home submitted an Annual Quality Assurance Assessment when asked to do so by the Commission. The assessment was only partly completed and contained limited evidence to support the self-assessment judgements that had been reached. However, this is due to a number of reasons including that the service has a new manager and the home has only recently re-opened with a new remit. Mr Robinson is in the process of designing a quality assurance system that will enable the staff team to evaluate and assess the extent to which the home is complying with the National Minimum Standards and Care Homes Regulations. Staff at the home take action to protect people’s health and safety. The premises are safe and well maintained. Health and safety records are kept and these showed that: • • • A range of premises related risk assessments have been carried out. However, none of these have been updated since they were originally carried out by a previous manager; The home’s electrical equipment has been tested and found safe; The home has a current fire risk assessment. It was identified during the inspection that the fire risk assessment had not been updated to take account of a decision made to lock the front entrance to protect a person living at the home. The manager agreed to immediately address this shortfall; Bamburgh Crescent, 10 DS0000033083.V371740.R01.S.doc Version 5.2 Page 28 • Fire drills and in-house training sessions have taken place on at least two occasions during the last 12 months. Three new staff have participated in a fire drill as part of their induction. Two members of staff have been delegated the responsibility of ensuring that regular fire prevention checks are carried out. Bamburgh Crescent, 10 DS0000033083.V371740.R01.S.doc Version 5.2 Page 29 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 3 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 X 2 X X 2 X Bamburgh Crescent, 10 DS0000033083.V371740.R01.S.doc Version 5.2 Page 30 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA1 Regulation 4&5 Timescale for action Revise the home’s service user 01/01/09 guide and statement of purpose to ensure that they reflect Bamburgh Crescent’s new remit. This will help to ensure that people have access to the information they need to make an informed decision about whether to use the service. 2. YA23 13(6) Ensure that all staff receive 01/01/09 training in safeguarding vulnerable adults. This will help to ensure staff protect people living at the home from potential harm or abuse. YA37 3. 9 The registered manager must 01/01/10 obtain a recognised qualification in management. This will help to ensure that a person with appropriate skills, competencies and knowledge manages the home. 4. YA35 18(1)(c)(i) Ensure that all staff complete 01/01/09 training in health and safety, DS0000033083.V371740.R01.S.doc Version 5.2 Page 31 Requirement Bamburgh Crescent, 10 food hygiene, infection control and certificated fire prevention. This will help to ensure that all staff have the skills and competency to provide people with good quality care that meets their needs. 5. YA36 18(2)(a) Ensure that staff receive: • • Supervision at least times a year; An annual appraisal. six 01/10/08 This will help to ensure that people working at the home are appropriately supervised and are providing care that delivers good outcomes for people using the service. 6. YA39 24 Establish and maintain a system 01/04/09 for evaluating the quality of services provided at the home. This will help to ensure that the home is run in the best interests of the people using the service. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA2 YA6 Good Practice Recommendations Devise a pre-admission assessment format for use by the service. Ensure that people’s: • Bamburgh Crescent, 10 Needs are clearly defined in their service plans; DS0000033083.V371740.R01.S.doc Version 5.2 Page 32 • • Service plans contain clear statements of desired outcomes; Service plans are available in a format more easily understood by the person using the service. (This is a repeated recommendation). Service plans should also address relevant equality and diversity issues. 3. YA6 Carry out an assessment of each person’s competency to make decisions, taking into account the guidance set out in the Mental Capacity Act. Provide all staff with Mental Capacity Act training. 4. YA9 Ensure that: • • Nutritional and moving and handling risk assessments are carried out for each person using the service; The home’s fire risk assessment is updated to reflect the decision made to lock the front door to keep one of the people using the residential service safe. 5. YA17 Ensure that the records of food provided to service users contain sufficient detail to enable judgements to be made as to whether people are receiving a satisfactory diet. Ensure that staff update their emergency epilepsy medication training every 12 months. The training provided should cover the specific needs of each individual. Provide all staff with the training they need to develop the skills and competencies required when working with people whose behaviour challenges the service. Ensure that the manager’s hours are included on the home’s rotas. Ensure that: • • Risk assessments are reviewed and updated every 12 months. They should be signed and dated; The home’s fire risk assessment is reviewed and updated to take account of changing circumstances within Bamburgh Crescent. 6. YA20 7. YA32 8. 9. YA33 YA42 Bamburgh Crescent, 10 DS0000033083.V371740.R01.S.doc Version 5.2 Page 33 Bamburgh Crescent, 10 DS0000033083.V371740.R01.S.doc Version 5.2 Page 34 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Bamburgh Crescent, 10 DS0000033083.V371740.R01.S.doc Version 5.2 Page 35 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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