CARE HOME ADULTS 18-65
10A Coates Lane Whitehaven Cumbria CA28 7BZ Lead Inspector
Nancy Saich Unannounced 03 June 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. 10A Coates Lane F58 F10 s22544 10a coates lane v226340 030605 ui stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service 10A Coates Lane Address Whitehaven Cumbria CA28 7BZ 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) 01946 691336 Turning Point Karen Elizabeth Russell-Haines Care Home 9 Category(ies) of MD - Mental Disorder registration, with number of places 10A Coates Lane F58 F10 s22544 10a coates lane v226340 030605 ui stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The home is registered for a maximum of 9 service users in the category MD (Mental disorder) 2. 1 named service user in the category of MD(E) (Mental disorder over 65 years of age) Date of last inspection 10 January 2005 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 F58 F10 s22544 10a coates lane v226340 030605 ui stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place on Friday 3rd June 2005 starting at 8.45 a.m and lasting for four hours. All eight residents were spoken to either in a group or individually. Both of the staff members were fully involved in the inspection. All the residents’ files were seen and all the documents relating to medication were checked. Other documents were seen relating to residents’ financial transactions. A tour of the building was undertaken with all residents’ rooms seen. What the service does well:
Coates Lane is good at providing a safe and well supported home for people with enduring mental health problems. They ensure that prospective residents have suitable social and psychiatric assessments to make sure that they take people who can benefit from the care and services they provide. Residents are well supported so that risk factors are minimised and they can live a normal life as part of a wider community. The house is safe, clean, comfortable and well-decorated giving residents the kind of environment where they can feel relaxed and pressure free. There are good levels of staff in the home and they are given support, supervision and training to ensure they know how to care for people with these problems. There was evidence to show that the management systems were operating correctly to allow the residents to live in a home that meets their needs in a holistic way. 10A Coates Lane F58 F10 s22544 10a coates lane v226340 030605 ui stage 4.doc Version 1.30 Page 6 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 F58 F10 s22544 10a coates lane v226340 030605 ui stage 4.doc Version 1.30 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 10A Coates Lane F58 F10 s22544 10a coates lane v226340 030605 ui stage 4.doc Version 1.30 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, 4,5 The home has a thorough assessment process that ensures the home is able to provide appropriate care and services for prospective residents. EVIDENCE: Residents said that were given plenty of information about the home before they decided to move in. Residents’ files showed that a thorough assessment of need had been completed prior to admission so that staff could give the right levels of care and services. A prospective new resident was making a first visit to the home and the staff showed this person around and explained how things were arranged in the home. Residents’ files had signed contracts for each person that gave details of the terms and conditions of their stay. 10A Coates Lane F58 F10 s22544 10a coates lane v226340 030605 ui stage 4.doc Version 1.30 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 home is good at helping residents to make suitable choices about lifestyles and encourages them to be as independent as possible. EVIDENCE: Residents were aware of the content of their written plans of care. Several people spoke about the arrangements for the next review of these documents. They were able to talk about their plans in relation to their mental health issues and all those spoken to in depth thought that their plans were realistic and manageable. Most of the residents said that the way they were cared for helped them to stay as well as possible. The care plans were read in some depth and they contained good levels of detail that reflected the things residents said they wanted out of life. Residents spoke about how the staff helped them to make the right decisions about all aspects of their lives. One person in particular spoke about the supportive way the manager helped with this 10A Coates Lane F58 F10 s22544 10a coates lane v226340 030605 ui stage 4.doc Version 1.30 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 The residents’ lifestyle is very good with plenty of scope for choice and flexibility. EVIDENCE: Residents spoke about the different activities they were engaged in. These ranged from normal daily activities like shopping and socialising to individual hobbies and interests. Residents were well aware of what was happening in their community and each person had different things they were involved in as part of this community. Residents spoke about their relatives and friends and said that staff helped them to maintain these relationships. The written care plans gave details of any relationship difficulties and directions on how to help people keep away from inappropriate relationships. Staff behaved in a respectful way with residents. They encouraged them to be independent but were also able to guide people where their lifestyle choices were being coloured by the symptoms of their mental illness. This was done in a sensitive and patient manner. 10A Coates Lane F58 F10 s22544 10a coates lane v226340 030605 ui stage 4.doc Version 1.30 Page 11 Residents were happy with the food provided. The staff and residents said that fresh food was bought every day from local shops and that they had good quality meals and snacks 10A Coates Lane F58 F10 s22544 10a coates lane v226340 030605 ui stage 4.doc Version 1.30 Page 12 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 residents are given good levels of support to allow them to maintain optimum levels of mental and physical wellbeing. EVIDENCE: Residents spoke openly about their mental health needs and about other health issues. They said that staff helped them to get the best care possible. They were complimentary about the staff team and said they were given the kind of levels of support from staff that helped with their health needs. The daily notes showed that staff supported residents in getting the best health care possible. Residents said that staff ensured they saw the psychiatrist on a regular basis. The medication stored on behalf of residents was in order. One or two people manage some of their medication themselves. Residents said that the doctor or the psychiatrist regularly checked that their medication was right for them. The medication records were seen and they showed that the system for helping residents was working well. The staff needed to give more detail about one aspect of recording how ‘as required’ medication was administered. 10A Coates Lane F58 F10 s22544 10a coates lane v226340 030605 ui stage 4.doc Version 1.30 Page 13 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 good systems for managing complaints and for protecting residents from potential abuse. EVIDENCE: The notes of the last two residents meetings were seen and the issues raised had been dealt with. Residents views were also recorded in the monthly visits completed by the company and suitable action had been taken about all the matters raised. The two members of staff were both relatively new to the service but they had a good understanding of the steps they needed to take to protect residents from harm. The individual files had very good strategies for managing risk to residents. Residents had no problems with the way these standards were handled and they felt that they were respected and kept safe. 10A Coates Lane F58 F10 s22544 10a coates lane v226340 030605 ui stage 4.doc Version 1.30 Page 14 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 standards were very good providing a safe, comfortable well-decorated environment where residents felt very much at home. EVIDENCE: The building was clean and tidy in all areas. Residents said that they had plenty of support with their household chores allowing them to be responsible but not burdened with too many household tasks. Residents liked their bedrooms and said they were helped to make them as comfortable and personal as possible. Several bedrooms had new carpets and the furniture was of a good standard. Residents said the communal areas were comfortable and relaxing places to spend their leisure time. 10A Coates Lane F58 F10 s22544 10a coates lane v226340 030605 ui stage 4.doc Version 1.30 Page 15 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 The home has a well-trained and supervised workforce. They give the right levels of support for people with mental health needs. EVIDENCE: Residents said that staff “know their jobs and get plenty of training”. Staff spoken to on the day discussed how they were inducted to the home and were aware of their future training needs and how they were to be met. An induction programme was seen and this contained all the necessary details for this member of staff to be able to do her job. The staff were confident about the tasks they had to undertake and were able to give residents suitable support and advice. They were aware of the content of the plans of care and knew the different strategies to take with each person. 10A Coates Lane F58 F10 s22544 10a coates lane v226340 030605 ui stage 4.doc Version 1.30 Page 16 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 This home is managed with the well being of the residents to the fore and all the systems were operating correctly. EVIDENCE: Residents said they were asked their opinions and that this was done both formally and informally on a regular basis. Residents opinions –both group and individual – were used to base plans for the home. One resident was able to explain how the process operated and she felt that this worked smoothly and allowed the residents to really own Coates Lane as their home. The residents felt that “staff make sure we are looked after properly”. There was evidence to show that things like fire safety, food hygiene and infection control are managed so that residents stay well cared for and happy in the home. 10A Coates Lane F58 F10 s22544 10a coates lane v226340 030605 ui stage 4.doc Version 1.30 Page 17 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 3 3 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
10A Coates Lane Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x F58 F10 s22544 10a coates lane v226340 030605 ui stage 4.doc Version 1.30 Page 18 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 20 Regulation 13 (2) Requirement Records of as required medication must give suitable details of adminstration Timescale for action 31st July 2005 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 10A Coates Lane F58 F10 s22544 10a coates lane v226340 030605 ui stage 4.doc Version 1.30 Page 19 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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