CARE HOME ADULTS 18-65
10a Coates Lane Whitehaven Cumbria CA28 7BZ Lead Inspector
Nancy Saich Unannounced Inspection 5th June 2006 01:00 10a Coates Lane DS0000022544.V291289.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.V291289.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.V291289.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) of places 10a Coates Lane DS0000022544.V291289.R01.S.doc Version 5.2 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) 28th November 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 challenges 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.V291289.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the ‘key’ inspection for the home and involved the lead inspector, Nancy Saich visiting the home unannounced. The visit started just after lunchtime and lasted until after six o’clock in the evening. She saw seven of the residents and spoke to them in a group and individually. She also spoke to the staff on duty and spent some time with the manager. Some weeks before the site visit the inspector sent out questionnaires to residents, relatives and professionals who visit the home. These were very positive and gave a good picture of how everyone felt about the home. The manager had also provided information about how the home operates. On the day of the visit the inspector observed how staff and residents interacted and checked on files and documents that backed up what she saw or what people had told her. What the service does well:
Coates lane is good at making sure they only admit people who they feel sure they can care for and who will fit into the group of people who make it their home. They look especially at the mental health needs of each person and do this by asking for a lot of information from mental health professionals. The home is good at writing plans that allow the residents to have the kind of care and attention they need and deserve. These plans and the way the staff work with them allows residents to make their own decisions despite their mental health problems. They also allow people to have their individual needs and choices met with in a fair way. The residents said they could take risks like we all do but were protected from taking unnecessary risks when their illness might make them act rashly. The inspector saw a good balance of risk and protection in the way staff worked with the residents. The home is good at providing residents with a ‘normal’ lifestyle. Residents said they went out to town for shopping and coffee, went for walks and joined in with local activities. Some people had specific hobbies and activities they enjoyed, others just enjoyed the kinds of leisure pursuits we all enjoy. This includes having a holiday. Residents go in twos or threes and staff and residents said they enjoyed these. The home is run very much with the interests of the group at heart and as in any family home people do things together and also do things just for themselves. Friends and relatives are welcomed into the house. They felt that they lived in a nice home where they were free to live out their chosen lifestyle and encouraged to make the most of their free time. Staff recognised residents as individuals with different needs. The home is good at making sure that residents stay as healthy as possible. The residents said they had health check ups and got good attention when they were unwell. Medicines are looked after properly in the home.
10a Coates Lane DS0000022544.V291289.R01.S.doc Version 5.2 Page 6 The inspector thought that the staff were good at helping the residents cope with the changes we all go through as we get older. The home is good at giving residents the chance to voice their opinions and make complaints. There had been no formal complaints in the home. The staff were good at protecting people from the risk of harm and abuse. Residents said they felt very safe and secure in the home. Coates Lane has enough well trained staff on duty to make sure that residents’ health and wellbeing are at the centre of things in the home. The manager makes sure that new staff don’t have a criminal record and haven’t been sacked from any other job working with vulnerable people. Staff are given the opportunity to talk in confidence about their work and their training needs. Staff meetings are used to give information and to let staff talk together about their work. Coates Lane is a well managed home. The manager is enthusiastic, competent and has residents’ needs at the heart of everything she does. Not only does she understand individual needs but she is also able to plan for the future of the home. The manager and the staff have good systems to check that the home gives good quality care. They make sure that things like maintenance and health and safety checks are completely as a matter of course so that residents are safe and well. 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.V291289.R01.S.doc Version 5.2 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.V291289.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The manager and staff are good at making sure they only take new residents who they know they can care for and who will fit in with the existing residents. EVIDENCE: There had been no new admissions to the home since the last inspection but current residents spoke about how they had visited before they decided to come to the home. One person spoke about being visited during a stay in hospital to make sure they could get good levels of care on their return to Coates Lane. Residents’ files showed that the manager had made sure she could care for the resident before they came to the home. The files had social work reports and assessments made by psychiatrists. Staff were aware that it was important that any new resident had these assessments and they could talk about how they made sure that they could meet a new person’s needs – especially in relation to their mental health. They were aware that admitting someone who they couldn’t care for properly would have a big impact on the wellbeing of the existing residents. Residents and staff said that the group of residents got on well together and that the manager was careful to only admit new people who would fit in. 10a Coates Lane DS0000022544.V291289.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents’ needs are very well met by the care provided. They are given a range of choices and are prevented form taking unnecessary risks. EVIDENCE: The inspector read all of the care plans and found them to be up to date and very detailed. They told staff what residents wanted and needed and also showed them how to deal with a change in the mental health of the person. They also showed how the residents wanted to live their lives. Residents said they knew what was in their care plans and that they had been fully involved in writing them. The residents said they were asked their opinions during the reviews of these plans. They also said that they were helped and encouraged to make their own decisions. The inspector saw lots of evidence of residents being supported to make their own decisions. Residents said that they needed this help and that they trusted staff to give them a chance to do things for themselves but were also prevented from doing things that might be harmful.
10a Coates Lane DS0000022544.V291289.R01.S.doc Version 5.2 Page 10 Staff said that they would talk to residents about anything that was risky. The inspector judged that the staff understood that people with mental health problems might take unnecessary risks when they were unwell. Every resident file had assessments of risk that showed that the team protected these people but also encouraged them to be as independent as possible. 10a Coates Lane DS0000022544.V291289.R01.S.doc Version 5.2 Page 11 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 the following standard(s): 12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. This home is good at providing residents with lots of options about how they spent their time and is careful to allow the resident to have as much freedom of choice as is possible. EVIDENCE: The inspector enjoyed talking to residents about how they spent their time. Several people had hobbies that they enjoyed doing. One person liked pottering in the garden, another was doing a tapestry but lots of people just enjoyed simple pastimes that most of us enjoy. They said they liked watching TV, listening to music and reading the paper. A number of the men liked “going out for a pint”. These leisure activities were accepted as the residents’ own wishes. They said no one pushed them to attend classes or join in activities they didn’t want to get involved with. One or two people did want to do more challenging activities and they go to things like yoga and computer courses and social clubs. Some of the residents enjoy going to local events in Whitehaven while others just like going shopping
10a Coates Lane DS0000022544.V291289.R01.S.doc Version 5.2 Page 12 or going out for a coffee. People went out during the inspection and the residents said that they liked the fact that the home was so near to the market, the harbour and the shops. Residents had either been on holiday in small groups or were planning a week away. Staff and residents spoke about the holidays and how much they had all enjoyed the break. Residents usually go out in small groups or on their own. Sometimes everyone goes out together for a social night out. The residents said that they liked the fact that they didn’t just go out in one big group but could choose what they wanted to do. The residents in the home said they got on really well together and were very relaxed in each other’s company. They also have friendships outside the home and friends and family members are encouraged to visit in the home. Residents have good networks and their care plans show that staff help them to make new relationships and help to heal any relationships that have been damaged by the symptoms of their mental health problems. Residents said they went out shopping for food and helped with cooking. They liked the food in the home and said they had helped create a new menu and that the staff were helping them to eat as healthily as possible. The inspector judged that residents here have a good lifestyle that is very much like other people of their age who live in the area. She also thought that the staff recognise the differences in people but gave every one equal choices and opportunities to live the way they wanted. 10a Coates Lane DS0000022544.V291289.R01.S.doc Version 5.2 Page 13 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 the following standard(s): 18,19,20,21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents get the kind of care they want and this helps them to stay well both mentally and physically EVIDENCE: The residents said that they were happy with the way that the staff helped them with personal care and support. They all felt comfortable when staff had to help them with personal care and said that the staff did it in such a way that they didn’t feel awkward or embarrassed. The inspector thought that the staff worked well with the residents and treated them in a respectful and supportive way. Residents said that they saw the G.P and other health care professionals when they were unwell. The files showed that this happened and also showed that people went for check ups and that their medicines were kept under review by the doctor or their psychiatrist. The medicines looked after by the staff were being stored, given out and disposed of correctly. Some people were being encouraged to look after at least some of their medicines. Staff had been trained in how to give out different types of medicines. 10a Coates Lane DS0000022544.V291289.R01.S.doc Version 5.2 Page 14 Talking to residents and looking at their notes showed the inspector that a great deal of care was being taken to support residents who had some form of physical illness or who were going through some of the things that happen as we grow older. One resident spoke about how good staff were during a bereavement and another spoke about a health problem they were going through and again they said staff understood and gave them help and encouragement. 10a Coates Lane DS0000022544.V291289.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The residents in this home feel confident that they are listened to and that they are given the right kind of protection from harm. EVIDENCE: Turning Point has good policies and procedures about both of these standards. Staff understood what was in these and said they could support residents if they had to. The inspector saw staff meeting notes and other notes that showed the manager spoke to the team about abuse and residents rights. There had been no formal complaints and residents had no complaints during the visit. The residents’ care plans showed if there were any risks of the residents being abused and good steps in place to stop this happening. Residents said that they felt secure within the home and there was nothing of concern in the house. They said that if there was any threat from outside the staff would make sure they were protected. 10a Coates Lane DS0000022544.V291289.R01.S.doc Version 5.2 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): 24,27,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Residents live in a comfortable and well-furnished house but this is being compromised by dampness in upstairs bedrooms. EVIDENCE: 10a Coates lane is a Georgian house right in the centre of Whitehaven. It is near to all the local amenities and is within walking distance of the harbour, G.P surgery, shops, library, pubs, cafes and restaurants. The residents like the setting of the home and they felt they could just ‘nip out’ whenever they wanted. The house is on two floors with a large lounge on the ground floor where people may smoke. Upstairs there is a smaller non-smoking lounge. Each person has a single room and there are toilets and a bathroom and shower room on each floor. There is a small utility room where residents can do their own washing. Residents eat in the large kitchen cum dining room. The residents were very relaxed in this room and helped out with things like preparing food and setting the table. This room has French doors that lead out to a small walled garden
10a Coates Lane DS0000022544.V291289.R01.S.doc Version 5.2 Page 17 that has recently been landscaped and is now an attractive area to sit out in on a good day. All areas of the home have good quality décor, furniture and carpets. The house has a modern kitchen but bathrooms and shower rooms could be improved on. Being a Georgian house the rooms are large and have high ceilings. There have been numerous problems with the structure of the building in the past and Turning Point has pressed their landlord to repair the house. Work has been carried out on the roof but when the inspector looked at two rooms in particular there was evidence of damp again coming in from the roof or the walls. Turning Point must deal with this before it again becomes a major problem. The house was very clean and tidy in all areas. Residents are encouraged to look after their own rooms and to do chores around the home. The staff are aware of how to keep good standards in the home and the house reflected their commitment to give the residents a nice home. 10a Coates Lane DS0000022544.V291289.R01.S.doc Version 5.2 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35,36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home is staffed by the right kind of people who are well trained and competent enough to give good levels of care. EVIDENCE: The inspector looked at four weeks of rosters. These showed that by day there were always two members of staff around and one person awake at night. Residents said that there were enough staff to meet their needs. Staff felt that there were enough staff on duty at any time to do all the tasks and to give residents support. The inspector observed staff working and looked at the notes that showed how they had given care and assistance to the residents. From this and from talking to residents the inspector judged that the staff were very good at caring for residents, encouraging them and keeping them safe and well. She also looked at the staff files and spoke to a new member of staff. She found that new staff were only allowed to work with the residents after all the right checks had been made. The manager makes sure that new staff don’t have a criminal record and have not been dismissed from another care setting. She also noted that recruitment was done in a fair way that didn’t discriminate against people from minority groups. Staff talked about their training and the manager provided a training plan that showed staff were trained in all the most important skills they need to care properly for the residents. Training had covered the safe handling of
10a Coates Lane DS0000022544.V291289.R01.S.doc Version 5.2 Page 19 medicines, infection control, the protection of vulnerable people, risk assessment, epilepsy awareness and good practice issues. Staff were working on (or had completed) their National Vocational Qualification in care. The staff files showed that the manager gives the staff support in a formal way. Each person is given the chance to talk about their work with residents and to discuss things like training and how they get on with other workers. Staff said that they got a lot of benefit from this and from the regular staff meetings. 10a Coates Lane DS0000022544.V291289.R01.S.doc Version 5.2 Page 20 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. This home has an experienced and competent manager who has built good systems in the home to protect residents and give them a comfortable life. EVIDENCE: When the inspector arrived the manager was not on duty but the support workers she met were able to talk about all of the systems that make the home a well run place. The manager makes sure that all the staff understand the way things need to be done to protect and support residents. The residents and the staff knew the manager really well as they said she makes it her business to know everything that happens in Coates Lane. She came over as a competent person who has the needs of the residents at the heart of her work. She is developing a new system that checks on quality in all areas of the home. She showed the inspector the draft of her new system that will make her ‘quality assurance’ system even better than before. Currently everyone
10a Coates Lane DS0000022544.V291289.R01.S.doc Version 5.2 Page 21 who works in the home is involved in all these checks on the running of the home. She has different ways of involving residents in this and uses different ways to ask them their opinions. The residents felt that the home was safe and clean. They said that this helped them to feel secure in their home. The staff had good levels of skills and knowledge. For example they were all aware of how to deal with fire safety, had good understanding of how to make sure kitchen hygiene was in place and had been trained to move and handle people and objects. The paperwork that backed this up was seen and it was of a good standard. 10a Coates Lane DS0000022544.V291289.R01.S.doc Version 5.2 Page 22 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 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 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 X 3 X X 3 X 10a Coates Lane DS0000022544.V291289.R01.S.doc Version 5.2 Page 23 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 YA24 Regulation 23 (2) (b) Requirement Turning Point must ensure that the dampness in two upstairs bedrooms is investigated and the problem resolved. Damaged ceilings and walls must be repaired after the damp problem is dealt with. Timescale for action 31/08/06 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 YA27 Good Practice Recommendations It is recommended that the registered manager look at ways to make improve the bathroom facilities in the home. 10a Coates Lane DS0000022544.V291289.R01.S.doc Version 5.2 Page 24 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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