CARE HOME ADULTS 18-65
12 High Street Brant Broughton Lincolnshire LN5 0SL Lead Inspector
Alison Marshall Unannounced Inspection 8th February 2006 09:45 12 High Street DS0000040002.V270073.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 12 High Street DS0000040002.V270073.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 12 High Street DS0000040002.V270073.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service 12 High Street Address Brant Broughton Lincolnshire LN5 0SL 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) 01400 272929 01400 273438 Cambian Care Services Limited Mr Robert Noble Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 12 High Street DS0000040002.V270073.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. A maximum of 5 young adults aged between 16 and 25 years of age, on admission, may be accomodated. Two named Service users, who are both over the age of 25 years, may remain at the home pending plans to identify appropriate move on placements. Young Adults, who have aged beyond 25 years of age, due to placing authorities not having identified and obtained appropriate move on placements, may only be accomodated at the home on an Application for Variation. The provision of care is for medium to long-term placements. Admissions are planned and emergency admissions are not acepted. 4. 5. Date of last inspection 26th July 2005 Brief Description of the Service: 12 The High Street is a 5 bedded home and was registered for younger adults with a learning disability in March 2003. The home is operated by Cambian Care Services and is situated across the road from Broughton College, a larger residential establishment, owned by the same company, for the same service user group. The home is located in Brant Broughton, where local shops are within walking distance. Access to public transport is available and the home has its own vehicle in order to access resources in the wider community. The home is a two storey domestic style residence and in keeping with the local community. All bedrooms are for single occupancy and, with the lounge, dining and kitchen areas; this home provides a homely and comfortable environment for the service users. Attached to the rear of the building is a self contained annexe with lounge/kitchen, bedroom and bathroom to promote independent living. The home is situated within landscaped gardens. The aim of the home is to provide a safe and supportive environment and to promote the emotional, social and independence skills of the service users. The staff promote a clear perspective on respect for the rights of individuals to privacy and dignity and to work in partnership with families and other agencies. 12 High Street DS0000040002.V270073.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was carried out between 9:45 am and 2:00 pm. The inspector joined the service users for lunch and spent time talking with the care services manager, senior on duty and the training officer. The inspection focused on the key standards not covered in the previous inspection of 26 July 2005 and the changes that had been made since then. What the service does well: What has improved since the last inspection? What they could do better:
This was a positive inspection. Only two recommendations were made with regards to continual development of work in relation to mealtimes and holidays for the service users. 12 High Street DS0000040002.V270073.R01.S.doc Version 5.0 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 12 High Street DS0000040002.V270073.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 12 High Street DS0000040002.V270073.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were assessed. The service users had all lived at the home for a number of years. EVIDENCE: 12 High Street DS0000040002.V270073.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 and 7 Service user needs were clearly documented and promoted. EVIDENCE: Following the last inspection service user records had been reviewed and reorganised and as a result the files were clearer and the information was all current and easily accessible. The main file contained an audit sheet which showed that the team manager was regularly checking the contents of the files to ensure that they contained all of the information required. The audit sheet showed that the speech and language therapist for the organisation was in the process of drawing up specific communication support plans for each service user. Each service user had a daily journal. This was a bound book which contained formatted sheets for staff to record how the service user had been on each shift. These were detailed and cross-referenced with other records such as medication, accident and incident recording. Service users were enabled to make as many choices and decisions about their daily life as they were able to. These were primarily choices about clothing, food and activities.
12 High Street DS0000040002.V270073.R01.S.doc Version 5.0 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 the following standard(s): 12, 13, 14, 16 and 17 Service users had busy and varied lifestyles with opportunities to engage in a range of educational, vocational and leisure activities. EVIDENCE: There was a weekly programme (Monday to Friday) of activities drawn up for the service users. Since the last inspection tutors from Broughton House College (part of the same organisation) were assisting High Street staff in supporting the service users to access activities. As a result activities were taking place as planned and were not being cancelled or changed due to staff shortages or other appointments or events. On the day of the inspection three service users had gone out for a long walk in local woods; one service user had a private appointment and one service user chose to get up slowly and then helped to prepare lunch before going to see friends at the college across the road. Service users, rights were respected and recognised in their daily routines. Service users’ were able to choose when they wanted to get up and go to their rooms in the evening. They were encouraged to take as much responsibility
12 High Street DS0000040002.V270073.R01.S.doc Version 5.0 Page 11 for their own household chores such as tidying and cleaning their rooms. Following the last inspection the staff had started to consider how to enable service users to have an annual holiday. At the last inspection discussion had taken place with staff around improving practice at mealtimes. Following that, some improvements had been made and the care manager explained that work was ongoing. There was evidence that staff were now giving service users choices over drinks, food and accompaniments. Staff, although eating their own food, were sitting with service users at mealtimes and did eat with service users if they went out socially for a meal. The menus were being changed to a rolling rota with more direct input from service users. 12 High Street DS0000040002.V270073.R01.S.doc Version 5.0 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 the following standard(s): These standards were not inspected. EVIDENCE: 12 High Street DS0000040002.V270073.R01.S.doc Version 5.0 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 the following standard(s): These standards were not inspected. EVIDENCE: 12 High Street DS0000040002.V270073.R01.S.doc Version 5.0 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 the following standard(s): These standards were not inspected. EVIDENCE: 12 High Street DS0000040002.V270073.R01.S.doc Version 5.0 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 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, 33 and 35 There was a dedicated training officer and training was strongly promoted throughout the organisation. Staff numbers had improved and as a result service users received consistency from staffing and in their daily routines. EVIDENCE: The staff were divided into three teams, each of which was headed up by an assistant team manager. There were three other support workers on each team and so ideally there were four staff on duty through out the waking hours. In addition there was an additional tutor on duty during the daytime hours, Monday to Friday, which ensured that planned activities were able to take place. There were two waking night staff on each night. Records showed that staffing levels were being maintained. Twelve staff across the organisation were working towards NVQ 3. The training officer said that 3 senior staff were working towards becoming Internal Verifiers by July 2006 and that the organisation was intending on applying to become an approved NVQ centre. Both of these actions would mean that more staff would complete the NVQ. The company had a dedicated training programme most of which took place on the south coast. The training officer sent staff to the most appropriate sessions, such as management training. She had established a rolling in-house training programme. Training for the next few months included sessions on basic care, supervision, autism, first aid
12 High Street DS0000040002.V270073.R01.S.doc Version 5.0 Page 16 and communication. There was a set induction programme that all new staff followed. Each staff member was given a file and encouraged to maintain their own continuous development portfolio. Every six months the organisation held a presentation evening to give staff their training certificates. The next one was due to be held shortly and over 60 certificates would be presented. 12 High Street DS0000040002.V270073.R01.S.doc Version 5.0 Page 17 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): 39 and 42 Good quality assurance systems were in place. This ensured that the service continued to develop and improve. Good health and safety systems were in place. EVIDENCE: There were a number of systems in place to review the service provided. The company carried out monthly visits as required by regulation 26 of the Care Home Regulations 2001. The company had obtained Investors in People status. There was a development plan for the home for the next 5 years. This had been drawn up with staff input and was reviewed annually to assess what progress had been made. There was a health and safety officer for the organisation. She had just completed the advanced certificate in health and safety. The fire service had carried out an inspection on 6 January 2006. All accident and incident forms were monitored centrally. Staff received health and safety training as part of the induction programme and received regular updates through the rolling inhouse training programme.
12 High Street DS0000040002.V270073.R01.S.doc Version 5.0 Page 18 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 X X X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X X X Standard No 24 25 26 27 28 29 30
STAFFING Score X X X X X X X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 3 X 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
12 High Street Score X X X X Standard No 37 38 39 40 41 42 43 Score X X 3 X X 3 X DS0000040002.V270073.R01.S.doc Version 5.0 Page 19 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA14 YA17 Good Practice Recommendations The registered person should continue to think around ways of enabling service users to go on holiday. The registered person should continue to develop practice around mealtimes. 12 High Street DS0000040002.V270073.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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