CARE HOME ADULTS 18-65
134 Newtondale 134 Newtondale Sutton Park Hull East Yorkshire HU7 4BP Lead Inspector
Christina Bettison Unannounced Inspection 31st October 2005 09:30 134 Newtondale DS0000056742.V263075.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 134 Newtondale DS0000056742.V263075.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. 134 Newtondale DS0000056742.V263075.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service 134 Newtondale Address 134 Newtondale Sutton Park Hull East Yorkshire HU7 4BP 01482 329226 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) Avocet Trust Position Vacant Care Home 1 Category(ies) of Learning disability (1) registration, with number of places 134 Newtondale DS0000056742.V263075.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 22nd June 2005 Brief Description of the Service: 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 dining 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. 134 Newtondale DS0000056742.V263075.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over 3 hours and was an unannounced inspection. The service users care file, menus, staff lists, staff files and training records were all examined. 1 member of staff, the service user and their advocate and the manager were spoken to. Care practices and interactions were observed during the inspection. What the service does well: What has improved since the last inspection?
The policy and procedure (rules) for the use of restrictive physical interventions has been reviewed and amended, therefore staff are clear about their role and responsibilities in relation to this. 134 Newtondale DS0000056742.V263075.R01.S.doc Version 5.0 Page 6 Recruitment practices have improved, all staff now have an up to date CRB disclosure and two written references obtained. Overseas workers now have the appropriate work permits to work in this country; this means that service users are protected. 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. 134 Newtondale DS0000056742.V263075.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 134 Newtondale DS0000056742.V263075.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): EVIDENCE: There had been no admissions to the home since the previous inspection; therefore none of these standards were assessed. 134 Newtondale DS0000056742.V263075.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): 6,7 The Service user has a detailed individual plan, however this had not been updated for over a year and this may mean that his specific needs and goals may not be met. EVIDENCE: All of these standards were met at the previous inspection, therefore only NMS 6 was assessed at this inspection. The service users individual plan was examined as part of the inspection process and had been developed to cover all aspects of assessed needs. However the plan had not been updated since May 2004. The staff member spoken to confirmed that the service users needs had changed in respect of his health and this had not been recorded. Risk assessments were in place for any areas that posed a risk and measures put in place to minimise the risks, e.g. personal safety, access to the kitchen and leisure activities. There was evidence of behaviour management plans in relation to the service user’s challenging behaviour either whilst out in the community or at home.
134 Newtondale DS0000056742.V263075.R01.S.doc Version 5.0 Page 10 The service user was enabled to be as independent as possible within his capabilities this was confirmed by talking to the member of staff, the service user and their advocate. It is evident from interaction with the service user and staff that he makes daily decisions about what happens in his life. It was evident throughout the inspection and from discussions with the service users advocate that the member of staff had a good rapport with the service user and that staff make an effort to ensure the service user is given the chance to make informed choices. However in discussion with the service users advocate it was highlighted that a car had recently been purchased for the service users use. It is not clear if the service user actually owns the car and how much involvement he had in making choices about aspects of the car i.e. colour. The car is a two-door car and the advocate felt sure that the service user risk assessment stated that he must sit in the back of the car to minimize any health and safety concerns. This would be difficult for the service user as access to the rear of the car is limited. The registered person must clarify in writing if the service user owns the car and how much involvement/participation the service user had in making a choice about the car to be purchased. The risk assessment for the service user travelling in the car must be updated. 134 Newtondale DS0000056742.V263075.R01.S.doc Version 5.0 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): 17 The service user is provided with meals that meet both his nutritional needs, maintain his health and weight and allow him to make informed choices. EVIDENCE: NMS 12,13,14,15 and 16 were assessed at the previous inspection and were met therefore only NMS 17 was assessed at this inspection. The service user that lives in the house has a special interest in food. A varied menu is provided to follow a healthy eating plan whilst ensuring that the service user is enabled to make informed choices about the food he wishes to eat. The menu consisted of meat, fish, pasta, soups, sandwiches, quiche, and jacket potatoes. The service user informed the inspector that his favourite food was pilchards or any fish but he doesn’t eat these all of the time. He also stated that enjoys rides out to the seaside and eating fish and chips, which staff support him to do regularly. 134 Newtondale DS0000056742.V263075.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): 19,20 The service users physical and emotional needs are met, by the provision of a wide range of healthcare professionals and outside agencies, however the inadequate medication training and lack of update to the individual plan compromises this. EVIDENCE: NMS 18,19 and 20 were assessed at the previous inspection. NMS 18 and 19 were met. NMS 20 was only partially met; the home has policies and procedures for the administration of medication however training for staff administering medication has not been completed. New staff are instructed in medication administration by existing staff. To meet this part of the standard there must be written evidence that staff training in safe practice has been provided for all staff involved in the handling of medication from an external creditable source with relevant knowledge about medication. This must include a competency check or a workbook to complete at the end to ensure that staff understand their responsibilities. The inspector was informed that all of the staff had completed the first part of the medication training with the local authority however the staff have not yet
134 Newtondale DS0000056742.V263075.R01.S.doc Version 5.0 Page 13 completed the second part. This remains an outstanding requirement from the previous inspection. The service user has a recent period of ill health; this had been managed by visits to the GP and changes in medication. The service users advocate was satisfied that the service users health was being monitored and action taken in an appropriate and timely way. However as previously stated in NMS 6 the individual plan had not been updated to reflect this change in circumstances. 134 Newtondale DS0000056742.V263075.R01.S.doc Version 5.0 Page 14 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): 23 The staff team are not fully aware of the Protection of Vulnerable Adults policies and procedures and their responsibility within these therefore strategies are not in place to ensure that service users are protected from abuse, neglect and harm EVIDENCE: NMS 22 and 23 were assessed at the previous inspection. NMS 22 was met and NMS 23 partially met, therefore only NMS 23 was assessed at this inspection. From discussion with staff it was apparent that they were not fully informed about the Protection Of Vulnerable Adults Policies and Procedures and their responsibilities within this. Only the member of staff on duty on the day of inspection had completed the POVA training and the remaining staff had not. Therefore this remains an outstanding requirement from the previous inspection. 134 Newtondale DS0000056742.V263075.R01.S.doc Version 5.0 Page 15 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): EVIDENCE: All of these NMS were assessed and met at the previous inspection; therefore they were not assessed at this inspection. 134 Newtondale DS0000056742.V263075.R01.S.doc Version 5.0 Page 16 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 The Service user is cared for by a staff group, which is sufficient in numbers to meet their needs, however staff are not receiving sufficient training to enable them to meet the service users needs. EVIDENCE: From examination of records, discussion with staff and observation it was evident that staff work to support the written aims and objectives of the home. It was also evident from discussion with staff that they knew how to meet the needs of the service user and there was good evidence in case records of the involvement of other agencies with specific expertise. It was evident throughout the inspection and discussion with the service users advocate that the staff member had a well-developed relationship with the service user. The service user had 1; 1 staff at all times. Throughout the inspection it was evident that staff member respected the service user and was seen to be accessible, approachable, and comfortable with him. 134 Newtondale DS0000056742.V263075.R01.S.doc Version 5.0 Page 17 The staff team is made up of 2 full time workers and 3 part time workers, since the previous inspection, 2 part time workers have left the employment of avocet trust and 134 Newtondale. Some of the vacant hours have been filled and the other hours are covered by the other part time staff. None of the staff have achieved NVQ level 2; therefore a requirement has been made in respect of this. A sample of staff recruitment records were examined, all staff now have an up to date CRB disclosure and two written references obtained. Overseas workers now have the appropriate work permits to work in this country. Some staff files still did not contain all of the ID required by schedule 2 and this remains an outstanding requirement. The manager reported that within Avocet Trust there is a Human Resources section responsible for organising training. From examination of records and discussion with the manager and staff there was some evidence of training and this was linked to the needs of service users, e.g. moving and handling, epilepsy, use of stesolid, basic food hygiene and first aid, however all staff were still not up to date with their mandatory training specifically infection control and had not completed the medication training. New staff are supposed to complete Learning Disability Award Framework – accredited training to meet the Sector Skills Council targets for staff induction, this has still not happened and all of the staff have still not received training with regard to the Protection of Vulnerable adults, therefore this remains an outstanding requirement. 134 Newtondale DS0000056742.V263075.R01.S.doc Version 5.0 Page 18 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): 37,40 The policies and procedures are out of date and do not reflect current practices in the home. EVIDENCE: NMS 37,39,41,42,43 were assessed and met at the previous inspection. However since the previous inspection there has been a change of manager for 134 Newtondale. Therefore NMS 37 and 40 were assessed at this inspection. Policies and procedures were examined as part of the previous inspection since then some have been updated, one of these being the use of physical interventions. The quality assurance manager is making steady progress in reviewing and amending the policies and procedures in line with changes in legislation and best practice guidance and the timescale for completion has been agreed at 31/1/06. The registered person must ensure that the CSCI is formally notified of whom the registered manager is intended to be at the home. 134 Newtondale DS0000056742.V263075.R01.S.doc Version 5.0 Page 19 134 Newtondale DS0000056742.V263075.R01.S.doc Version 5.0 Page 20 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 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 2 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 x 12 x 13 x 14 x 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score x 2 x 2 2 x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
134 Newtondale Score x 2 2 x Standard No 37 38 39 40 41 42 43 Score 2 x x 2 x x x DS0000056742.V263075.R01.S.doc Version 5.0 Page 21 Yes 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 YA6 Regulation 15 Requirement The registered person must ensure that the service user has a care plan that details the level of care and support required to meet the service users needs. This must be updated as needs change. The registered person must clarify in writing if the service user owns the car and how much involvement/participation the service user had in making a choice about the car to be purchased. The risk assessment for the service user travelling in the car must be updated. The registered person must ensure that all staff have received training in the safe handling of medication and that they have been assessed as competent and written records kept (Timescale of 30/9/05 not met). The registered person must ensure that all staff have received training in the Protection of Vulnerable Adults (Timescale of 30/09/05 not met) The registered person must
DS0000056742.V263075.R01.S.doc Timescale for action 31/12/05 2 YA7 12 (2 and 3) 31/12/05 3. YA20 13 31/01/06 4. YA23 13 (6) 31/01/06 5. YA32 18 30/06/06
Page 22 134 Newtondale Version 5.0 6. YA34 7,9,19 Schedule 2 18 7. YA35 8. YA35 18 9. YA34 7,9,19 Schedule 2 18 10. YA35 11. 12. YA37 YA40 8 24 ensure that at least 50 of staff are qualified to NVQ level 2. (Timescale of 30/09/05 not met) The registered person must ensure that all ID as required by schedule 2 is retained on file. (Timescale of 30/09/05 not met) The registered person must ensure that all staff are up to date with mandatory training. Specifically infection control. (Timescale of 30/09/05 not met) The registered person must ensure that all new staff receive induction training that meets LDAF standards. (Timescale of 30/09/05 not met) The registered person must ensure that documentary evidence is maintained on staff files of staff qualifications. (Timescale of 30/09/05 not met) The registered person must ensure that all staff have an individual training profile. 30/09/05 The registered person must ensure that the manager of the home is registered with the CSCI The registered person must ensure that Avocet’s policies and procedures are reviewed and amended in line with changes in legislation and best practice guidance. 31/12/05 31/01/06 31/01/06 31/01/06 31/01/06 31/01/06 31/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations
DS0000056742.V263075.R01.S.doc Version 5.0 Page 23 134 Newtondale Standard 134 Newtondale DS0000056742.V263075.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Hessle Area Office First Floor 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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