Inspection on 14/10/08 for 134 Newtondale

This inspection was carried out on 14th October 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

134 Newtondale 30/11/06

134 Newtondale 31/10/05

134 Newtondale 22/06/05

134 Newtondale 21/03/05

134 Newtondale 09/09/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Muston Road (70)

Grayling

Extracts from inspection reports are licensed from CQC, this page was updated on 09/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 134 Newtondale 134 Newtondale Sutton Park Hull East Yorkshire HU7 4BP     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Christina Bettison     Date: 1 4 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: 134 Newtondale 134 Newtondale Sutton Park Hull East Yorkshire HU7 4BP 01482829276 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Avocet Trust Type of registration: Number of places registered: care home 1 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home The service at 134 Newtondale is owned and managed by Avocet Trust. It is one of a small number of similar services that Avocet provides. Avocet Trust is a registered charity. 134 Newtondale is registered to provide care and accommodation for one adult with a learning disability. The home is on Sutton Park close to the North Point Shopping Centre on Bransholme. 134 Newtondale is a bungalow with two bedrooms. There is a sitting room, kitchen, a large bedroom and the second small bedroom has been utilised as a staff sleeping in room. There is a driveway to the side with space for car parking and a garage. There is a small garden to the front and rear. There are shops, public houses, a medical centre and a post office all within walking distance. Public transport to various parts of the city is easily accessible. 1 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 stars. This means that the person who uses the service experiences good quality outcomes. This visit was announced to ensure that the person and staff would be at home on the day of the visit and took place over 3 hours on 14th October 2008. This home was last inspected on 30th November 2006 and an annual service review was completed on 20th December 2007. During the visit we observed how staff interacted with the person to find out what it was like for the person living at this service. Care Homes for Adults (18-65 years) Page 5 of 28 We spoke to the previous manager, new manager and staff member on duty on the day of the visit, we also spoke to the person who lives there who told us they liked living there and they felt very lucky. We received a survey back from the person who lives in the home and from two staff. We checked documents that related to the persons care and safety. These included care plans, daily records, risk assessments, staff supervision and training records. We looked at the environment and checked maintenance records to make sure the bungalow was safe and well maintained for the person who lives there. Before the site visit we also looked at a range of other information we had received about the service since the previous inspection. This was a key inspection and was carried out by Regulation Inspector Tina Bettison, we would like to thank the person who lives at the service and the staff for their co operation during our visit. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the care home does well: What has improved since the last inspection? What they could do better: The person that lives in the home needs to have a plan that guides staff in how to support the person when they are anxious and displaying behaviour that may pose a risk to themselves or others. All staff need to receive training in how to support the person in times of high anxiety. Care Homes for Adults (18-65 years) Page 7 of 28 All staff need to receive training in how to write factual reports following incidents. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome area has not been assessed. Evidence: There have been no new admissions to the home since the previous key inspection therefore none of these standards were assessed. Care Homes for Adults (18-65 years) Page 10 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The persons needs continue to be met on a 1 to 1 basis by a stable and consistent staff team however plans need to be prepared to guide staff in how to manage the person in periods of anxiety this will better protect the person from the risk of harm. Evidence: The care file was examined as part of this inspection. The standard of records remained the same as at the previous key inspection. It included a very detailed pen picture that gave a very good initial overview of the person, their history, needs, likes and dislikes. The individual plan was very detailed to ensure that staff are aware of their needs and are able to provide appropriate and consistent care to meet their needs. Some attention was being given to enabling the person to maintain their independence skills and develop new skills. All care records were in lever arch files and presented in a tidy and organised way. Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: There were good diary records to indicate what care has been delivered on a daily basis. The files contained a wide range of risk assessments to cover all areas that may pose a risk to the person and /or staff. The care had been reviewed in house in November 2007 and by the placing Local authority in February 2008, there were no concerns raised and the placement remained stable. The manager told us that they were intending to look at preparing plans in a more person centred way. A survey was returned by the persons advocate who attends all meetings and visits regularly, they commented that the home give the person a very good quality of life and gets them involved in the community, they said that they look the happiest now in all the time that I have known them. Since the previous key inspection the person that lives in the home has started displaying some behaviours that may pose a risk to themselves or others. There was a behaviour management plan in place however records indicated that on occasions the person was either told or asked to go to their bedroom to calm down. This use of isolation as a technique was not detailed in the behaviour management plan and did not appear to have been agreed by the placing local authority Records made by staff commented that the person was put in his room where he continued to scream and hit himself for 25 minutes and another record stated he was left in his room for 45 minutes before calming down. A psychology assessment had been carried out and a series of recommendations made however none of this had been incorporated into a behaviour management plan, therefore staff will not be clear about what strategies and techniques they may use to assist the person in times of anxiety. In addition to this records indicated that none of the staff at 134 Newtondale had been provided with training in how to manage difficult behaviours and also how to write factual reports after an incident. This does not protect the person from the risk of harm. On any occasion that restrictive physical interventions are used as a strategy the CSCI must be informed as per regulation 37 requirements. Care Homes for Adults (18-65 years) Page 12 of 28 Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The person continues their personal development and access to the community for a wide range of leisure pursuits and holidays. The person enjoys a healthy diet that respects their choices. Evidence: The person that lives in the home continues to enjoy an active social life which is detailed in their individual care file, such as bowling, shopping, attendance at the walking club run by the local Mencap group, art and craft sessions and attendance at local clubs such as Sullivans and Buckingham St centre. More evening activities have been introduced since the previous inspection. In a survey received from a member of staff they commented that since moving to the service they have helped the person to put together a new activity programme Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: incorporating all the things they like to do. There was a photographic display of all the places the person had visited throughout the summer which included Beverley Westwood, the Deep, a week in the caravan at Skipsea, day visits to Bridlington and Hornsea and time spent relaxing in the garden. The manager and staff promote a healthy eating menu but try to balance this with the persons likes/dislikes and special treats on occasions. Any restrictions are clearly documented in the care file and agreed to by the person living in the home. The person was observed choosing what he would like to have for his lunch on the day of the visit and although this changed a couple of times his choices were respected. The person has a pet budgie and told us that his name was Blue, he also told us that he was looking forward to Bonfire night and the Halloween party he would be attending. He had a fancy dress costume for the occasion and so did the staff that would be supporting him. The person has also recently acquired a new car through the motability scheme and was involved in choosing it by specifying that he wanted a blue car. Staff told us that relationships with the next door neighbours was very good and that they regularly chatted with the person that lives in the home. On ocasions the neighbour has brought over a casserole etc that they had extra of. Staff said they never receive any complaints from the neighbours. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The persons health needs are met by good identification, planning and meeting of health needs. Medication is well managed meaning that the person is kept safe from the risk of harm. Evidence: The persons care file was examined as part of the inspection process this evidenced that their healthcare needs continue to be met. The community nurse had completed their health screening and records evidenced that appointments had been attended with dentist, chiropody, psychology, GP and the community nurse. The person had recently had a Physiotherapy assessment completed which identified that the person needed regular walking therapy for a physical condition, this had been met by the introduction of the Mencap walking group. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: Avocet Trust have their own health action plan entitled Healthy Me which clearly identified the persons health needs and how these would be met. However this document had not been updated for some time. The staff told us that they thought Avocet were bringing out new paperwork and that they were waiting for this. Staff were advised to update the current paperwork in the absence of new paperwork so that the persons health needs continue to be identified and met. The service user does not self-medicate. There are written policies and procedures in place for staff to adhere to regarding administration of medication and medication records were examined as part of the inspection and found to be in good order. Staff had received training and had been assessed as competent to administer medication. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff team are aware of the Protection of Vulnerable Adults policies and procedures and their responsibility within these however behaviour management plans need to be improved to ensure that the person is fully protected from the risk of abuse, neglect and harm. Evidence: There had been no complaints to the home since the previous inspection but some friends of the person that lives there had written a thank you letter saying - just a note to say thank you for the bonfire tea you invited us to. The food and firework display were lovely. Avocet Trust has good recruitment processes in place. All staff have now completed training in the Protection Of Vulnerable Adults Policies and Procedures, this means that the person is better protected from abuse, neglect and harm. However as previously stated in this report attention must be given to improving the quality of the behaviour management plans and provision of staff training in how to manage difficult behaviour. Care Homes for Adults (18-65 years) Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The person lives in a safe, attractive and homely place that is individual to them and that meets all of their needs. Evidence: The service at 134 Newtondale is owned and managed by Avocet Trust. It is registered to provide care and accommodation for one adult with a learning disability. The home is on Sutton Park close to the North Point Shopping Centre on Bransholme. 134 Newtondale is a bungalow with two bedrooms. There is a sitting room, kitchen, a large bedroom and the second small bedroom has been utilised as a staff sleeping in room. There is a driveway to the side with space for car parking and a garage. There is a small garden to the front and rear. There are shops, public houses, a medical centre and a post office all within walking distance. Public transport to various parts of the city is easily accessible. The home is well decorated and maintained, all maintenance certificates were seen and were up to date which means that the home is safe and provides a very individual Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: home for the person who lives there. We were told and observed that since the previous inspection new sofas had been purchased, the lounge had been decorated and a new carpet fitted, the hallway had been redecorated and new fence panels had been erected in the garden. Plans for the next year included a new driveway to be laid, the bedroom window to be replaced and new facias and guttering to be fitted to the front of the bungalow. Care Homes for Adults (18-65 years) Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The persons needs are met by a competent staff team that are aware of the persons complex needs and are able to meet them, however the provision of further training, would ensure that the person is better protected from the risk of harm. Evidence: The person that lives in the home is provided with 1 to 1 staff at all times. Throughout the inspection it was evident that the staff member respected the person and was seen to be approachable and caring. The staff team is made up of 2 full time workers, one of these a B grade and the other a C grade and 2 part time workers both of which are A grades. Staff support the person on a 1 to 1 basis and there is a sleep in member of staff through the night. From examination of records and discussion with the manager and staff there was evidence of training and this was linked to the needs of the person e.g. moving and handling, epilepsy, use of stesolid, basic food hygiene and first aid and since the previous inspection all staff are now up to date with their mandatory training and have completed the medication and POVA training. Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: All staff have now received an annual appraisal and supervision is being provided on a regular basis, in addition to this regular staff meetings are held. However as previously stated in this report staff need to be provided with training in how to manage difficult behaviours and would benefit from some report writing training. Care Homes for Adults (18-65 years) Page 22 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager provides effective leadership; guidance and direction to staff to ensure that the person receives consistent quality care promoting and safeguarding their health, safety and welfare. Evidence: The manager for 134 Newtondale has recently retired and a new manager has been appointed however the previous manager is currently working part time to induct the new manager and assist with the transition. The home is safe and comfortable for the person living there and provides a clean, comfortable and homely environment. As part of the inspection all of the maintenance records were examined and those seen were in order. At the previous inspection a fire officer had visited the home following a request by the Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: manager and required that Intumescent fire and cold smoke seals be fitted to the fire doors, the manager stated that this has now been completed. Care Homes for Adults (18-65 years) Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 13 The person at the home 31/12/2008 must have a plan that has been agreed by the placing local authority and gives staff guidance on how to assist the person in times of high anxiety, this must include recomendations from health professionals. This will help to protect the person from the risk of harm 2 32 18 All of the staff must be 31/12/2008 provided with training in how to write factual reports following incidents and detail how these have been managed. This will ensure that records give a factual account of incidents and help to protect the person from the risk of harm. 3 32 18 All of the staff must be provided with training in how to work with people who at times may display 31/12/2008 Care Homes for Adults (18-65 years) Page 26 of 28 behaviour that may pose a risk to themselves or others. This will help to protect the person from the risk of harm. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!