Inspection on 26/01/07 for 50 Belle Vue Grove

This inspection was carried out on 26th January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

50 Belle Vue Grove 12/12/08

50 Belle Vue Grove 04/01/08

50 Belle Vue Grove 09/02/06

50 Belle Vue Grove 16/12/05

50 Belle Vue Grove 03/11/04

50 Belle Vue Grove 16/06/04

Similar services:

1 Lanark Close

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 50 Belle Vue Grove Middlesbrough TS4 2PZ Lead Inspector Mrs Ann Ferguson Key Unannounced Inspection 26th January 2007 09:30 50 Belle Vue Grove DS0000000056.V330179.R01.S.doc Version 5.2 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 50 Belle Vue Grove DS0000000056.V330179.R01.S.doc Version 5.2 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. 50 Belle Vue Grove DS0000000056.V330179.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 50 Belle Vue Grove Address Middlesbrough TS4 2PZ 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) 01642 851160 www.mencap.org.uk Royal Mencap Society Miss Janine Louise Walker Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 50 Belle Vue Grove DS0000000056.V330179.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named individual who is above the age category is allowed to reside in the home. 9th February 2006 Date of last inspection Brief Description of the Service: 50 Belle Vue Grove is registered with the Commission for Social Care Inspection, under the Care Standards Act 2000 as a care home providing care and accommodation for up to five adults who have a learning disability. Currently there are four residents who live there, and one bed for respite use. The home is part of the Mencap organisation. It is situated in a leafy residential area close to shops and a large hospital. Residents are provided with support to enable them to lead an independent lifestyle and they are encouraged to participate fully with the local community. The service charges £1189.56 per week. 50 Belle Vue Grove DS0000000056.V330179.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection commenced at 11.10 am and lasted for almost six hours. Three staff members, including the manager, and the community nurse were spoken to during the inspection. Two residents also spoke to the inspector. Two staff members were case-tracked throughout the inspection and their records including their recruitment files, training and supervision records were looked at. Two service users were case-tracked throughout the inspection and their records including care plans, medication processes and monies, were examined in detail. Also health and safety records, and policies and procedures were examined. Questionnaires were received from all the service users, and three relatives/ visitors comment cards were received too. A tour of the home was carried out. What the service does well: What has improved since the last inspection? The manager has completed a lot of work towards her management award, and hopes that it will be completed by the end of March 2007. 50 Belle Vue Grove DS0000000056.V330179.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. 50 Belle Vue Grove DS0000000056.V330179.R01.S.doc Version 5.2 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 50 Belle Vue Grove DS0000000056.V330179.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is excellent Discussion with the manager and an examination of records indicates that prospective users’ individual aspirations and needs are assessed before moving into the home. EVIDENCE: The home’s policy regarding admissions states clearly that an assessment will be completed and introductory visits offered before people move in. If the placement is suitable then a contract will be produced, and the placement reviewed regularly to make sure it continues to be suitable. Provision is made for residents to move on in a planned way. Two residents files were examined and the care plans from Social Services were found. The placements are reviewed monthly by the home and the funding authorities. In some cases work is already taking place to prepare for the residents to move on. On the day of inspection the manager was involved in training in readiness for a possible future placement to make sure that the home had the skills to meet service user needs. 50 Belle Vue Grove DS0000000056.V330179.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is excellent An examination of records and discussion with service users indicates that the service users know their needs and their goals, and they make decisions about their lives. The service users are supported to take risks as part of everyday life. EVIDENCE: In the two individual files examined, both had very clear individual plans based on the Care Management Assessment. They were very thorough and recently reviewed. The self-advocacy sheet in particular was respectfully written and explained the individual’s preferences in different areas of their life, for example, eating and drinking, or personal hygiene. At the front of the files there was a summary of the key information that staff needed to know quickly, at a glance. 50 Belle Vue Grove DS0000000056.V330179.R01.S.doc Version 5.2 Page 10 Any restrictions to choice or freedom were evidenced well too, with the service users having signed such pieces of paper to indicate their understanding or acceptance. In all the questionnaires received from service users, they said that they were the ones who chose what they would do each day. Staff confirmed that they would support them with what they wanted to do, obviously taking into account pre-arranged or regular activities. Service users handle their own money, with support from staff as required. In each file there was an individual support plan showing how much support was needed with their finances and in what form this support would take. These really were individualised in the content and approach to be taken with each person. Relevant risk assessments are in place for each service users. These had all been recently reviewed. The home actively tries to promote the taking of risks within everyday life; the beginning of each risk assessment reminded the writer to find ways to make the activity happen rather than not, within obvious limits of course. The home has excellent relationships with outside agencies and their contribution to risk assessment was evident too. The home fully understands how to respond to any unexplained absences. Such procedures are very clear in the house, and have been used appropriately since the last inspection. 50 Belle Vue Grove DS0000000056.V330179.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good A discussion with service users and staff, and an examination of records indicates that the service users do take part in appropriate activities, and are part of the local community. Service users’ rights and responsibilities are recognised within the home, and arrangements are in place within the house to manage relationships with others. The service users are supported to eat healthily and are responsible for their own shopping. EVIDENCE: In the two individual files examined, there were very clear structured plans for a typical week including domestic tasks to be done and activities outside the home to pursue interests and improve skills. The events each month for each service user were reviewed. This provided detailed information about the previous month and identified what people had done including activities both within the home and outside. 50 Belle Vue Grove DS0000000056.V330179.R01.S.doc Version 5.2 Page 12 One service user confirmed that each week he did a variety of activities, including going to college to learn about Information Technology, doing his laundry and other jobs, cooking, and going out with staff. In addition he goes to church, supported by staff. When asked he replied ‘I love it here. I like everything about here’. A relative said ‘I am very satisfied with the care and attention … at Cinnamon House’. Service users make full use of community facilities, accessing banks, shops, doctors, and pubs, for example. Relationships with other people are managed by the home. To minimise upset to some service users, people visit at times agreed beforehand with all service users. Staff discreetly support the service users to maintain relationships, for example, to the pub where the service user can socialise with their friends. The service users have signed up to a number of agreements within the home to protect their rights and ensure they maintain their responsibilities. For example, each person has individual arrangements regarding the handling of their post if they are not in when the post arrives. This takes into account fully the individual’s preferences. Also, one service user wanted a pet and, to enable this to happen, a contract was drawn up which identified the service user’s responsibilities and also got the agreement of the other service users too. All of these documents are signed by all the appropriate people and are current and up to date. All the service users are responsible for their own meal planning, shopping and cooking. Staff support them to choose what they need to buy, taking into account what they have in the fridge/ freezer already. The service users write out their own menu for the week. The inspector examined one of these and found it to be varied and nutritious. The kitchen facilities can be used by the service users whenever they wish for drinks, snacks and meals. During most of the week the service users are responsible for their own meals, but on a Sunday they cook for each other and share out the tasks of setting the table, cooking, washing up, and clearing away. One service user spoke really positively about this occasion, describing it as ‘lovely food’. 50 Belle Vue Grove DS0000000056.V330179.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good An examination of records and discussion with staff and service users indicates that service users receive support in the way they require. Their physical and health needs are met. The systems in place for the administration of medication are individualised and robust. EVIDENCE: The support plans in the service users’ individual files are all individualised and reflect people’s needs and wants, to encourage independence. One service user said ‘I have a lot of fun with the staff’. A member of staff said ‘The people are getting very independent. This is what we want, independent living in the community’. On the day of the inspection all staff and service users were extremely positive about the service they provided and received. All of the records kept on the service users are regularly reviewed and updated by the service users, staff and external people, to ensure that they reflect the preferences of the service users. 50 Belle Vue Grove DS0000000056.V330179.R01.S.doc Version 5.2 Page 14 Service users are supported to attend appointments with other health professionals as required. Clear records are made of all contact with these people. If appointments are missed, the staff work specifically with the individual to identify why the appointment was missed and to re-schedule it as soon as is appropriate. One professional said ‘Possibly one of the best homes I visit with regards to service users’ health and well-being’. The medication procedure is robust in the home. Service users are encouraged to self-medicate as much as possible, and examples of such arrangements were found in individual files. There is a small locked room in the home where medication is stored securely. At the time of the inspection the records contained on the MAR sheets reflected exactly the stock that was in the home. A record was kept of all medicines coming into the home and any disposed of medication. 50 Belle Vue Grove DS0000000056.V330179.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good An examination of records and discussion with staff indicates that service users are protected from abuse, neglect and self-harm, and that they feel that their views are listened to. EVIDENCE: The home has a complaints procedure for service users, which contains all the required information although it needs to be updated to include the name of the funding authority rather than CSCI. All the service users said that they were aware of the complaints procedure and what to do if they were unhappy with anything. As well, the three visitors/ relative comment cards returned indicated that they too were aware of the complaints procedure but they had not had to make a complaint. At the moment there is an internal investigation going on into a complaint made by the service user. The service user has been kept informed of the progress of the complaint. The home has very clear procedures regarding the handling of people’s monies. All balances are checked at each handover. The inspector, with the permission of the service user, checked one balance and reconciled it to the written balance, checking receipts too. There were no discrepancies. Two risk assessments regarding service users’ finances were examined. They were detailed, individualised, and signed by the service user. 50 Belle Vue Grove DS0000000056.V330179.R01.S.doc Version 5.2 Page 16 Robust procedures are in place with regards to abuse, neglect and whistle blowing. Staff all have a CRB check prior to starting work and also a PoVA check too. Staff receive training in No Secrets and also other service-specific training although the training records are not up to date so it was not possible to see exactly how many staff had received such training and when. The home has excellent relationships with outside agencies, whom they can call on quickly if there was any concern about any service user. 50 Belle Vue Grove DS0000000056.V330179.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good A tour of the building indicates that service users live in a homely, comfortable environment. The home is safe, clean and hygienic. EVIDENCE: The inspector was shown around the home by one of the service users. The home provides suitable accommodation and is decorated to a good standard throughout. Bedrooms are personalised to reflect the individuals’ tastes. New furniture has been bought for the lounge and the dining room. The kitchen is suitable for the needs of the service users and the repairs to the flooring have been carried out. The hall and landing areas were very clean and bright, personalised with pictures too. The home benefits from a large garden, and one service user told the inspector that they enjoyed being involved in the maintenance of the garden. The laundry facilities are adequate for the size of home. 50 Belle Vue Grove DS0000000056.V330179.R01.S.doc Version 5.2 Page 18 There are some areas in need of improvement. The upstairs bathroom is in need of re-decorating and the loose bath panel needs securing. Also, the filler above the washbasin was in a poor state. The light pull in the shower rooms needs replacing. Repairs are also needed to some worn areas of the worktop in the kitchen. The manager of the home has contacted the Housing Association about some of these repairs. The carpet in the small lounge area is badly stained and needs cleaning or replacing. On the day of the inspection the home was found to be very clean. A number of records were examined including boiler servicing, monthly health and safety inspections, fire safety checks and Portable Appliance Testing (PAT). All of these were found to be in order with the exception of the PAT testing. 50 Belle Vue Grove DS0000000056.V330179.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36 Quality in this outcome area is good An examination of records and discussion with staff indicates that the home has robust recruitment procedures, which protect the services users. Staff are suitably qualified and trained, and are supervised to ensure that they can meet the needs of the service users. EVIDENCE: The two staff files that were looked at both contained an application form and two written references, although one reference was an internal one and had not been completed fully. Required checks with the Criminal Records Bureau at the required level were found. 50 Belle Vue Grove DS0000000056.V330179.R01.S.doc Version 5.2 Page 20 The home provides a lot of training for staff to attend. It provides appropriate mandatory training including refreshers. Since the last year training has been provided in: • Person-Centred Planning • Moving and Handling • First Aid • NVQ • Health and Safety • Food Hygiene In addition, the home provides service-specific training to meet the needs of the service users. Examples of these include • • • • Bi-polar disorder Sexuality Dual diagnosis Autism In discussions with the inspector, staff confirmed that they do receive a lot of training. 50 of staff have an NVQ at level 2 or above, and there are two members of staff all ready to commence a course in February. Individual and up to date training records were not evident. A training plan is needed for the home as well as for all individual staff. Staff receive a good level of supervision at the home. In the two files examined staff were supervised at least six times in a year, which complies with the standard. Again, staff confirmed this, saying that ‘supervision is frequent. But we can discuss things before a supervision as well’. Another staff member said that the support structure internally and externally is’ fantastic’. The manager’s supervision record held within the home needs to be brought up to date. It showed the last supervision to have been in August 2006 although this could not be verified because the manager’s file is not kept on the premises. Staff currently are in need of annual appraisals and the manager is aware of this. 50 Belle Vue Grove DS0000000056.V330179.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good An examination of records and discussion with staff and service users indicates that the home is well-run for the service users. Their views underpin developments in the home, and their health and safety is protected. EVIDENCE: The manager has made good progress towards completing her management qualification and is confident that it will be completed by the end of March 2007. The manager makes sure that the views of everybody who comes into contact with the service are listened too. Service users have meetings on a monthly basis, and team meetings take place monthly too. 50 Belle Vue Grove DS0000000056.V330179.R01.S.doc Version 5.2 Page 22 Also there are meetings with the relevant external agencies held regularly. Minutes of all these meetings were examined. A staff member said ‘Everyone’s opinion is valued’ and another staff member said that anyone was able to add items to the team meeting agenda. Whilst it is clear that the views of the service users are listened to, there is no formal system of collating and recording these views and then publishing the findings. The home needs to address the issue. The health and safety of the service users and staff who access the home is well-managed. Appropriate training is provided for staff to ensure that they follow safe working practices in the key areas. Regular maintenance checks are carried out on, for example, fire safety systems, water temperature checks, electrical testing, and all were found to be within date with the exception of the PAT testing. Risk assessments for the home were examined and were found to have all been recently reviewed. The recording of accidents is thorough and up to date. 50 Belle Vue Grove DS0000000056.V330179.R01.S.doc Version 5.2 Page 23 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 Standard No Score 1 X 2 4 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 X LIFESTYLES Standard No Score 11 X 12 3 13 4 14 X 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 4 x 2 X 2 X X 3 x 50 Belle Vue Grove DS0000000056.V330179.R01.S.doc Version 5.2 Page 24 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 .YA37 Regulation 9 Requirement The Registered Manager must attain qualifications at National Vocational Qualification Level 4, or equivalent, in care and management. Timescale for action 30/09/07 2. YA39 24 30/06/07 The Registered Manager must ensure effective quality assurance and quality monitoring systems, based on seeking the views of service users, are in place to measure success in achieving the aims, objectives and statement of purpose of the home. Previous timescale of 01/07/06 not met The Registered Manager must ensure that the electrical appliances are tested by a person competent to do so, and a certificate obtained for this. 31/03/07 3. YA42 13 (4) 50 Belle Vue Grove DS0000000056.V330179.R01.S.doc Version 5.2 Page 25 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 YA24 Good Practice Recommendations The Registered Manager should make sure that the upstairs bathroom is maintained appropriately, in particular the bath panel, the filler above the washbasin, and re-decoration. The Registered Manager must ensure that an overall training programme is in place for all staff, and that individual training records are up to date in staff files. The Registered Manager must ensure that staff receive an annual appraisal. The Registered Manager should arrange for the cleaning or replacement of the carpet in the small lounge. 2. YA35 3. 4. 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