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Inspection on 03/10/07 for 10a Coates Lane

Also see our care home review for 10a Coates Lane for more information

This inspection was carried out on 3rd October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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.

What the care home does well

This home is good at giving people enough information for them to be able to make a real choice about coming to Coates Lane. New people can visit the home before they make the choice and staff are good at ensuring they only take people they know they can care for and who will fit into the home. Residents in this home had good written plans that helped them help the staff to understand their wishes. The residents were able to make their own choices and take risks. The staff support them in this so that any problems with their mental health do not stop them having choices and options. The residents are very much a part of their local community and are involved in all sorts of activities and entertainments in the area. They have also been encouraged to go further afield and try different activities. The residents told us that the food is very good and they are all trying to eat as healthily as possible. Residents help to shop, cook and develop menus. The staff are good at giving people the right levels of support and help to allow people to live as independently as possible and to deal with any physical or mental health problems. We judged that the service is good at giving people with longstanding mental health problems the kind of care they need. The staff team are good at listening to and dealing with complaints. They are also very good at protecting people from abuse. Residents felt they had control over both these things and they felt secure in the knowledge that the staff had their best interests at heart. This home has skilled, knowledgeable and well-trained staff who have warm but respectful relationships with residents. Residents get the chance to help choose new staff. The organisation only takes on staff of good character. We judged that most of the systems used to manage the home were working well and were centred on what residents thought made a quality service.

What has improved since the last inspection?

The service has improved the information it gives potential new residents. The residents have become much more involved in the way the home runs. Staff have really listened to what residents want and made changes to the daily things like the menus and how the chores are done. They have also got the residents involved in a national pilot scheme where residents have become involved with interviewing new staff. We judged that the special care plans relating to `wellness and recovery` were helping to both prevent and treat bouts of mental ill health. We also judged that the new systems in place to develop individual staff had the promise of helping the staff team to give the very best help to individual residents.

What the care home could do better:

All of the very positive work going on in the home is being undermined by the fact that four bedrooms, an office, the hall and the lounge all have visual evidence of penetrating dampness from the roof and walls. Turning Point must take action to have the outside problems (blocked and inadequate guttering, cracked render and roof problems) solved. Residents cannot live in a house where dampness may be damaging their health. We are concerned about this, as we have previously taken enforcement action about the dampness in all of these rooms. The repairs completed some two years ago have not dealt with this problem. The company also need to consider how they can improve the bathrooms and toilets in the house to give residents more comfortable and easy to use facilities.We judged that although the manager had tried to address these things more could have been done by management and the company to deal with the problems in the building.

CARE HOME ADULTS 18-65 10a Coates Lane Whitehaven Cumbria CA28 7BZ Lead Inspector Nancy Saich Unannounced Inspection 3rd October 2007 9:30 10a Coates Lane DS0000022544.V346181.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 10a Coates Lane DS0000022544.V346181.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 10a Coates Lane DS0000022544.V346181.R01.S.doc Version 5.2 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), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (1) 10a Coates Lane DS0000022544.V346181.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 9 service users to include: up to 9 service users in the category of MD (Mental disorder, excluding learning disability or dementia under 65 years of age) 1 named service user in the category of MD(E) (Mental disorder over 65 years of age) may be accommodated within the overall number of registered places. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 5th June 2006 2. 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 problems with their mobility. Information about the home can be obtained from the manager at the above address or from Turning Point’s website. Charges range from £322 to £1011 per week 10a Coates Lane DS0000022544.V346181.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The lead inspector, Nancy Saich asked the residents’ representative to give out postal surveys to the other residents, to relatives, health professionals and social workers. This was done very promptly and an advocate from a mental health group was asked to help with this. A good number of very positive responses were received because the residents made sure that everyone realised how important these surveys were. We also asked the manager to complete an annual quality assurance assessment (the AQAA) that allowed her to describe what the home does well and where they want to improve and develop. The staff team were fully involved in this and we received a very thorough and detailed AQAA. We also receive detailed monthly reports from this service and are fully alerted to accidents or incidents that might affect the residents’ lives. We visited the home unannounced and the lead inspector spoke to residents and staff, walked around the building, observed how things were in the home and checked on paperwork that backed these things up. We met with a representative of the company who came to the home to help with the inspection. What the service does well: This home is good at giving people enough information for them to be able to make a real choice about coming to Coates Lane. New people can visit the home before they make the choice and staff are good at ensuring they only take people they know they can care for and who will fit into the home. Residents in this home had good written plans that helped them help the staff to understand their wishes. The residents were able to make their own choices and take risks. The staff support them in this so that any problems with their mental health do not stop them having choices and options. The residents are very much a part of their local community and are involved in all sorts of activities and entertainments in the area. They have also been encouraged to go further afield and try different activities. The residents told us that the food is very good and they are all trying to eat as healthily as possible. Residents help to shop, cook and develop menus. The staff are good at giving people the right levels of support and help to allow people to live as independently as possible and to deal with any physical or mental health problems. We judged that the service is good at giving people with longstanding mental health problems the kind of care they need. The staff team are good at listening to and dealing with complaints. They are also very good at protecting people from abuse. Residents felt they had control 10a Coates Lane DS0000022544.V346181.R01.S.doc Version 5.2 Page 6 over both these things and they felt secure in the knowledge that the staff had their best interests at heart. This home has skilled, knowledgeable and well-trained staff who have warm but respectful relationships with residents. Residents get the chance to help choose new staff. The organisation only takes on staff of good character. We judged that most of the systems used to manage the home were working well and were centred on what residents thought made a quality service. What has improved since the last inspection? What they could do better: All of the very positive work going on in the home is being undermined by the fact that four bedrooms, an office, the hall and the lounge all have visual evidence of penetrating dampness from the roof and walls. Turning Point must take action to have the outside problems (blocked and inadequate guttering, cracked render and roof problems) solved. Residents cannot live in a house where dampness may be damaging their health. We are concerned about this, as we have previously taken enforcement action about the dampness in all of these rooms. The repairs completed some two years ago have not dealt with this problem. The company also need to consider how they can improve the bathrooms and toilets in the house to give residents more comfortable and easy to use facilities. 10a Coates Lane DS0000022544.V346181.R01.S.doc Version 5.2 Page 7 We judged that although the manager had tried to address these things more could have been done by management and the company to deal with the problems in the building. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 10a Coates Lane DS0000022544.V346181.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 10a Coates Lane DS0000022544.V346181.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,4 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. This home is good at making sure they only take new residents they are sure they can care for and who will fit into the existing group. EVIDENCE: We were given copies of new documents that help people understand what this home does. We saw a new ‘Statement of Purpose’ and new brochure. Both of these gave the reader more information in a clearer format than before and explained what went on locally and what Turning Point as an organisation is about. We also checked on the records that showed that new residents were given good details of the service, were allowed to visit before they made up their minds and that showed that the manager had made sure the new person would fit into the home. We also saw evidence to show that psychiatric services had a say in these admissions to make sure the new person would be able to benefit from everything on offer in the home. They have a very thorough assessment form that residents are fully involved in and which allows all the details of their lives to be recorded before their care needs are planned. 10a Coates Lane DS0000022544.V346181.R01.S.doc Version 5.2 Page 10 We saw that residents’ mental health continued to be assessed once they came to live in the house and that the staff make sure that the group of people in the home can live together happily. Residents were happy with the way they were introduced to the service. 10a Coates Lane DS0000022544.V346181.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. This service makes sure that the people who live in it are able to live life to the full despite their care needs. EVIDENCE: We read the written plans of care and these were very detailed and were up to date. They showed the strengths and needs of each individual and gave staff strategies for helping people with all aspects of their lives. These included how to support people in their social activities and how to help them if they have mental health problems. These plans showed lots of creative ways of helping people to be well and to have a rounded and interesting life. Two people had a new type of plan called ‘Wellness and Recovery Action Plan’. These gave very detailed and carefully thought through actions that would help residents to avoid ill health. These also helped people to get well again and showed staff exactly what to do to help their recovery from a time of mental ill health. All of the plans were centred round the wishes, hopes and needs of each individual. 10a Coates Lane DS0000022544.V346181.R01.S.doc Version 5.2 Page 12 The people who live in this house have regular meetings and their representative attends both local and national meetings that Turning Point hold. One of the residents always attends staff meetings. There was evidence to show that they influenced how the home runs, they have changed the menus, got rid of a cleaning roster and now discuss and volunteer for chores and have influenced who works in the service. They have also had their say about the policies and procedures of the company in general. The lead inspector judged that they were fully involved in all aspects of their own home. There were very good risk assessments on file. These cover physical risks and ways to lessen or remove them. We saw risk management plans that helped to counteract any mental health problems. There was evidence to show that the people who live and work in this house do not let risk stop them making the best of their lives. As the manager said • ‘We have become more risk confident than risk averse, encouraging service users to embrace new experiences’. And as a resident said • ‘I am helped to make the right decisions and I am feeling more able to run my own life…’. 10a Coates Lane DS0000022544.V346181.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. The people who live in this house are very much part of the local community, get involved in all sorts of activities and are able to have personal lives that give them rights, responsibilities and choices. EVIDENCE: The people who live in this home are well known in the area. The lead inspector has often seen them going out shopping, to church, the doctors surgery, taking things to recycling, having coffee or a drink or just having a walk around town. They each have individual preferences for activities. One person likes to go to luncheon clubs, some people are regulars at church and others like to go to local entertainments and activities. One or two people prefer to spend time at home reading or watching TV, doing the garden or helping out around the house. Each person has his or her social and recreational activities written into their care plan. Residents had been on holiday and for days out in small groups or 10a Coates Lane DS0000022544.V346181.R01.S.doc Version 5.2 Page 14 individually. The residents are planning to go abroad and staff have helped them get passports. Looking for birth certificates for this has also started residents talking and thinking about their past and their identity. Residents spoke about their friendships and their families and how they were supported and helped to keep in touch and to meet new people. A lot of their daily activities and leisure pursuits give people plenty of opportunities to have a full life. On the day of the inspection one person was on holiday with a friend, one had lunch with a relative, one was at a club and the others went out shopping or were busy following their own interests and pursuits with different groups of people. Residents said that staff listened to their opinions and took note of what they wanted as individuals and as a group. There were a number of examples of how the people in the home are actively influencing and changing both forward planning and day-to-day life. They are visiting other establishments as the company plan to relocate the service in the future and residents are thinking about what kind of home they want to live in. We saw formal minutes of meetings and documents that showed residents were consulted and listened to. One of the things they have influenced is the menu. They keep on making changes to the menu and how the meals are prepared. Residents go out with staff daily and use local shops for fresh ingredients so they can vary their meals and have healthy options. We saw the lunchtime meal and we also saw residents helping with dinner. The kitchen was well stocked with healthy snacks. Residents also said they had plenty of opportunities to go out for treats just as we all might want to do. They usually did this individually but they also go out for meals as a group and have the occasional take away. 10a Coates Lane DS0000022544.V346181.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20,21 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People in this home are encouraged and supported to get the very best health care and support possible for themselves but are living in a damp environment. EVIDENCE: Residents told us they manage most of their personal care. One or two people spoke about how they were supported to do things for themselves. We saw people being subtly and carefully monitored and gently reminded and assisted by staff. Residents said that often due to their mental health needs they needed “ a little bit of prompting. …or someone to do things with me…”. Residents said they trusted the staff and felt they understood their emotional needs. Care plans show that these needs are thought of as being vital to people’s mental well being. We saw lots of reassurance and encouragement on the day that were appropriate to the different needs of individuals in the house. Residents see their psychiatrist and also the local G.P, dentist, optician and district nurse when needed. One person went out to the G.P on the day and 10a Coates Lane DS0000022544.V346181.R01.S.doc Version 5.2 Page 16 was given support by the staff. The notes showed that people who live in the home are encouraged to go for check ups and take healthy living advice so they can stay well. We did, however, judge that this very good approach to health care is being undermined by the fact that people are living in a damp house. We urge the manager and the staff team to monitor peoples’ health closely until the dampness problem is resolved. We checked on medicines in the home and found that they were cared for properly. Each person has their medicines checked regularly by their psychiatrist or their G.P and changes made to ensure people are as well as possible. Residents said they were encouraged to manage their own medication but could get as much support as they needed when they were unwell. Generally we saw a staff team who were sensitive and responsive to the changes and challenges of the mental illnesses residents suffer from. Social work surveys showed us that they were happy with the way the staff deal with the residents care needs. Residents said they could talk openly about their fears or concerns and they trusted staff to help them understand when these were features of their illness or were justified. There were a number of examples of how staff helped people with physical ill health and the ageing process. One person described how he had been helped through a period of grief and loss. We judged that staff are good at responding to these subtle needs that trouble everyone but can be very challenging to people with mental health needs. 10a Coates Lane DS0000022544.V346181.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There is openness in this service that allows people with longstanding mental health problems feel it is safe to complain and that they will be listened to and protected. EVIDENCE: The residents said that staff or representatives from Turning Point were good at listening to their suggestions, complaints or concerns. They said they would talk to the staff or the manager first but also said they could talk directly to someone from outside the home. One or two people spoke to the representative of Turning Point during the inspection and were open about their preferences. They said they could talk individually to staff or at residents meetings and their representative went to staff meetings. All of them had access to social work support and to advocacy. Residents knew how to contact the lead inspector and one or two people have done this in the past. No one had any complaints about staff or how they were treated but one or two people were unhappy with the state of repair of the house. This is dealt with later in the report. This service is very quick to report anything that might be abusive to residents. They are extra careful to accept what people say to make sure that nothing abusive is dismissed as being a feature of their ill health. There were some issues that had been investigated and resolved appropriately. The residents said there was nothing abusive going on in the home and they felt they were suitably protected from harm. The company have good written policies and a simple ‘What to do if…’ chart that both residents and staff had 10a Coates Lane DS0000022544.V346181.R01.S.doc Version 5.2 Page 18 easy access to. We spoke to staff on the day and they were fully aware of how to listen to residents and how to protect them from harm. They knew how to report any suspected abuse and understood the importance of following procedure. They had all received updates to their training. On the day of the inspection the staff and residents were planning to get the police to come to the home to discuss personal safety with them as part of improving confidence and independence. 10a Coates Lane DS0000022544.V346181.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,27,30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. This building is damp in a number of areas and this is putting residents’ health and well being at risk. EVIDENCE: Coates Lane is a Grade II listed building that Turning Point lease from Impact Housing. It is situated in the centre of Whitehaven and residents like the fact that it is so near to all the town amenities. Every person has his or her own single room that is nicely furnished. None of these rooms have ensuite facilities. The bathrooms and toilets are quite small and would be improved by a complete refurbishment so that they can have some adaptations to help with any one who may develop a mobility problem. The home was clean, tidy and well organised on the day. The residents do their own laundry and these areas would benefit from upgrading. The house has a large well-equipped kitchen and dining room and a large lounge and a smaller smoking lounge. All of these areas and residents rooms were well decorated and furnished with good quality furniture and equipment. 10a Coates Lane DS0000022544.V346181.R01.S.doc Version 5.2 Page 20 All of these positive things are, however, being undermined in that the outside of the house is not being properly maintained to keep the internal rooms dry and safe for residents. From outside we could see that the guttering is blocked and weeds are growing out of one gutter. We could also see that some of the windows are rotten and in one case weeds are growing through the window. A door to a fire escape is rotten and the fire- escape itself is rusted and slippery with moss. The outside render is cracked and crumbling in several areas. This is having a very bad effect on the internal arrangements in the building. There are four bedrooms that have some damp in them. We saw that two of these rooms have minor patches of damp and that plaster is beginning to crack. One room is so badly affected by water coming in that the corner of the ceiling is damaged. The staff have moved the resident out of this room and created a new bedroom from the smoking room. This room is so damp that no one is currently using it - even as a smoking room. The fourth bedroom has a resident in it and the wall is damp and the plaster has crumbled and there was black mould on the wall. The resident was concerned that this might be damaging her health. The main hallway also has a rotten window and patches of damp where water is coming through the walls. The same problem is evident in the administrator’s office. The main lounge has stained areas that may also be caused by water coming in through cracks in the render. The representative from Turning Point said that they were hoping to deal with these problems in a number of ways. We judged that whatever the outcome was for the future of the home Turning Point need to make sure that in the interim period the home is kept safe and dry enough for residents to live in without their health being at risk. Turning Point must deal with these problems as a matter of urgency. This service has previously had enforcement action taken against it because of these problems of damp. The repairs made then have not dealt with the fundamental problem that lies in the outside fabric of the building. Urgent work is needed on this building. 10a Coates Lane DS0000022544.V346181.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This home has a dedicated, skilled and competent team of staff who have residents’ needs at the centre of all they do. EVIDENCE: We looked at staff rosters, recruitment files and training and supervision records. We also spoke to staff and to residents and watched how staff interacted with residents. The home works on a minimum of two staff during the day and one person awake at night. The staff roster makes sure that there is always someone senior on duty by day. At all times there is a manager on call for staff if they need support. We looked at the way new staff were recruited and all these files were in order. Residents have been involved in recruitment as a pilot study for Turning Point and they enjoyed this experience and had very strong ideas about qualities needed for staff. The company is careful only to take on people who have the right qualities to care for vulnerable people. Staff have a very structured induction and training plan. We judged that on the day the people on duty were very confident that they could run the home and 10a Coates Lane DS0000022544.V346181.R01.S.doc Version 5.2 Page 22 deal with the inspection. They came over as knowledgeable and skilled. They were patient and competent in all the tasks of the day. We checked their training files and saw that staff do all the basic training courses needed to fulfil their roles. We also saw that there were plenty of opportunities to take care qualifications and do specific learning that will help them with their work. We saw the company training plan and staff said it gave them a lot of choices about training. The company have a new way of doing supervision, training and development. Staff were quite enthusiastic about this and the notes showed promise of good future planning for individuals to fulfil their potential. 10a Coates Lane DS0000022544.V346181.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. This could be a very well managed home once the health and safety concerns about the building are properly resolved. EVIDENCE: The manager sent in a very detailed AQAA that showed that she and the staff team followed the detailed systems that Turning Point have in their homes. During the inspection we judged from talking to staff and residents that all these things are working very well. The manager knows her residents well and guides and leads a highly committed staff team. It was evident from what residents said and from things like residents meeting minutes and care plans that residents of the home have a big say in what happens in Coates Lane. They arranged for the surveys for the inspection to go out and said: 10a Coates Lane DS0000022544.V346181.R01.S.doc Version 5.2 Page 24 • “Karen (the manager) wants us to make decisions and speak up and ask for things ….she always asks us …and likes it if we suggest things can be done differently…and she improves things for us when she can”. They also said they had been involved in a national scheme for Turning Point about being involved in recruiting new staff and have influenced the way the company do this throughout the country. Residents have been involved in the planning for the future of the home and have been able to discuss their wishes. Residents told us they have been fully involved in the talks about moving to a new build home at some time in the future. The home uses the Turning Point quality assurance system and different members of the residents group and of the staff team have responsibilities for checking that good standards are met in the home. Residents’ views are sought on a regular basis and in different ways. Checks on how the home runs are made regularly –for example one member of the team makes sure that fire safety is kept up to date and he trains other staff and the residents. The targets he had set had been met in the year and all the residents had a new awareness of their responsibility in the home. There were other examples – for example in food hygiene standards - that showed that residents were encouraged to take responsibility for their home. We looked at a number of records about health and safety and found these to be kept properly and we saw evidence to show that staff had received training in these matters and were careful in how they looked after the house. It was therefore disappointing that the problems with dampness have not been resolved by the manager and the staff team or by Turning Point. Residents felt that it wasn’t good enough for them to live with these problems until a new property could be found. The company and the registered manager must now address any potential or actual health and safety risk for residents due to this problem. 10a Coates Lane DS0000022544.V346181.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 4 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 1 25 X 26 X 27 2 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 X LIFESTYLES Standard No Score 11 X 12 3 13 4 14 X 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 2 3 3 3 X 3 X X 1 X 10a Coates Lane DS0000022544.V346181.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? NO 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 YA24 Regulation 23 (2) (b) Requirement Turning Point must ensure that external repair, maintenance and improvement be completed as soon as possible to ensure that bedrooms 6, 7,8,10, the office, the hall and the lounge no longer suffer from water coming through the walls and roof. The registered manager and the company must provide evidence that they are monitoring the health, safety and well being of all the residents whilst they are living in a damp building. Timescale for action 30/11/07 2 YA42 12 30/11/07 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 YA19 Good Practice Recommendations The registered manager must carefully monitor the health of residents given the dampness in the building. It is recommended that she keep the lead inspector informed of DS0000022544.V346181.R01.S.doc Version 5.2 Page 27 10a Coates Lane 2. YA27 any illness that might be due to this problem. It is recommended that the registered manager look at ways to make improve the bathroom facilities in the home. 10a Coates Lane DS0000022544.V346181.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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