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Inspection on 30/09/08 for 58 Ormesby Road

Also see our care home review for 58 Ormesby Road for more information

This inspection was carried out on 30th September 2008.

CSCI found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 58 Ormesby Road 58 Ormesby Road Normanby Middlesbrough TS6 0HS three star excellent service The quality rating for this care home is: 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: Susan Lowther Date: 3 0 0 9 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 Audience Further copies from Copyright Inspection report CSCI 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. Internet address www.csci.org.uk Information about the care home Name of care home: Address: 58 Ormesby Road 58 Ormesby Road Normanby Middlesbrough TS6 0HS 01642463549 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Real Life Options Name of registered manager (if applicable) Mr Richard Linton Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 6 0 care home 6 learning disability Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Learning disability Code LD, maximum number of places: 6 The maximum number of service users who can be accommodated is: 6 Date of last inspection Brief Description 58 Ormesby Road offers long term care to younger adults with learning disabilities. The house stands in its own private garden and is situated close to all local amenities. Accommodation is provided in single bedrooms on two floors. 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: three star excellent 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 How we did our inspection: The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. This unannounced inspection of 58 Ormesby Road took place on the 30th September 2008. Records were examined and a tour of the building took place. Time was spent talking to staff and residents. The manager supplied some written information to the CSCI before the inspection on a document called an AQAA (Annual Quality Assurance Assessment). Information was also obtained from surveys returned by staff and relatives who had completed them on behalf of some of the people who live in the home. The inspection focussed on key standard outcomes for people who live in the home. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations – but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The fees charged at the time of this inspection were between 932 pounds and 49 pence and 968 pounds and 60 pence per week. This does not include chiropody, hairdressing, toiletries and personal clothing and travel. What the care home does well What has got better from the last inspection What the care home could do better: All of the National Minimum Standards examined during this inspection have been met. The manager submitted on the AQAA areas which he considered could be improved. This critical self appraisal has resulted in action plans being formulated and work being undertaken. There are therefore no recommendation from this inspection. 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 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 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 . People are appropriately assessed before they are admitted to the home. Their individual needs and aspirations are considered. Evidence: The manager said that there have been no admissions to the home for several years as there have been no vacancies. However two sets of documentation were reviewed, which showed that a full assessment of need had been carried out before the person moved into the home. Documentation showed that during the assessment areas of need are identified with regard to personal care, nutrition, mobility, continence, sensory loss, emotional status, medication and health issues. They also show that personal preferences are considered with regard to recreational and social activities, independance, culture and times with regard to going to bed and getting up. These assessments are reviewed on a three monthly basis, but would be reviewed earlier should the need arise. The manager said that people would be invited to spend some time in the home, including an overnight stay, before they made a decision about whether they would like to live there. One relative said, I was well consulted before my relative came to live here. I was fully acquainted with the staff and surroundings and found these to be fine. 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 . Care plans are regularly reviewed to ensure that they support the changing needs of the individual. Choice making is encouraged where possible. Risk mangement stategies are in place to protect people. Evidence: Each person who uses the service has an individual care plan. These showed that where possible the person, his or her key worker and relative had been involved with the plan. If appropriate, other people such as day centre workers and care manager would also be involved. Two care plans were examined. Both contained detailed information about the individual personal and social need. They also contained information about how each person spent their day. They showed involvement from the person, his or her key worker in the home and key worker in the day centre. Two sets of documentation were examined, which showed the information was detailed. Within the plans there was also a personal profile of the person and a pen picture. Daily notes detailed how the person spent their days. One relative who returned a survey said, My relative is unable to make his own decisions but the staff are very good at knowing his likes and dislikes and are always ready to please him. Each person also has an lifestyle plan. The plans covered areas such as important people, likes and dislikes of food, activities, how the person wants to be supported and daily routines. Risk assessments were in place for each person with appropriate plans to support any identified risk. 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 at the home are supported by staff, while maintaining links with their family and friends. They can make choices about their lifestyle. Evidence: Due to their poor verbal skills people were unable to tell the inspector about their experiences. Some of the people who use the service attend day centres during the week, where they have an individual programme of activities. One person has an individual package tailored to their need rather than attending the day centre. The activities for this person are on a one to one basis. During the evenings evenings and at weekends people take part in a variety of activities and enjoy socialising with family and friends. Family and friends are welcome to visit at any time and some people also spend time out of the home with them. One relative who returned a survey confirmed that they take their relative home when it is suitable for them to do so. The menus are varied and tailored to individual need. 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 . The health and personal care needs of people are met. There are suitable arrangements in place for dealing with medication. Evidence: Two care plans were examined which detailed the personal support given to the people who use the service. Each person has their own General Practitioner and they also consult with other health professionals when needed. People who use the service also have individual health action plans, which are completed in consultation with their families, key worker and other professionals. Some of the plans had been personalised with pictures relating to a health need. Health needs are identified such as oral hygiene, weight management and eye sight. These are updated regularly. Policies and procedures are in place for the ordering, receipt, storage, disposal and administration of medication. Medication is securely stored in a locked cupboard. Records of the administration of medication are in place and up to date. The manager stated on the AQAA that all staff are to be trained to ensure competencies in medication administration are acheived. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People can be confident that their concerns and complaints are dealt with appropriately and that safeguards are in place to protect them from abuse. Evidence: The home has a complaints policy and procedure in place. Information about complaints, how and who to make them to, is made available to the people who live in the home and their families through information displayed in the entrance to the home and in the Service Users Guide. There have been no complaints recorded since the last inspection. One relative who returned a survey said, I have never had a problem, the staff are very alert and would know if anything wasnt right. All of the staff who returned surveys confirmed that they were aware of the complaints procedure. The home had a comprehensive adult protection procedure. This gives staff the support they need to make a referral should this be required. The staff spoken to during the inspection were asked about abuse and what they would do if they saw or heard anything inappropriate. All said that they would tell someone, for example the manager, or make a referral themselves if this was more appropriate. Training is provided for all staff in adult protection. One memeber of staff We are here for the people who live here, I would not hesitate to whistleblow. 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 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 clean and well maintained. It is decorated and furnished to a good standard and provides a homely environment for the people who live there. Evidence: A tour of the home was carried out. All areas were very clean, tidy and well decorated. People who use the service are involved in choosing the décor and furnishings in their own rooms and also in the communal areas. Bedrooms were very individual containing personal possessions. The manager confirmed that people are are encouraged to bring in personal items when they are admitted. As there is no lift in the building, the manager confirmed that people whose bedrooms are upstairs are assessed by occupational therapists and have risk assessments in place to make sure that having an upstairs room is suitable. 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 are appropriately recruited, trained and in sufficient numbers to meet the needs of the people who live in the home. Evidence: The home has a rota in place, which is flexible for the needs of the people who use the service. Extra staff can be rostered where a person needs to have a one to one. There is a policy and procedure in place for the recruitment of staff. There was information within the home to confirm that references and CRB checks were in place prior to staff commencing work in the home. However these are held at head office. Staff receive appropriate training, which helps them with their work. There is very little turnover of staff in the home, they know the people well and positive comments in the surveys reflected this. Staff training files were examined which showed training had been carried out in first aid, moving and handling and food safety. At the time of the inspection 75 of staff had achieved NVQ level 2 or above. Another member of staff is currently working towards acheiving this award. Staff confirmed that they receive aaan induction and ongoing training. One member of staff said, I had a two week induction course and then had to complaete a booklet to show I understood. Another said, The company carry out a very thorough and well set out induction. The home has a formal supervision system in place with staff receiving regular supervision. 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People can be assured that the home is well managed and they are given the opportunity to comment on how the home is run. Policies and procedures are in place to safeguard their health, safety and wellbeing. Evidence: The manager is qualified and competent to run the home. There was an open and friendly culture between the management team and staff working at the home. There was evidence in staff files to show that supervision was taking place and that the staff were being appraised. Staff confirmed that supervision takes place on a regular basis and that they are well supported. Staff confirmed the manager is approachable and that they woukd go to him with any concerns. Regular meetings are held and there are a number of systems in place to consult with people. Relatives and the people who live in the home can approach the staff at any time. The area manager completes a regulation 26 visit monthly. This is an audit which covers all aspects of the environment and the care delivered. The manager said that during this audit staff, the people who live in the home and visitors are consulted about their views. Any suggestions made are considered and improvements made where possible. The manager also carries out regular audits covering all environmental and care aspects which may result in improvements being made. The manager confirmed that all equipment in the home is regularly checked. The Evidence: maintenance certificates that were seen at this inspection were found to be in order. Health and Safety checks are carried out regularly to safeguard people living and working at the home. 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 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 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 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. - 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. 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