Inspection on 15/02/06 for 8 Yealand Drive

This inspection was carried out on 15th February 2006.

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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

8 Yealand Drive 02/11/06

8 Yealand Drive 06/10/05

8 Yealand Drive 27/01/05

8 Yealand Drive 10/05/04

8 Yealand Drive 25/02/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 8 Yealand Drive Ulverston Cumbria LA12 9JB Lead Inspector Ray Mowat Unannounced Inspection 15th February 2006 15:00 8 Yealand Drive DS0000022684.V279148.R01.S.doc Version 5.1 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 8 Yealand Drive DS0000022684.V279148.R01.S.doc Version 5.1 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. 8 Yealand Drive DS0000022684.V279148.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 8 Yealand Drive Address Ulverston Cumbria LA12 9JB 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) 01229 582764 The Oaklea Trust Mrs Susan Millington Care Home 5 Category(ies) of Learning disability (5), Learning disability over registration, with number 65 years of age (5) of places 8 Yealand Drive DS0000022684.V279148.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 5 service users to include: up to 5 service users in the category of LD (Learning Disabilities) up to 5 service users in the category of LD (E) (Learning Disabilities over 65 years of age) The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 6th October 2005 2. Date of last inspection Brief Description of the Service: Yealand Drive is situated on a residential housing estate on the outskirts of the town of Ulverston in Cumbria. It is on a bus route and is within walking distance of local amenities and approximately two miles from the town centre. It is owned, managed and staffed by the Oaklea Trust, a not for profit charitable organisation, specialising in providing services to people with learning disabilities. The home is registered to provide a service to five people with learning disabilities, some of whom may be over sixty-five. The front garden has been made into off road parking for two vehicles. There is ramped access to the front door and the downstairs of the home and rear garden are fully accessible. The ground floor consists of a large lounge, an open plan dining room and kitchen. There is also a laundry/utility room a walk-in shower room with toilet and a single bedroom. Upstairs there are five bedrooms, one being a staff sleep-in room the other four being residents bedrooms, there is also a bathroom with a traditional bath, overhead shower and a toilet. There is a good size rear garden that is accessible from the patio by a paved path. The home has access to a people carrier style vehicle. 8 Yealand Drive DS0000022684.V279148.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. I arrived at the home at 3pm so I could see the afternoon and early evening routines. I met with all the residents and three care staff that were on duty. I also spoke to a resident and member of staff who were visiting from another home. I looked at records that help staff to understand and meet resident’s needs. I also looked at records that make sure the home runs smoothly and is safe. What the service does well: What has improved since the last inspection? What they could do better: The main area for improvement is to cover the staff absences consistently with suitable staff this will improve the quality of life for residents. A new contract that explains the rules about living in the home will be helpful to residents and their representatives. The home need to look at the role of staff and the routines in the home to make sure residents remain independent and are given choices. The home should ask the community learning disability nurse for advice, support and guidance on health issues. 8 Yealand Drive DS0000022684.V279148.R01.S.doc Version 5.1 Page 6 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. 8 Yealand Drive DS0000022684.V279148.R01.S.doc Version 5.1 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 8 Yealand Drive DS0000022684.V279148.R01.S.doc Version 5.1 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): 2, 3, 4, 5. The home has good systems and procedures in place to enable prospective new residents to make an informed choice about moving into the home. The issuing of contracts of terms and conditions to new residents was inconsistent. EVIDENCE: There have been no new admissions to the home since the last inspection. I examined the personal file of the resident who moved into the home most recently. A detailed care plan had been developed based on assessments completed by the home and the social worker, with input from other relevant agencies. There was a written record of this resident making several visits to the home for meals or an overnight stay prior to making a decision about moving in. This planned approach is good practice and enables the new and existing residents to make informed choices. There was no contract of terms and conditions available as it was under review. 8 Yealand Drive DS0000022684.V279148.R01.S.doc Version 5.1 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. Needs and preferences were well documented, however the involvement of residents in all aspects of life in the home was inconsistent and did not promote or encourage independence. EVIDENCE: All the residents had a detailed care plan in place and some key workers had met with residents with a view to compiling a more person centred plan. Progress on this had been slow and judging from the minutes of some of the meetings held with residents, some staff had not fully understood the concept of person centred planning. It is recommended the home liaise with the person centred planning coordinator for advice and guidance on developing the plans, particularly for people with limited communication skills. The care plans in place had been kept under review, with the home liaising with family and significant others to monitor and update the plan and to discuss major life decisions and significant events. The care plans recorded how individuals get involved with the day to day running of the home, with guidance for staff on how they can promote people’s independence. Based on my observations during the shift the staff were very task orientated and did not involve residents in the activity. Both staff were involved in making the tea and other domestic tasks, which resulted in minimal 8 Yealand Drive DS0000022684.V279148.R01.S.doc Version 5.1 Page 10 interaction with residents. The home must ensure staff understand their role and responsibilities in enabling and supporting residents and to maintain and promote their independence. Whilst one staff was making tea I feel the other member of staff could have used their time more effectively, supporting residents with household tasks or conversing with them. Detailed personal and general risk assessments were in place, which are kept under review. Staff were familiar with these and had signed the file to say they had read and understood them. 8 Yealand Drive DS0000022684.V279148.R01.S.doc Version 5.1 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, 14, 15, 16, 17. On the whole residents enjoy a full and active lifestyle of their choosing. How residents are supported in the home environment is inconsistent and should be reviewed. EVIDENCE: The care plans record individuals leisure interests, hobbies and social contacts. Two residents are effectively retired from formal educational and vocational activities and enjoy a predominantly sedentary lifestyle. Leisure activities they regularly take part in include attending a social club, music therapy, day trips, walks, visits to the pub for a meal or a drink. Other residents attend day services and the local college, which provides them with a good selection of educational and leisure activities, which from my discussions with them they obviously enjoy. Residents also enjoy regular contact with both family and friends, who either visit the home or the residents visit them. On the night of the inspection one resident had a friend come to visit and they enjoyed a game of darts. This is a regular activity he looks forward to and values. He also meets his friend outside of the home going for a game of pool at the local pub, with support from staff. Once a week they also attend a social club that he used to attend 8 Yealand Drive DS0000022684.V279148.R01.S.doc Version 5.1 Page 12 in another town prior to moving to Ulverston. This enables him to keep in touch and maintain contact with friends, which is good practice. Residents enjoy an annual holiday, which is important to them and something they value. One resident described how he is going abroad this year and how much he is looking forward to it. “I can’t wait,” he said. I examined the menus for the last four weeks and noted an improvement in the selection of meals provided with no meals repeated within a week. Meal planning and shopping is done on a weekly basis with individual tastes catered for. The residents enjoyed a freshly cooked meal whilst I was there. The residents all sat together in the dining room making the meal an enjoyable social occasion. The staff ate their meal together after the residents, which again I feel was not best use of staff time. During this period one resident sat for half an hour with his cordless headphones on, which he was not able to switch on, before staff noticed the problem. 8 Yealand Drive DS0000022684.V279148.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19. Resident’s personal and healthcare needs were well documented. The home provides good support and ensure appropriate services are provided when needs change. EVIDENCE: Each resident’s file contains a detailed record of all health interventions and any outcomes from appointments that need to be incorporated into the care plan. Staff were aware of individual needs and were aware of recent changes to individuals. One resident was experiencing ongoing health problems that were a cause for concern. The home had made several GP appointments and also been to the hospital for specialist appointments and investigations. It is recommended the home involve a community nurse, who will be able to advocate and support the resident and staff when attending appointments. Resident’s weight is monitored on a monthly basis and action taken in response to any fluctuation. 8 Yealand Drive DS0000022684.V279148.R01.S.doc Version 5.1 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): The home’s policies and procedures continue to safeguard residents. EVIDENCE: These standards were met at the last inspection. There have been no recorded complaints or adult protection referrals. 8 Yealand Drive DS0000022684.V279148.R01.S.doc Version 5.1 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): 24, 25, 26, 27, 28, 29, 30. The home environment is on the whole appropriate with further improvements taking place. It provides a safe and comfortable living environment. EVIDENCE: A new fully fitted kitchen has just been installed with new appliances. The home is awaiting the new flooring to be fitted. This was good quality and enhances the home. The carpet in the hall and lounge were being measured for replacement, which is much needed and should be completed as soon as possible. The resident’s bedrooms have recently been decorated and some new furniture purchased. These had been tastefully done and residents were rightly proud of them, with one resident telling me how they chose the colour scheme, which is good practice. There is a minimal amount of aids and adaptations required, however needs are monitored and appropriate referrals made for advice and guidance. The home was well maintained and there were no obvious hazards noted. All areas of the home were clean and hygienic with residents supporting staff with some cleaning in their own rooms. 8 Yealand Drive DS0000022684.V279148.R01.S.doc Version 5.1 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): 31, 32, 33. The staffing levels in the home were inconsistent and at times not sufficient to meet people’s needs and provide a continuity of care. EVIDENCE: Since the last inspection the staff levels in the home have continued to be affected by a long-term sickness absence and a temporary transfer of a senior staff to cover a management vacancy. Both these posts are over 30 hours a week leaving over sixty hours to be covered each week. The cover has been inconsistent resulting in disruption for residents and permanent staff. Bank staff, permanent staff working overtime and agency staff have covered the hours. Staff did sometimes not know the staff that were coming on duty and were not sure if they had been inducted to the home. In addition staff have had to lone work on a full shift, which is dangerous and impacts on the quality of life of the residents. Longer-term solutions such as temporary contracts to cover these vacancies would be beneficial to the continuity of care. The home must ensure staff levels in the home are adequate to meet the needs of the residents and maintain a continuity of care. This requirement is outstanding from the last inspection. 8 Yealand Drive DS0000022684.V279148.R01.S.doc Version 5.1 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, 39, 40,42. The manager is providing good support to the staff team despite the continued staff shortages. The safety and welfare of residents is dependant on staff levels that must be improved. EVIDENCE: Despite the difficulties they have experienced when lone working or working with staff they are not familiar with, the staff said they were” well supported” by the manager and they had “regular supervision”. They confirmed the manager spends “a lot of time in the home” and will always make herself available to discuss any concerns. They also said that staff meetings take place on a regular basis. These forums provide opportunities to raise issues of concern and maintain some continuity. The home and the organisation provide opportunities for both formal and informal consultation with residents, staff and significant others. This ensures the home is run in the best interests of residents. Person centred plans, when they are developed, will contribute towards this planning with individual needs and preferences identified. 8 Yealand Drive DS0000022684.V279148.R01.S.doc Version 5.1 Page 18 The home has a full range of policies and procedures in line with the National Minimum Standards that support and guide good practice and maintain the safety of residents and staff. There were no hazards noted during the inspection and all routine health and safety checks had been completed and records were up to date and accurate. 8 Yealand Drive DS0000022684.V279148.R01.S.doc Version 5.1 Page 19 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 3 4 3 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 2 32 2 33 1 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 2 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X 3 X 3 3 X 3 X 8 Yealand Drive DS0000022684.V279148.R01.S.doc Version 5.1 Page 20 Yes 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 YA5 Regulation 5 Requirement Contracts of terms and conditions must be issued to and agreed with residents or their representative at the point of admission to the home. The home must ensure adequate numbers of suitably trained staff are on duty at all times. (The original timescale of 01/11/05 was not met.) Timescale for action 01/04/06 2 YA33 18(a) 01/04/06 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 YA6 Good Practice Recommendations It is recommended the home liaise with the person centred planning coordinator for advice and guidance on developing the plans, particularly for people with limited communication skills. It is recommended the home review daily routines and staff roles to ensure independence and choice are promoted and maximised within the home. It is recommended the home involve a community nurse, who will be able to advocate and support the resident and DS0000022684.V279148.R01.S.doc Version 5.1 Page 21 2 3 YA16 YA19 8 Yealand Drive staff when attending appointments. 8 Yealand Drive DS0000022684.V279148.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP National Enquiry Line: 0845 015 0120 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. 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