Inspection on 30/10/08 for 24 Station Road

This inspection was carried out on 30th 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

Ashlea Mews Residential Home

Eastwood

West Lodge

Arran House

Avenue Community Nursing Home

Cosin Lodge

Farmborough Court

Cragston Court

Extracts from inspection reports are licensed from CQC, this page was updated on 08/06/2011.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 24 Station Road 24 Station Road Darlington County Durham DL3 6SU 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: Tanya Newton Date: 3 0 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. They reflect the things that people have said are important to them: 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. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 26 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2009) 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 26 Information about the care home Name of care home: Address: 24 Station Road 24 Station Road Darlington County Durham DL3 6SU 01325333192 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Middleton St George Healthcare Ltd care home 3 Number of places (if applicable): Under 65 Over 65 3 0 mental disorder, excluding learning disability or dementia Additional conditions: The registered person may provide the following category of service only: Care Home onlyCode PC To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following category: Mental Disorder, excluding learning disability or dementia, Code MD maximum number of places 3 The maximum number of service users who can be accommodated is: 3 Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 26 A bit about the care home 24 Station Road is a care home registered to provide care for up to three people who are recovering from mental illness and wish to rehabilitate and integrate back into the local community. The home is a large Victorian terraced property near to the centre of Darlington and all amenities and transport links. The ground floor includes a large lounge, a dining room and a kitchen. There are three large single en-suite bedrooms on the first floor and a communal bathroom. Externally there is a small garden area to the front of the property and a rear yard which includes a designated smoking area. Fees at the home are £280.00 per day. Care Homes for Adults (18-65 years) Page 5 of 26 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 Care Homes for Adults (18-65 years) Page 6 of 26 How we did our inspection: This is what the inspector did when they were at the care home We carried out an unannounced visit to the service between the hours of 9 AM and 2.PM. We looked at records in the home and spent some time talking to the nurse on duty, staff and people living at the home. prior to the inspection we asked the home to complete an annual quality assurance assessment (AQAA). this provides us with information about the service. We also sent out questionnaires to people living at the home, one of which was completed and returned. What the care home does well The home provides clear information about its service. Written documents such as assessments and care plans which demonstrate how the home will meet peoples needs were well written. People living at the home say they are well cared for. Systems to support peoples health and well being are good. The home supports people to become more independent, encouraging every day living skills. People are given good opportunities to fulfill their social and leisure needs and people can go out independently where they are are able to do so. Each person has their own individual food budget and is encouraged to plan, shop and help cook their own meal. Staff say that the morale Care Homes for Adults (18-65 years) Page 7 of 26 is high and that they are given good training opportunities and support to carry out their jobs effectively. Management are said to be supportive and flexible in the way in which the home is ran. The service is very much adapted around meeting the needs of the people living there. What has got better from the last inspection What the care home could do better The level of fees should be included within the contract. Risk assessments should be carried out for people holding their own keys. The local authorities policy on protecting adults should be sought and a copy kept at the home. This supports the homes procedure on protecting vulnerable adults. Some areas of maintenance need to be addressed and consideration given to providing emergency lighting throughout the home. Maintenance should be provided in a timely manner and it may be beneficial for the home to be able to access their own contractors so that work can be carried out more efficiently. Policies and procedures need to be reviewed and updated so that they are Care Homes for Adults (18-65 years) Page 8 of 26 relevant to the care home, at present they are very clinical as they have been written for a hospital environment. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Tanya Newton 33 Greycoat Street London SW1P 2QF 02079792000 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 9 of 26 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 10 of 26 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 . Information is provided to enable people to choose a home which will meet their needs. Assessments are provided to ensure that the home can meet the needs of the people placed there. Evidence: The home provides a statement of purpose which is relevant to the client group it supports. It also provides a service users guide to the home which gives people information about the service being provided. Admissions are not made to the home until a full needs assessment is carried out. Assessments were detailed and outlined clearly the ways in which peoples needs should be met. Admissions to the home only take place if the service is confident that staff have the skills and ability to meet the assessed needs of the individual being placed. Contracts are provided to all people living at the home. Although contracts were detailed and contained information about what is included within the fees, they did not show how much fees were. This information should be made available to all people Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: living at the home. Care Homes for Adults (18-65 years) Page 12 of 26 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 . Information which shows how the home will meet individual needs is well recorded within each persons care plan. Risk taking is encouraged and people are supported to make decisions and choices about all aspects of their lives. Evidence: Care plans are well written and contained detailed information about peoples health and personal care needs. Care plans are reguarly reviewed and updated. There is evidence of peoples input within their individual plans of care. People are supported in making decisions about all aspects of daily life which may include decisions about what to eat, what to do and where they want to go. People are supported in taking risks and risk taking is well managed with regular reviews in place to ensure peoples safety. Care Homes for Adults (18-65 years) Page 13 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People are supported in attending social and leisure opportunities which they choose. They have good links with the local community and are able to maintain friendships and relationships. Mealtimes are flexible and based around the needs of people living at the home. Evidence: Peoples social and recreational needs are discussed and documented within their individual care plan. Social and recreational needs are based around peoples individual choices and abilities. None of the people work or are able to attend day placement schemes at present. People access the local community and carry out their own food shopping with their own food budgets. People gave examples of social activities which include trips in to town, trips out to play snooker, car boot fairs and markets. Although the home does not have its own transport people are able to book transport from Middleton St George Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: hospital. Staffing numbers are flexible around meeting individuals activities and some people go out alone. Relatives are able to visit and people are supporting in visiting friends or relatives outside of the home. One of the people accomodated has a friend that visits reguarly and staff take another person home to his parents. Daily routines are flexible and based very much around the individual needs of the people accomodated. Each person has a key to both the front door and their bedroom. This should be risk assessed and included within each persons individual care plan. People have their own individual budgets for food, they go shopping and plan their own menus. They are also supported in the preparation of food where possible, although some meals such as sunday lunch are taken together. Care Homes for Adults (18-65 years) Page 15 of 26 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 . Peoples health and personal care needs are recorded within their individual care plan. The health and personal care which people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: Peoples health and personal needs are well documented within care plans. People are able to access support from other health professionals where this is required. All of the people living at the home are registered with a GP, optician and dentist of their choice on admission. People said that they were well cared for. It was observed throughout the inspection that people were treated with respect and their individuality was acknowledged. Members of staff adopt a person centered approach with attention given to promoting peoples dignity and privacy. Systems to safely store, administer and record medication are in place. People are supported in managing their own medication wherever possible. All staff have received training on the safe administration of medication. Care Homes for Adults (18-65 years) Page 16 of 26 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 . People who use the service are able to express their concerns, and have access to a robust, effective complaints procedure. Policies, practices and staff training support people in being safe. Evidence: One concern had been raised regarding lack of transport at the home. The home have applied for additional funding in the next financial year to address this. Each care plan has a copy of the complaints procedure in place and people living at the home said that they would feel confident in raising any concerns with the home. One questionnaire which was completed by one of the people living at the home confirmed that they knew how to complain. The home has an adult protection procedure in place which makes reference to the local authorities safeguarding procedures. They were advised to gain a copy of this procedure to keep in the home. Protection of vulnerable adults (POVA) training is included in induction for all staff. Whistle blowing procedures were also in place and staff said that they would have no hesitation in using these. Pre-employment checks are carried out on staff which include enhanced checks with the criminal records bureau (CRB). Two references are obtained in almost all cases. The manager confirmed that all new staff employed would have reference checks made prior to them starting work. New staff members go through induction and foundation training so that they have the right knowledge and skills to do their jobs Care Homes for Adults (18-65 years) Page 17 of 26 Evidence: competently. Care Homes for Adults (18-65 years) Page 18 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The physical design and layout of the home enables people who use the service to live in a reasonably safe, well maintained and comfortable environment. Evidence: The home is furnished and decorated to a high standard. People can choose how they want to personalise their own bedroom. There were no unpleasant odours and the home was clean throughout. People spoken to said that they were pleased with the home and liked their bedrooms. Some concerns were raised about the lack of emergency lighting throughout the home but particularly the stairway from the staff sleepover room which is very steep and could be quite dangerous to try and access with no lighting in the event of a fire. Some concerns were also raised about the time that it takes for repairs to be carried out as the home has to request these through the hospital. The temperature of the home was fluctuating and was very hot on the first floor. The home was advised to monitor this and to seek advice if necessary. The infection control policy would benefit from being updated to reflect practice within the home. Care Homes for Adults (18-65 years) Page 19 of 26 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 . Staff have the training, support, skills and qualifications needed to carry out their jobs effectively. Evidence: Staffing levels were found to be appropriate and were based very much around meeting the needs of the people living in the home. There is a range of training available to staff which includes induction, first aid, food hygiene, moving and handling, fire and training specific to the people who are living at the home. Comments from staff about the training available were positive and all said that there were lots of opportunities available. Future planned training includes infection control, drug awareness, advanced medication and leadership and management. The home should consider providing training on the mental capacity act (MCA). In the main staff recruitment files contained all of the required information, although one of the files viewed did not have two references. The home must ensure that two references are always obtained prior to people starting work. Supervision is provided and staff say that they are well supported. Care Homes for Adults (18-65 years) Page 20 of 26 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 home is well managed and run. Quality assurance systems and policies need to be further developed. Evidence: People expressed satisfaction with the way in which the home was being managed. Staff said that both the manager and the nurse in charge were approachable and supportive. Many of the policies and procedures in the home were very hospital based as they had been written for Middleton St George Hospital. The home need to review all of the policies, to make sure that they are suitable to reflect the needs of a care home. Quality assurance systems have started to be developed, systems include resident meetings and staff meetings. A range of internal audits are also carried out such as medication audits and audits on the standard of care plans. The home should continue to develop their quality assurance systems to ensure that the views of other stakeholders, those living and working at the home and relatives are sought. Care Homes for Adults (18-65 years) Page 21 of 26 Evidence: Health and Safety systems were looked at. The home is generally well maintained and is attractively decorated. There are clear records of maintenance in place, although some people felt that smaller maintenance tasks were left for too long as maintenance has to be accessed through the hospital. This area has been addressed under standard 24. Care Homes for Adults (18-65 years) Page 22 of 26 Are there any outstanding requirements from the last inspection? Yes  No  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 23 of 26 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 Description 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 Description Timescale for action 1 24 23 Advice must be sought about 18/12/2008 the lack of emergency lighting throughout the home but particularly the stairway from the staff sleepover room which is very steep and could be quite dangerous to try and access with no lighting in the event of a fire. Repairs must be carried out in a timely manner. The temperature on the first floor must be monitored so that the home is maintained at a comfortable temperature. Heating and lighting which is suitable for service users must be provided in all areas of the care home. 2 34 19 The home must ensure that two references are always obtained prior to people starting work. 18/12/2008 Care Homes for Adults (18-65 years) Page 24 of 26 To ensure peoples safety. 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 1 2 5 16 The contract should include the fee being charged. Each person has a key to both the front door and their bedroom. This should be risk assessed and included within each persons individual care plan. The home were advised to get a copy of the local authorities inter-agency policy on adult protection. The policy on the control of infection shopuld be reviewed and updated to reflect practice within the home. The home should consider providing training to staff on the Mental capacity Act. Quality assurance systems should continue to be developed. All of the policies and procedures should be reviewed and where necessary updated to reflect practice within the home. 3 4 5 6 7 23 30 32 39 40 Care Homes for Adults (18-65 years) Page 25 of 26 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 © (2009) 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 26 of 26 - 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!