CARE HOME ADULTS 18-65
48 Heath Road 48 Heath Road Holmewood Chesterfield Derbyshire S42 5SW Lead Inspector
Vanessa Davies Unannounced Inspection 10th November 2005 11:00 48 Heath Road DS0000063006.V272274.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 48 Heath Road DS0000063006.V272274.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. 48 Heath Road DS0000063006.V272274.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service 48 Heath Road Address 48 Heath Road Holmewood Chesterfield Derbyshire S42 5SW 01246 857620 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) Milbury Miss Vanessa Blackburn Care Home 10 Category(ies) of Learning disability (10) registration, with number of places 48 Heath Road DS0000063006.V272274.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 18th October 2005 Brief Description of the Service: Heath Road is a large detached home with a number of communal lounges and a large dining room. Each bedroom has an en-suite facility and there is a bedroom provided for relatives who need to stay to due travel distance. There is ample off road parking and pleasant outdoor areas. Heath Road is home to service users with a learning disability. All service users have access to a range of professionals via a referral system. 48 Heath Road DS0000063006.V272274.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced. Information was gathered by speaking with service users, staff and the manager and reading files kept by the home. This was the first inspection on the home since registration and it is clear that the manager and staff have worked hard to support the service users through a difficult move into a newly refurbished home. What the service does well:
A detailed Statement of Purpose assists potential service users with choice of home. Service users spoken with had received a copy and were aware of the services provided. Detailed information was on file for each of the service users. Care plans and risk assessments were in place and had clearly been reviewed. The manager and staff had built up positive, supportive relationships with the service users in a short time. One service user commented that the best thing about the home was the staff. All information relating to service users is kept securely and service users know this. Service users spoken with had made friends with others they now live with but they stated that they had also been supported to maintain friendships made at previous homes they had lived in. Service users access the local community on a regular basis and 1 service user has commenced work in a local school as a classroom assistant. Service users spoken with felt that the home met their healthcare needs, they are registered with a GP and attend appointments, supported by staff if necessary. All medication is administered by staff trained to do so. All staff have received a variety of training provided by the organisation, in order to meet the complex needs of the service users. The home has been open for a short time, however a high number of staff have achieved NVQ 2 or 3 and 12 staff are doing the Learning Disability Framework Award (LDAF). The home undertake a number of Health and Safety audits on a regular basis to ensure the safety of the service users. 48 Heath Road DS0000063006.V272274.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 48 Heath Road DS0000063006.V272274.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 48 Heath Road DS0000063006.V272274.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): 1,2,3,4 Detailed assessments of need and planned moves to the home have ensured that service users have settled well and lead a fulfilling lifestyle. EVIDENCE: The home has a detailed Statement of Purpose in place with information to assist prospective service users to make an informed choice. The two service users spoken with were aware of the Statement of Purpose and had a good knowledge of the services provided for them. Each of the files examined had detailed assessments of need, with evidence of input from the service user. However one file examined did not have information completed by staff at Heath Road but plenty of information from previous placements, this now needs to be updated. Each service user spoken with confirmed their input. It was evident on the day of inspection that a dedicated staff team meets service users needs and aspirations. One service user stated that she had lived in a number of homes and had never been happier. The service users spoken with stated that they had all visited the home prior to moving and all service users had met the manager or staff member prior to moving. 48 Heath Road DS0000063006.V272274.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): 6,7,8,9,10 Positive relationships with service users builds confidence and helps to support a more independent way of living. EVIDENCE: There was a detailed assessment of need in one files, however there was a large amount of information relating to previous placements but no assessment or care plan completed by the home. Service users spoken with stated that they had changed since moving to the home and that the staff have worked hard to ensure that they settle well and have all of their needs met. The assessments of need do not reflect the changes made. Service users spoken with stated that the staff worked closely with them to involve them with all aspects of their life. One service user said that it was the best home she had lived in and the reason given was the staff listen to her. Each of the files had risk assessments in place to address risks highlighted. Risk assessments seen in one file had been up dated regularly to address changing needs and there was evidence of input from the service user.
48 Heath Road DS0000063006.V272274.R01.S.doc Version 5.0 Page 10 All files relating to the service users a kept in the locked office. All service users are aware of where their files are kept and that they are kept securely. 48 Heath Road DS0000063006.V272274.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): 11,12,13,15,16,17 Choices and opportunities offered ensure that service users develop to their full potential and improve valuable social skills. EVIDENCE: It was evident throughout the inspection that service users are supported to develop. The service users spoken with stated that they had made friends with others living at the home and had also maintained contact with friends made at their previous home. Service users are able to access the local pub, library, colleges and supermarkets. Service users confirmed that they open their own mail, do not enter other service users rooms and that staff knock before entering their bedroom. It was evident on the day of inspection that staff and service users have an excellent relationship, all using preferred forms of address. Service users are actively involved with the preparation of meals and choices are offered. The service users decide between themselves what to have on the menu for the following week and do the shopping accordingly. 48 Heath Road DS0000063006.V272274.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): 18,19,20 Detailed information is documented and a variety of other professionals are involved as necessary, all ensuring that the health and social needs of service users are met. EVIDENCE: It was evident when reading files and speaking with service users that they choose what to wear and as far as possible who to work with. Care plans evidenced support with personal care where necessary. Service users spoken with confirmed that there were no times to go to bed or to get up in the morning, however they are supported to get up in time for any college or work placement. Medication is administered by staff trained to do so. The home has a policy and procedure on the safe administration of medication. A record of medication received, administered and returned is kept. All service users are registered with a GP and receive input from a variety of other professionals as necessary. The service users spoken with felt that their health needs were met and that the staff supported them to attend appointments as necessary.
48 Heath Road DS0000063006.V272274.R01.S.doc Version 5.0 Page 13 48 Heath Road DS0000063006.V272274.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): 22,23 Detailed procedures, policies and staff training ensure that service users feel listened to and are protected from abuse. EVIDENCE: All service users spoken with stated that they were aware of the complaints procedure and felt that any complaint they may need to make would be dealt with appropriately. The home keeps a record of any complaints made and the responses. All staff have received training in adult protection training or training as part of their induction and await further more formal training. 48 Heath Road DS0000063006.V272274.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: Standards within this section were not assessed on this occasion. The home has been completely refurbished and was opened recently. 48 Heath Road DS0000063006.V272274.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 Investment in training by providers has ensured that staff morale is high, resulting in an enthusiastic workforce that work positively with the service users to improve their quality of life. EVIDENCE: The providers ensure that all mandatory training is offered along with other training to help meet the needs of the service users. The home employs 26 care staff; 4 have NVQ 2 and 1 is completing it, 4 have NVQ 3 and 1 is completing it and 12 staff are doing the Learning Disability Framework Award (LDAF). Other training offered includes; Non-violent crisis intervention, epilepsy awareness, autism awareness and Makaton. The inspector examined a number of staff files all had 2 forms of identity, 2 written references, an application form and a job description. 48 Heath Road DS0000063006.V272274.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): 37,42 The manager is supported well by her manager enabling her to provide clear leadership throughout the home ensuring the service users are listened to, needs are met and quality of life is improved. EVIDENCE: This is a new service provision and service users appeared to be settling in well. Staff have built up supportive relationships with each other and service users in a relatively short space of time. The support of the manager and her manager have assisted in this. All staff have received Fire training, alarms are tested regularly and fire drills completed according to recommendations, service users are involved with the drills. Regular Health & Safety checks, vehicle checks and fridge/freezer temperatures checks are completed. 48 Heath Road DS0000063006.V272274.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 3 2 3 3 X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 3 3 3 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 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
48 Heath Road Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 X X X X 3 X DS0000063006.V272274.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? N/A 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 Refer to Standard YA6YA3 Good Practice Recommendations The assessments of need should remain up to date and previous information should be achived. 48 Heath Road DS0000063006.V272274.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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