Inspection on 23/05/07 for 54 Darlington Road

This inspection was carried out on 23rd May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

54 Darlington Road 21/09/05

54 Darlington Road 31/05/05

54 Darlington Road 20/10/04

54 Darlington Road 01/06/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 54 Darlington Road Hartburn Stockton-on-Tees TS18 5EN Lead Inspector Jane Bassett Key Unannounced Inspection 23rd May 2007 09:30 54 Darlington Road DS0000039039.V340146.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 54 Darlington Road DS0000039039.V340146.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. 54 Darlington Road DS0000039039.V340146.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 54 Darlington Road Address Hartburn Stockton-on-Tees TS18 5EN 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 806448 01642 866433 bryan.cutter@choicescare.com Choices House Mr Bryan Paul Cutter Care Home 7 Category(ies) of Learning disability (7) registration, with number of places 54 Darlington Road DS0000039039.V340146.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st September 2005 Brief Description of the Service: 54 Darlington Road is a seven bedded care home providing personal care to adults with learning disabilities. The level of disability is high and all of the residents are very physically dependant with communication needs. The home is a converted property, with seven single spacious bedrooms, one of which had an ensuite facility. There is a very spacious, nicely presented garden, which is accessible to all residents. The home is situated close to the centre of Hartburn, very close to a parade of shops, public house, community centre and church. The home currently charges fees of £1463.60 per week. 54 Darlington Road DS0000039039.V340146.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection report includes information obtained from a pre inspection questionnaire. An unannounced visit to the home was carried out. During the visit, which lasted four and a half hours the inspector walked around the building and looked at documentation including staff records and residents files. The inspector spoke to two staff members and the manager. The inspector walked around the home and carried out indirect observation of interactions between residents and staff. All the residents at 54 Darlington Rd have extremely complex needs and communication difficulties. Whilst it was difficult for the inspector to obtain the views of the residents all appeared settled and comfortable in their surroundings. What the service does well: What has improved since the last inspection? The home has developed and is implementing new documentation to record residents care needs and how these are to be met. The documentation was seen to be more concise and easier to follow. Staff at the home have completed training in relation to gastric feeding and the manager has developed a checklist of all training undertaken by staff. All staff employed at the home have been subject to a Criminal Record Bureau check and it is planned that these will be reviewed every three years. 54 Darlington Road DS0000039039.V340146.R01.S.doc Version 5.2 Page 6 The home is currently developing a DVD that will be a pictorial information tool for prospective residents and their representatives. It is planned that the DVD will have both a voice over and subtitles. 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. 54 Darlington Road DS0000039039.V340146.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 54 Darlington Road DS0000039039.V340146.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): Outcomes for standard 2 were looked at. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and their representatives have information needed to choose a home which will meet their needs. They have their needs assessed. EVIDENCE: During discussion with the manager it was confirmed that information from the prospective residents care manager and other relevant health professionals is obtained. The admission process was described as a detailed process that includes visits to the home by both the resident and their family. Prospective residents are given the opportunity to take part in planned activities provided by the home. Evidence was seen in residents files to confirm this. Staff at the home are developing a DVD of the home and the service provided as a pictorial information tool to assist both prospective residents and their families. It is planned that this will include both a voice over and subtitles. 54 Darlington Road DS0000039039.V340146.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): Outcomes for standards 6, 7 & 9 were looked at. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Each resident has an individual plan of care that reflects their interests and preferences. Evidence indicates that individuals are involved in decisions about their lives, the care and support they receive. EVIDENCE: The manager told the inspector that new documentation has been developed to record residents care needs and risk assessments. He said that this was currently being introduced. During the inspection two sets of residents notes were randomly selected to be examined, one of which contained the new documentation. Information was recorded in the new documentation in a more concise manner, whilst retaining a record of individuals care needs and how these are to be met. Records seen included details of the persons preferences, likes and dislikes in all aspects of daily living, care, leisure and health. 54 Darlington Road DS0000039039.V340146.R01.S.doc Version 5.2 Page 10 Documentation also included assessment of identified risks, regular reviews and in depth daily records. Evidence was seen that indicated families had been consulted about and agreed to the plans of care. Staff who spent time with the inspector were able to demonstrate a good knowledge of individual residents, their needs and preferences. Due to the cognitive and communication difficulties it was not possible to fully involve the residents. However it was clear from discussions with staff and observation that individual’s rights and choices were encouraged through body language and non verbal communication. 54 Darlington Road DS0000039039.V340146.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): Outcomes for standards 12, 13, 15, 16, & 17 were looked at. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff support residents to participate in a range of activities that match their interests, preferences and abilities. Contact with family and local community is encouraged. EVIDENCE: It was evident from discussion with the manager and staff the residents are offered a wide range of activities including personal shopping, hydrotherapy, trips out to local pubs and social events. Staff also support residents to pursue individual interests such as music, bird watching, and sport. Staff spoke of connections to local churches that residents could attend if they wished. It was clear from discussion that contact with families and friends was encouraged and supported. The inspector was told of one resident recently attending a family wedding and others having regular visits home. 54 Darlington Road DS0000039039.V340146.R01.S.doc Version 5.2 Page 12 The home provides a snoozelin therapy area for residents to use. Work is also being carried out to build a number of raised flowerbeds in the garden, enabling residents to grow their own herbs, vegetables and flowers. Copies of menus were submitted with the pre inspection questionnaire, these detailed a varied and nutritious choice of meals and snacks. The inspector was told the home can cater for specialised diets. 54 Darlington Road DS0000039039.V340146.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): Outcomes for standard 18, 19, 20, & 21 were looked at. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: The residents who live at 54 Darlington Road have very complex physical and health care needs. Due to their cognitive and communication difficulties it was not possible to fully include them in discussions. Through discussion with staff and observation of interaction it was clear staff have a good knowledge of individuals needs and how these are met. The home operates a keyworker system to promote individual care and communication with family and friends. Staff spoke to the inspector of the increased support and care given to two residents and their families at the time of their illness and recent deaths. Evidence was seen in care files of the involvement of other health professionals including GP’s, Occupational therapist, Physiotherapist, District nurse and Dentists. 54 Darlington Road DS0000039039.V340146.R01.S.doc Version 5.2 Page 14 Each resident has health action plans and medication plans. A sample audit of medication found no major concerns. The inspector was told medication is always administered by two staff. One of whom is a senior care staff who has completed appropriate training and takes the responsibility for the actual administration. Policies and procedures in relation to medication should be developed further to include the procedure for administration of controlled drugs. The home currently does not administer any controlled medication. Any medication that requires refrigeration is currently held in a secure box in the main fridge. The storage facilities would be improved with the provision of a fridge specifically for medication. The manager told the inspector that further training in relation to safe handling of medication is planned and the home is to implement competency checks 54 Darlington Road DS0000039039.V340146.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): Outcomes for standards 22 & 23 were looked at. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. It was not possible to ascertain the resident’s views however arrangements are in place through the complaints and safeguarding procedures that promote the safety and offer protection of residents. EVIDENCE: The home has a complaints procedure that is available to all staff and residents representatives. The manager told the inspector the home has not received any complaints since the previous inspection. Staff have received training in the prevention of abuse and the ‘ no secrets’ guidance. Staff demonstrated through response to questions a commitment to protecting resident’s safety and wellbeing and were able to describe the action they would take if a concern were raised. 54 Darlington Road DS0000039039.V340146.R01.S.doc Version 5.2 Page 16 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): Outcomes for standards 24 & 30 were looked at. Quality in this outcome area is good. This judgement has been made using available 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 safe, well maintained and comfortable environment which encourages independence. EVIDENCE: The inspector walked around the building and was able to look at the resident’s bedrooms as well as communal areas. The home offers lounge, dining room, conservatory and snoozeline rooms for residents to socialise and participate in activities. The home was found to be homely, comfortable, clean and odour free. Bedrooms are decorated and personalised to the individuals taste and interests. Suitable equipment is provided to assist with transferring and bathing. 54 Darlington Road DS0000039039.V340146.R01.S.doc Version 5.2 Page 17 Some new lounge furniture has been purchased. The garden area has been laid out to offer a tranquil and relaxing area for residents. Further work is being carried out to give some raised beds for residents to grow flowers, herbs and vegetables. Information in the pre inspection questionnaire indicates that the home and equipment are maintained as required. 54 Darlington Road DS0000039039.V340146.R01.S.doc Version 5.2 Page 18 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): Outcomes for standards 32, 34, 35, & 36 were looked at. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff at the home are trained, skilled and in sufficient numbers to support the people who use the service, and to support the smooth running of the home. EVIDENCE: During the inspection a random selection of staff files were examined. Evidence was seen that indicated staff have received training in moving and handling, ‘no secrets’, dementia awareness, epilepsy, safe handling of medication and gastric feeding. Records seen indicated over 50 of the care staff have achieved NVQ at level 2 or above. Staff who spoke to the inspector told her they have received the necessary training that enables them to effectively carry out their duties. They all said training had a high priority and was encouraged. A system of recording training has been developed making it easy to identify which staff have received which training and ensuring further training is 54 Darlington Road DS0000039039.V340146.R01.S.doc Version 5.2 Page 19 effectively planned. The manager told the inspector further training in fire safety, cross infection and safe handling of medication was planned. The inspector was told there are sufficient staff to meet the residents physical, social and emotional needs. The home employs separate staff for domestic and catering duties. The file of one staff member recently recruited was found to contain the appropriate information in relation to recruitment including CRB check and references. Records contained evidence of induction training. The manager told the inspector it is planned to recheck the CRB for all staff every three years. Staff files contained records of supervision. Staff confirmed this takes place on a regular basis and is structured to support their training and development. 54 Darlington Road DS0000039039.V340146.R01.S.doc Version 5.2 Page 20 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): Outcomes for standards 37, 39, 41, & 42 were looked at. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect, has effective quality assurance systems. EVIDENCE: Due to cognitive and communication problems it was not possible to gain the views of the residents, however the manager and staff were all able to demonstrate a commitment to the residents who are valued as individuals. Discussion with staff confirmed that the home is well run and place the residents at the centre of all the care provided. All staff who spoke to the inspector said that the manager of the home was open and approachable, issues raised were listened to and acted upon appropriately. 54 Darlington Road DS0000039039.V340146.R01.S.doc Version 5.2 Page 21 There is good communication between staff, residents and relatives. The organisation run regular family forums, and quality surveys enabling relatives to air their views and raise any concerns. Feedback from these is made available to all residents’ representatives. Relatives are involved in the reviews of resident’s care and placement. Regulation 26 visits are carried out and reports were made available. Further work needs to be carried out to ensure policies and procedures are applicable to the residential care home and include local information. Records seen indicate staff have all read the existing policies. An audit of residents personal monies held by the home evidenced that the system includes retention of appropriate receipts, two signatures, and a monthly check. A random sample of personal allowances found there were no discrepancies with the balance stated on the record sheet and the actual amount in the individual money envelope. Documentation seen indicated that the home and equipment are maintained as required, fire alarms are tested weekly, and hot water temperatures are checked and recorded. 54 Darlington Road DS0000039039.V340146.R01.S.doc Version 5.2 Page 22 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 3 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 4 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 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 4 x LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 3 3 X 3 X 2 3 x 54 Darlington Road DS0000039039.V340146.R01.S.doc Version 5.2 Page 23 No 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 YA20 Regulation 13 Requirement The policy and procedure in regarding to the safe handling of medication requires further development in relation to the administration of controlled medication. Timescale for action 01/10/07 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 2 Refer to Standard OP20 YA41 Good Practice Recommendations Storage facilities would be improved with the provision of a fridge specifically for medication. It is recommended that the policies and procedures be updated and include for general use only those relevant to the service to aid access and use. There is also the need to ensure that they contain any local arrangement that may exist. 54 Darlington Road DS0000039039.V340146.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX National Enquiry Line: 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 © 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 54 Darlington Road DS0000039039.V340146.R01.S.doc Version 5.2 Page 25 - 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. 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