CARE HOME ADULTS 18-65
1 Hill Close 1 Hill Close Pontefract West Yorks WF8 2SF Lead Inspector
Tony Brindle Unannounced 5 July 2005 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 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 Stationary 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. 1 Hill Close J51J01_s6250_1 hill close_v219662_050705.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service 1 Hill Close Address 1 Hill Close Pontefract WF8 2SF Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01977 797235 Mr J Hunt Mr J Hunt Care Home 3 Category(ies) of Learning Disability registration, with number of places 1 Hill Close J51J01_s6250_1 hill close_v219662_050705.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 21 March 2005 Brief Description of the Service: 1 Hill Close provides personal care for three adults with learning disabilities who are under 65 years old.. The home is located within a semi-detached house in a residential area of Pontefract. The home is a few minutes walk from the centre of Pontefract and all local amenities. It is on a main bus route, There are local shops, public houses and clubs close by. Service users are very able and a supported in living as ordinary life as possible.The services users, who are able to communicate the help they require from support workers set the tone of the home. The service users living in the home consider it a home for life and do not anticipate moving elsewhere. 1 Hill Close J51J01_s6250_1 hill close_v219662_050705.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced hour inspection was a positive and enjoyable inspection. During the inspection, the following documents were inspected: 2 care plans, the daily records, health and safety records and risk assessments. The building and gardens were seen. There have been no additional or complaints visit to this home since the last inspection in December 2004. There have been no changes to the Registered Persons registered with CSCI. The inspector would like to take the opportunity to thank the service users, the manager and support workers for their hospitality and patient cooperation throughout the inspection. What the service does well: What has improved since the last inspection? What they could do better:
From the standards inspected, there were no aspects of the care and support offered at Hill Close that were in need of improvement. No aspects of the management of Hill Close were found to be in needs of improvement.
1 Hill Close J51J01_s6250_1 hill close_v219662_050705.doc Version 1.40 Page 6 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. 1 Hill Close J51J01_s6250_1 hill close_v219662_050705.doc Version 1.40 Page 7 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 Standards Statutory Requirements Identified During the Inspection 1 Hill Close J51J01_s6250_1 hill close_v219662_050705.doc Version 1.40 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 The admission systems operated at Hill Close, and the work of the staff make sure that prospective service users’ individual aspirations and needs would be assessed prior to moving into the home. EVIDENCE: There have been no new admissions to this home for several years. The admission procedure operated by the home helps to guide staff on the actions they are to take to ensure that the needs of new service users are assessed effectively. The manager said that admission to the home follows a full assessment of need being obtained from the placing authority, which is backed by an assessment by staff at the home. These assessments are used to create a basic care plan prior to the service user moving into the home. 1 Hill Close J51J01_s6250_1 hill close_v219662_050705.doc Version 1.40 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 7 9 The systems operated at Hill Close, and the work of the staff make sure that service users know their assessed and changing needs and personal goals are detailed within an individual plan of care and support. The work of the staff supports service users to make decisions about their lives with assistance as needed, and take reasonable and assessed risks as part of an independent lifestyle. EVIDENCE: Discussion with the manager showed a good understanding of the support and care needs of the service users. The manager explained that service users are enabled to take risks based on shared information and a relevant risk assessment. The home has an appropriate procedure should service users have an unplanned absence. Service user plans contain detailed information about support and healthcare needs. The plans have a straightforward approach, concentrating on aspects of daily living, providing an holistic overview of the service user and the support they require in order to move towards greater independence. Restrictions are only placed on the service users following an appropriate risk assessment.
1 Hill Close J51J01_s6250_1 hill close_v219662_050705.doc Version 1.40 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 13 15 16 17 It is clear that the staff play a key role in supporting service users to live fulfilling lives outside as well as within the home, and this should continue. Opportunities for personal development and independent living are created, and service users access community facilities and leisure activities. EVIDENCE: Staff were seen to respect service users’ individuality, dignity and privacy both by appropriate form of address and by speaking with them respectfully. The daily records show that individual service user personal, cultural/religious and food preferences are observed. The manager said that service users spend time outside of the home including visits to local shops, training centres and other organised activities. 1 Hill Close J51J01_s6250_1 hill close_v219662_050705.doc Version 1.40 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 19 20 The systems and procedures operated by the home, and the work of the staff ensure that the personal and healthcare needs of the service users are identified and met. EVIDENCE: The service user’s individual plans detail key aspects of how an individual seeks to be supported. One service user has recently experienced poor health, and the records show how the staff have supported the service user to visit the hospital, access their GP and manage their healthcare while at home. The manager recognizes that service users have the right to good quality physical and emotional health wherever they are living. The service users are supported as far as possible, to manage their own healthcare and to access NHS community facilities. Details of specialist health, nursing and dietary requirements were seen in the service user’s wide-ranging individual plans. The manager said that service users are supported to manage their own medication following a risk assessment. 1 Hill Close J51J01_s6250_1 hill close_v219662_050705.doc Version 1.40 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 23 The home has a satisfactory complaints system in place that people can use to express their feeling and views about the care and services provided at Hill Close. There are satisfactory systems in place that can protect people from suspected or alleged abuse. EVIDENCE: Clear procedures enable service users to make their views known. Policies and procedures for dealing with suspicion or evidence of abuse are in place. Complainants are informed that they may make complaints directly to the CSCI. The manager said that adult protection issues are referred to the Local Authority, with a notification going to CSCI. 1 Hill Close J51J01_s6250_1 hill close_v219662_050705.doc Version 1.40 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 30 The standard of the décor within the home is good, providing people with a homely and comfortable environment. EVIDENCE: The manager said that respect for service users’ privacy is really important, including the freedom to come and go, and receive guests. The facilities within the home are as home-like as possible while being fit for the purpose of the home and for the people who live there. 1 Hill Close J51J01_s6250_1 hill close_v219662_050705.doc Version 1.40 Page 14 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 Service users are supported by an experienced and well-trained team of staff. EVIDENCE: The staff were seen to be approachable, and one service user said that they are good listeners. The rotas show that there is a continuity of staff support, allowing service users to get to know people and develop good relationships with key-workers. The personnel files show that the company undertakes satisfactory and appropriate recruitment checks, identifies training and development and provides appropriate supervision and support. New staff complete induction training, which is signed off by the home’s management team. 1 Hill Close J51J01_s6250_1 hill close_v219662_050705.doc Version 1.40 Page 15 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 42 The systems and procedures, and the work of the staff team ensures that the views of service users are sought and acted upon in relation to the services they receive. The health and welfare of the service users and staff is protected by the safety systems operated by the home. EVIDENCE: The manager was able to demonstrate that the home routinely seeks the opinions of the service users through annual service user’s questionnaires, which were seen within the service user’s individual files. The fire safety and other health and safety records and assessments were found to be satisfactory. 1 Hill Close J51J01_s6250_1 hill close_v219662_050705.doc Version 1.40 Page 16 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23
ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 3 x 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
1 Hill Close Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x J51J01_s6250_1 hill close_v219662_050705.doc Version 1.40 Page 17 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 Regulation Requirement Timescale for action 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. Refer to Standard Good Practice Recommendations 1 Hill Close J51J01_s6250_1 hill close_v219662_050705.doc Version 1.40 Page 18 Commission for Social Care Inspection Park View House Woodvale Office Park Brighouse HD6 4AB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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