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Inspection on 26/02/09 for Manor Road (14)

Also see our care home review for Manor Road (14) for more information

This is the latest available inspection report for this service, carried out on 26th February 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Manor Road (14) 14 Manor Road Knaresborough North Yorkshire HG5 0BN two star good service The quality rating for this care home is: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Linda Trenouth Date: 2 6 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. They reflect the things that people have said are important to them: 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 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Internet address www.csci.org.uk Information about the care home Name of care home: Address: Manor Road (14) 14 Manor Road Knaresborough North Yorkshire HG5 0BN 01423868918 01423868918 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : United Response care home 4 Number of places (if applicable): Under 65 Over 65 4 0 learning disability Additional conditions: Registered for a maximum of 4 Service Users with Learning Disabilities who also have Physical Disabilities Date of last inspection 0 2 1 1 2 0 0 6 A bit about the care home 14, Manor Road is registered to provide residential personal and social care for 4 service users with learning and physical disabilities. The property is a purpose built bungalow situated on a residential housing estate close to Knaresborough town centre and with good access to the towns services and amenities. All parts of the home are wheelchair accessible. The home is part of the United Response organisation and benefits from the support of the companys training and management structure. In 2007 the weekly charge was 1,322.52. 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 How we did our inspection: This is what the inspector did when they were at the care home We visited the service over one day for approximately 6 hours. The inspection also included gathering information and evidence before and after the visit to decide the overall judgement. We looked at records, watched staff working, and talked to people who live at the home. We also looked around the building. The main purpose of this inspection is to make sure the service provides a good standard of care. 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 as recommendations, but only when it is considered that people who use the service are not being put at significant risk or harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. We sent comment cards to people who use the service and to staff to give them the opportunity to comment on the service. The manager of the home completed a self-assessment form called AQQA, which is information we ask for every year and is used as part of the inspection process. The returned self-assessment documentation provides information about staffing and people who use the service. Feedback was given during the inspection to the manager of the home. The weekly fee is recorded in the contract and extras charged for include clothing, toiletries, aromatherapy and hairdressing. What the care home does well People are given good information and support to help them make important decision in their lives. The service provides a consistently good level of personal support in a dignified way for people living at the home. Staffing levels are now more consistent and make sure that people get the support they need to live a fulfilling life in a way they choose. People enjoy a wide range of interesting activities both within and beyond the home. The home is well maintained and people choose how they want the home to look. The staff are safely recruited and well trained. Staff tell us that they like working at the home and the management of the home is open and inclusive. The acting manager of the home makes sure the home is well maintained and that staff are well supported to do their work safely and competently. What has got better from the last inspection The service has improved staffing levels and recruited permanent staff since the last inspection. This has provided a better continuity of care for people living at the home. The home is regularly audited by a service manager who produces a monthly report. This is to make sure that the home is well run and people are kept safe. What the care home could do better A permanent manger registered with the CSCI is needed to provide the right support and continuity for everyone. When staff are recruited and work at the home before the CRB (Criminal record checks) are completed they must not work alone and must always be supervised. The manager should review the storage of recycling materials to make sure the home is maintained in a comfortable way for the people living there. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Linda Trenouth Regulation Inspector St Nicholas Building St Nicholas Street Newcastle Upon Tyne Ne1 1NB Tel 0191 233 3300 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 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 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 . People are told what the service can provide and have their needs fully assessed so everyone can decide if the home is right for them. Evidence: It is some time since there has been a new admission to the home but staff say that everyone is offered an introductory visit to the home. People visit the home over a long period of time and are also invited to stay, this is to make sure that the home is right for them. During a care review one person expressed interest in moving to another home and staff have supported them in their choice and an advocate appointed to make sure they have the right support to make their decisions. individual records showed that people had full assessments completed before anyone moves into the home. This is important to make sure the home can safely meet all their needs. People each have individual contracts, which explain the fees that they are charged and their rights whilst living at the home. The fees also include use of the minibus. 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 supported to be involved in important decisions in their lives. Evidence: Everyone has a person centred plan, which means that they are central to all decisions made about their lives. The care plans were very detailed and showed how people liked their care to be carried out. Records showed that care plans look at the best way to communicate with people, and the best way to interpret what people want. Care planning meetings are held for everyone, where they can have their say on planning any changes to services. The care plans are reviewed regularly and people are supported to take part in a meaningful way. Families and advocates are encouraged to take part in the care planning review. Individual wishes are recorded in the care plan. This makes sure that the activities are what the individual wants and explores their interests and choices. Personal development is encouraged alongside supporting people to engage in an active social life. Everyone has a key worker who helps make sure that all their care needs are met. Evidence: People have their own door keys and are encouraged to answer their front door when visitors arrive. One individual also has their own door bell to their bedroom door to further respect their space. People enjoy a comfortable routine in the home, the home is relaxed and people enjoy activities at their own pace. People are supported daily in making choices in all aspects of their daily lives. The households holds regular house meetings, to support people in making decisions as a group. Staff say the people are encouraged to shop and choose their own clothes. Individuals have their own tastes and bedrooms are decorated and personalised to reflect this. Staff make sure that people are supported to make the best of their appearance. This is important to make sure individual dignity is respected. Records showed clear risk assessments in areas such as nutrition, moving and handling and epilepsy, this is important to make sure people enjoy a fulfilling life with minimal risk. Daily records and observations at the visit confirm that people are supported to make many choices and decisions in their daily lives. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People enjoy a fulfilling life both in the home and wider community. Evidence: People have individualised bedrooms where they can spend time relaxing and enjoying their hobbies and interests. During the visit people enjoyed a variety of activities including visiting the hydrotherapy pool, visits to the barber, and shopping. One individual preferred spend time relaxing in their room. Staff support people in a variety of activities such as going out to local pub, shopping and visiting local attractions. Staff say that activities have got better since the last inspection and that people get out more and engage in more meaningful activities. People are encouraged to take part in the planning of the menu and helping in the weekly shop for food. Some individuals engage in local community activities with a local arts and crafts group. Some attend specialist day services which support them with their needs. People also take part in a larger social group called, Altogether which meet once per month and recently enjoyed a trip to the Media Museum in Bradford. Evidence: People also have the opportunity for holidays and last year there were holidays to Blackpool and a cottage holiday. People also enjoy regular day trips to the seaside and other places of interest. 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 . Peoples health needs are supported and met. Evidence: One Social Care Manager commented, There is good support of complex and physical care needs and Good personable support of complex individuals and they are caring and sensitive People are supported in attending appointments and health care information is well recorded in individual care records. Each persons care record provides good information about how each person is to receive personal support and how the health-care needs will be met. Staff support people well and make sure people always look good and their dignity is well supported. Each person is registered with a local GP and has regular health reviews. People are supported by a range of health care professionals including, Dentists, Chiropodists, Speech Therapists, Dietitian, and Epilepsy support. Any recommendations from these Professionals are included in their care plans. The service works alongside Physiotherapist, and Occupational Therapists to make sure all physical needs are safely met both in the home and in speciality equipment they require. It was observed that peoples personal care was supported in a dignified way. Staff approach in a relaxed way with reassuring voice tones to support people. Evidence: A Care Manager commented, There is good management of medication. The medication systems and procedures were satisfactory. Proper arrangements were in place for the administration and storage of medication and records accurate and upto-date. All staff who administer medication have received accredited training. 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 . People feel confident that the concerns will be acted upon properly and the procedures are in place to safeguard people from harm. Evidence: The staff team have training in how to make sure the people are protected from abuse. Staff meetings review the adult protection procedures and explore what is meant by abuse. People hold their own monies in their room with staff support. Daily checks occur of peoples individual monies at the handover. Records were seen and clear accountancy was evident. The manager monitors these records to make sure that everyone is safe. People have their own bank accounts and are supported by the staff to plan their expenditure for the week. 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 comfortable and safe home. Evidence: This was an unannounced visit and the home was found to be well decorated maintained and clean throughout. All accommodation is on one floor and there is level access to the home so it is suitable for people with mobility difficulties. The lounge and dining room are comfortable and well decorated. The lounge area has a range of sensory equipment and large bean bags and soft furnishings to enable people to enjoy a restful space. Bedrooms are personalised and well decorated to suit individual tastes. People are encouraged and supported to buy personal items to decorate their rooms. The home has two bathrooms both with specialist baths and changing areas. The main bathroom has a comfortable Jacuzzi bath. The kitchen is spacious to allow movement of the wheelchairs, however it was a concern that the storage of recycling materials in the kitchen area was a potential hazard and should be stored appropriately. The home has a spacious well-kept garden and patio area where garden furniture has been purchased for the use of people living at the home. 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 receiving good care from a committed and supported staff team, who are well trained to meet their needs. Evidence: Staff confirmed that they have completed induction training. Staff then move on the National Vocational Award. All permanent staff have completed NVQ level 2 and above. This shows the service is committed to making sure that the staff are well trained to safely meet all peoples needs. Staff say , The service provides a high standard of training and support. Staff also complete specialist training to support the needs of people in the home, this includes training in epilepsy and communication needs. Sufficient staff were on duty and staff rosters indicate that the home is well staffed. Staff say they have regular supervision for the manager and evidence of these records was seen. 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 run in the best interests of the people who live at the home but a permanent registered manager would provide more continuity and consistency for everyone. Evidence: The registered manager left the home sometime ago and acting managers have been put into place. The home does not have a registered manager, and no application has been received by the CSCI. Presently there is an acting manager in place who has previous experience in caring for people with a learning disability and has completed NVQ level 3 in Health and Social Care. The acting manager manages the home well. House meetings are held at the home regularly and views are gained through daily interaction with staff and their care planning meetings. The manager is presently developing ways in which to involve relatives more with the home. Staff say they have regular meetings and supervision. This makes sure people have the opportunity to have their say about the running of the home. One care manager commented, Care service delivery is of a high standard overall for a small number of complex clients Evidence: The service also conducts its own quality survey to find out how people feel about the running of the service. The area managers undertake monthly quality audits of the home and look at staffing levels, records and maintenance of the building. Health and safety checks are regularly carried out and records well maintained, the gas, fire systems were reviewed at the visit and found to be all in place. The five yearly electrical certificate however needed updating. Are there any outstanding requirements from the last inspection? Yes  No  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 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 Description 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 Description Timescale for action 1 34 19 Make sure that where people 15/05/2009 are working at the home before their CRB is completed are supported properly and do not work without adequate supervision. This is to make sure that people are safe from harm. 2 37 7 A registered manager must be put into place. 15/05/2009 This is to provide continuity of support to the home. 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 28 The manager should seek an alternative for accrued recycling materials, keeping the kitchen area safe, clean and comfortable for people living at the home. 2 41 The five yearly electrical hard wire certificate needs to be updated. Helpline: 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 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) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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