CARE HOME ADULTS 18-65
10a Coates Lane Whitehaven Cumbria CA28 7BZ Lead Inspector
Nancy Saich Unannounced Inspection 9:00 28 November 2005
th 10a Coates Lane DS0000022544.V268122.R01.S.doc Version 5.0 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 10a Coates Lane DS0000022544.V268122.R01.S.doc Version 5.0 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. 10a Coates Lane DS0000022544.V268122.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service 10a Coates Lane Address Whitehaven Cumbria CA28 7BZ 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) 01946 691336 karen.russell@turning_point.co.uk Turning Point Mrs K E Russell-Haines Care Home 9 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (9) of places 10a Coates Lane DS0000022544.V268122.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The home is registered for a maximum of 9 service users in the category MD (Mental disorder) 1 named service user in the category of MD(E) (Mental disorder over 65 years of age) 3rd June 2005 Date of last inspection Brief Description of the Service: 10a Coates Lane is a Georgian house situated in the centre of Whitehaven. It is home to nine people who have long-term difficulties with mental health. There is one person who is aged over sixty-five. The home is operated by Turning Point who run residential homes and other services throughout the country. Karen Russell- Haines manages the home on their behalf. The home is on two floors and is not suitable for people who have a disability that effects their mobility. 10a Coates Lane DS0000022544.V268122.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection. Nancy Saich, the lead inspector arrived just before nine in the morning and stayed until mid afternoon. She spoke to all of the residents either individually or in a group. She had also sent questionnaires to them some weeks before the inspection. She spoke to the manager and the staff on duty and read documents that supported what was said and what she saw. What the service does well:
This home is good at making sure that they can give a new resident the kind of care they need. They also make sure that any new person will fit in with the group of people who already live in Coates lane. The staff team are good at helping residents to make suitable decisions about their lives while also helping them lessen any risks involved due to their mental health needs. Coates Lane is good at encouraging people to have individual hobbies and interests and to take part in clubs and training. The staff team encourage all of the residents to look after and care about each other. This means they genuinely enjoy each other’s company and sometimes like to do things together. Residents said that the staff helped them with the symptoms of their mental health problems and also supported them through difficulties. Some of these were to do with worries and concerns they had about relatives or about growing older themselves. The inspector heard lots of examples of staff reassuring and supporting people. One person said “The staff are great…they are very good listeners…”. The home is good at dealing with complaints and in making sure that residents are not abused in any way. The furnishings and decoration in the home are of a very good standard. The house is comfortable and the residents are very relaxed in their own home. The home is fully staffed by a well trained and suitably qualified staff team. Residents thought they did their jobs really well. The manager makes sure she talks to each of them individually to make sure they get the right kind of support to be able to care properly for residents. There are very good systems in the home that allow residents to have their say about how the home is run and about future plans for their lives in the house. The manager makes sure that things like fire safety and good hygiene are maintained by routine systems that mean the home is clean, safe and
10a Coates Lane DS0000022544.V268122.R01.S.doc Version 5.0 Page 6 comfortable. Residents are relaxed, as they know that the home is managed properly and with their well being in mind. What has improved since the last inspection? 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. 10a Coates Lane DS0000022544.V268122.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection 10a Coates Lane DS0000022544.V268122.R01.S.doc Version 5.0 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 the following standard(s): 2 The home is good at making sure that only people they can care for and who will fit in with the existing group become residents in the home. EVIDENCE: The inspector met with two new residents and they said they had been able to visit the home before coming to stay. They also said that the manager and the staff were keen to know all their needs. The inspector read the assessment notes and these showed that the manager was careful about admitting new residents so that only people with mental health needs they can meet will come into the home. 10a Coates Lane DS0000022544.V268122.R01.S.doc Version 5.0 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 the following standard(s): 6,7,9 There was lots of evidence to show that individual needs and choices are important in the home but problems with care planning mean this is not working as well as it might. EVIDENCE: Residents said that they had written plans that let them tell the staff what they needed. The inspector saw these plans and found that most of them were detailed and up to date. There were two new residents who had been in the home for some time and neither of them had up to date care plans. The manager said they were still looking at their needs but the inspector saw that staff were caring for these people and that they weren’t sure of some of the details because these are not written down. Some of the plans did show that the staff supported residents to make their own decisions and that any risk was weighed up. The residents confirmed that they were encouraged to make balanced decisions and that the staff helped them to see any risks that might be involved. Residents were seen asking for support and doing things independently on the day. The manager said that the home was planning to start on a new way of finding out about needs and risks and agreed that the written care plans needed to be looked at in some depth and appropriate changes made.
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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 the following standard(s): 11, 12, 13,17. The residents in the home have the kind of lifestyle they prefer and are very much part of their community. EVIDENCE: Residents spoke about the different activities and events they attend. They told the inspector about their holidays and it was nice to see that the residents went on holiday in twos and threes and their choice of holiday suited their personal needs. Residents went out during the day to shop and to clubs and to personal appointments. Residents also did routine household chores and spent time just socialising with each other. The inspector thought that there was a good range of activities in the home. People are encouraged to have individual interests but the group of people in the home also enjoy each other’s company and like to spend time together. Residents said the food was good and that they were being encouraged to cook more for themselves. The inspector thought that the residents did have plenty of the kind of food they wanted. She did however think that the staff might be able to help people make even more healthy choices than they do at the moment.
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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 the following standard(s): 18,19,20,21 The home is very good at helping people to deal with all of their health care needs and this helps people to cope with their mental health needs and to deal with physical changes. EVIDENCE: Residents said that the staff were very good at supporting and helping them with all of their needs. The inspector saw different examples of how staff encouraged and persuaded the residents. She also saw staff giving residents good boundaries and guidelines to follow so that any symptoms of ill health were kept to a minimum. Staff are good at helping with emotional and psychological needs. Several residents said they had worries or concerns that staff helped them with. Some of this related to their health problems but some were also to do with family issues and with changes and losses. Residents said the staff did this really well. The pharmacy inspector for the Commission for Social Care Inspection had completed a visit to the home some time before and she found that medicines were being dealt with properly. There were one or two things that needed looked at and these had been done by the time of this inspection. (A copy of the pharmacist’s report can be accessed by contacting the Penrith area office). Residents see local G.P’s, chiropodists, opticians and dentists. Everyone sees a psychiatrist on a regular basis and they look at their medication to make sure they have the right kind of treatment. One person had been referred to a
10a Coates Lane DS0000022544.V268122.R01.S.doc Version 5.0 Page 14 specialist about a health worry and he felt pleased that staff were supporting him in this. 10a Coates Lane DS0000022544.V268122.R01.S.doc Version 5.0 Page 15 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 the following standard(s): 22, 23 The home is good at dealing with complaints and in protecting people so that residents feel they are listened to and action is taken. EVIDENCE: None of the residents had any complaints on the day. They did know how to complain and several people said they had no worries about putting in a complaint. They would tell the manager, a member of staff or the representative of Turning Point who visits and speaks to them every month. Staff were aware of what sort of things would be abusive. One member of staff talked about how there was “a fine line” between bullying people and encouraging them. Staff did seem to be aware of the less obvious things that are abusive and are careful about how they help people. Residents said that there was nothing going on in the home that concerned them but they said that if they were worried they would have staff to talk to or would talk to someone from outside the home. 10a Coates Lane DS0000022544.V268122.R01.S.doc Version 5.0 Page 16 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 the following standard(s): 24,25,30 The residents live in a comfortable home that they feel relaxed and secure in. EVIDENCE: Coates Lane is an older Georgian property set in the centre of Whitehaven. All of the rooms are spacious with high ceilings. The building is well decorated and furnished. The building has some drawbacks because of its age. The rooms are on two floors and there is no lift. This means that the manager has to be careful about admitting people who find stairs a problem. There have also been problems in the past with dampness from the roof and in the hall. These problems have been dealt with but there was some new damp evident in one room. The manager said that this was going to be dealt with and the inspector agreed to look at this at the next inspection. Despite these problems the house is homely and comfortable and was clean and tidy in all areas. The walled garden has been improved over the summer and is now an attractive place to sit out when the weather is fine. New raised beds will help people to be involved with growing things in the summer. Residents’ bedrooms were nicely decorated and furnished and several people said how much they enjoyed spending time in their rooms.
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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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,36 The way the home is staffed allows the residents to be cared for by staff who understand their needs and have the right kind of qualities. EVIDENCE: The inspector spoke to residents and watched how staff worked with them. She also checked records and documents. The residents said they felt that the staff knew what they were doing and they felt that the team were very good at their jobs. The records showed that people on the team had suitable qualifications and that the manager checked on their skills and knowledge. This means that staff can care properly for the residents. A new member of staff had been taken on and the residents had helped to choose this new member of the team. Her file showed that all the proper checks and references had been made and she was the right kind of person to be caring for the residents. Staff said they got a lot of support from the manager and that she was easy to talk to. The inspector saw written notes that proved the manager spent time with each member of staff and talked to them about their role and their needs. These ‘supervision notes’ were detailed and up to date. 10a Coates Lane DS0000022544.V268122.R01.S.doc Version 5.0 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39,42 This home runs smoothly and this allows residents to live with as few anxieties as possible. EVIDENCE: There was lots of evidence to show that the manager of this home knows everything that is happening in the home and that she makes sure that the management systems protect and support the residents and staff. She has regular residents and staff meetings and knows each individual very well. The residents and staff have a lot of trust and respect for her and know that she organises the home for the good of the residents. The manager regularly asks the people who live in the home about their levels of satisfaction with the care and services. She also makes sure that when things need to be developed that she includes and involves the people who live and work in the home. This shows that the ‘quality assurance’ system is working well. The health and safety systems were working well with things like fire and food safety being completed as part of the every day working life of the home. 10a Coates Lane DS0000022544.V268122.R01.S.doc Version 5.0 Page 20 10a Coates Lane DS0000022544.V268122.R01.S.doc Version 5.0 Page 21 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 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 X 3 X Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 X X X X 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 X 3 CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
10a Coates Lane Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 3 X DS0000022544.V268122.R01.S.doc Version 5.0 Page 22 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 YA6 Regulation 15 Requirement The registered manager must complete care plans for the two new residents. Timescale for action 14/01/06 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 YA17 Good Practice Recommendations It is recommended that the registered manager look at ways to help residents make more healthy choices in their diet. 10a Coates Lane DS0000022544.V268122.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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