Inspection on 06/10/05 for 8 Yealand Drive

This inspection was carried out on 6th October 2005.

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 but made no statutory requirements on the home.

Other inspections for this house

8 Yealand Drive 02/11/06

8 Yealand Drive 15/02/06

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 6th October 2005 08:30 8 Yealand Drive DS0000022684.V253526.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 8 Yealand Drive DS0000022684.V253526.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 8 Yealand Drive DS0000022684.V253526.R01.S.doc Version 5.0 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 Mr Robert Faragher 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.V253526.R01.S.doc Version 5.0 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) 27/1/05 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.V253526.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place at 8.30 am on 6th October 05. The inspector spent time with four of the residents who are currently residing in the home, the fifth resident was on holiday. The inspector met with the four staff that were on duty for the course of the inspection, including the manager. Care plan files and other records required by the care home regulations were examined. What the service does well: What has improved since the last inspection? What they could do better: Although the information has improved in the new contracts there is still a need to clarify the full terms and conditions for residents. There is a need for the home to review their menus and monitor meals provided to ensure a balanced and nutritious diet. The staff levels in the home have been affected by long term absences of permanent staff, resulting in some shortages, which must be addressed. It is recommended the home liaise with all relevant parties to ensure appropriate information is held on care plan files. All the risk assessments in the home should be reviewed and updated. Good practice relating to the labelling and storage of food should be followed at all times. The responsibility for the maintenance of the garden and grounds needs to be resolved. 8 Yealand Drive DS0000022684.V253526.R01.S.doc Version 5.0 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.V253526.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 8 Yealand Drive DS0000022684.V253526.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5. Although some aspects of the information supplied to residents has improved, some of it is inappropriate and continues to cause confusion. The organisation must supply residents with clear contracts of terms and conditions for residential care. EVIDENCE: A new resident has recently moved in and appeared to have settled into the routines of the home. However he had exhibited some challenging behaviours that were not expected, based on the information provided to the home on admission. This was a basic pen picture and did not document pertinent information, to support and guide staff in providing an appropriate personalised service and ensure they were aware of historical problematical behaviours. This lack of information was grossly unfair on both the home and the new resident and could have a detrimental effect on the success of the placement. It was evident these were known behaviours that required input from specialist health services in the past. The home was undertaking a more in depth assessment, however the care plan and a record of recent health interventions from the persons previous placement were not available. The fact that the resident has a right to have his care plan records was discussed with the manager. It is recommended the home liaise with the resident’s social worker, family/representative and the previous placement to ensure all the necessary information is available. A new customer agreement (2005 version) has been issued to residents. The document refers to “terms and conditions of the occupancy/tenancy 8 Yealand Drive DS0000022684.V253526.R01.S.doc Version 5.0 Page 9 agreement, between the customer (resident) and the housing provider”. This agreement was not available for inspection, in addition although the home is required to issue a contract of terms and conditions, there should be no agreement between the housing provider and the resident, as this would constitute a tenancy. The agreement should be between the housing provider and the residential care provider. The home had also received a memo from the housing association that own the house. This was explaining a new system for “tenants” to contact them if they want to raise issues. There were three of the Trust’s registered care homes in receipt of the memo. This issue of treating residents in a registered care home as tenants, as described in the customer agreement and memorandum, is something that must be clarified once and for all with residents and their representatives, so they understand their status and the terms and conditions of their residence. 8 Yealand Drive DS0000022684.V253526.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9, 10. Individual needs and choices were well documented with evidence of ongoing consultation. Risk assessments were in need of review and updating. EVIDENCE: The new manager is currently attending training in compiling person centred plans, with a view to training the staff team, to enable them to facilitate the process. The care plans examined were detailed and provide staff with sufficient information to, on the whole, meet the varied needs of the residents. As described previously the information on file for the new resident must be strengthened. It was evident files were kept under review and pertinent information updated. There was evidence of residents being involved in day-to-day decisions in the home. This was reflected in the minutes of the monthly residents meetings and in the care plans. During the inspection staff spoke to residents respectfully and offered choices in an appropriate manner. Two of the residents in particular have severe communication difficulties, however staff were skilled at ensuring their needs were understood and met. The home has developed a wide range of risk assessments that support and promote an independent lifestyle. These covered a range of both individual 8 Yealand Drive DS0000022684.V253526.R01.S.doc Version 5.0 Page 11 and group activities. It is recommended these are now reviewed to ensure they are up to date and accurate. All personal and confidential information was securely stored in line with data protection guidelines. 8 Yealand Drive DS0000022684.V253526.R01.S.doc Version 5.0 Page 12 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. The home is encouraging residents to lead independent lifestyles of their choosing. The meals provided in the home were basic and lacking in choice and nutritional value. EVIDENCE: There are currently five residents in the home. One resident attends a local day service five days each week, this involves attending a college of further education for one day each week. On the other four days they are involved in a range of vocational, educational and leisure activities. Two of the other residents attend college and day services, on a part time basis, two and three days respectively. On the other days they are supported by staff from the home, to pursue their interests and hobbies. The remaining two residents are effectively retired from formal vocational and educational activities, enjoying a more sedentary lifestyle, accessing community activities from home with support from staff. Some of the activities they enjoy are on a weekly basis, such as attending a social club, music therapy and going to the local church service. Other activities that have been popular include, short day trips, visits to the local pub for a meal or a drink and a trip to the local theatre. The new manager is reviewing the 8 Yealand Drive DS0000022684.V253526.R01.S.doc Version 5.0 Page 13 activities provided with a view to introducing new activities, to assess individual’s preferences and provide them with new experiences. The menus for the home and record of meals provided were examined. It was evident that convenience meals were being used on a regular basis. In one week the same meal was served three times on consecutive days. Due to the complexities of the dietary needs of the residents, menus must be planned more effectively and incorporate fresh ingredients and good nutritional value, based on specialist advice as required. Some food stored in the home was not appropriately labelled in line with good food hygiene practice. 8 Yealand Drive DS0000022684.V253526.R01.S.doc Version 5.0 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20, 21. The home has good systems in place to monitor and maintain residents personal and healthcare support. EVIDENCE: Personal and healthcare needs and interventions were well documented in individual’s care plan files. All routine and one off appointments were recorded, including any actions or outcomes arising from the visit. There was evidence the home has liaised with a range of specialist services for advice and guidance when needs have been identified. The home has sound policies and procedures in place in relation to the management and administration of medication. The contents of the medication cupboard were checked against the medical record sheets (MAR charts) and found to be in order. Individual and family wishes upon death were recorded in care plans, such as specific funeral arrangements. The home had dealt sensitively with the recent death of a resident, providing appropriate support to residents and staff. 8 Yealand Drive DS0000022684.V253526.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. The home’s policies, procedures and practice ensure residents are safeguarded from mistreatment and abuse and that their views will be listened to and acted upon. EVIDENCE: There have been no recorded complaints since the last inspection. The complaints procedure is in line with the requirements of the Care Home Regulations 2001 and is readily available to residents or their representatives. Staff had received training with regard to mistreatment and abuse of vulnerable adults and showed a good awareness of their role and responsibilities. The home’s policies and procedures were also in line with current good practice. 8 Yealand Drive DS0000022684.V253526.R01.S.doc Version 5.0 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 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. Although improvements have been made, there is a need for further remedial action, to ensure a safe and comfortable environment is maintained. EVIDENCE: All areas of the home were inspected on this occasion and issues arising discussed with the new manager, Mrs Millington. The lounge carpet has become worn in an area by the window and is in need of replacement before it becomes a tripping hazard. The carpet in the hallway was badly stained and is also in need of replacement or thorough cleaning. The kitchen worktops are damaged and also in need of replacement. The manager explained that a new kitchen was on order, including cupboards, worktops and appliances. To the rear of the home there is a paved path and patio area, the paving stones are starting to sink in places and will become a tripping hazard, however the manager explained that this had also been identified as a priority in the programme of repairs and renewals. Currently staff are expected to maintain the gardens and gravel driveway to the front of the home, which is proving difficult. It is recommended the manager explore alternatives for the maintenance of the gardens and grounds. There are plans for the landlord to replace the central heating boiler in the near future. 8 Yealand Drive DS0000022684.V253526.R01.S.doc Version 5.0 Page 17 The home was found to clean and hygienic on the day of the inspection and there were no obvious hazards to the safety of residents and staff. 8 Yealand Drive DS0000022684.V253526.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 35, 36. The staffing of the home has been disrupted recently, which has impacted on the quality of care. Relief cover must be improved to maintain a continuity of care. EVIDENCE: Currently the home is experiencing difficulties in covering some long-term staff absences. There are currently two regular staff on long-term sick leave and the seniors hours have been temporarily reduced, to allow her to cover a management absence in another home. Adequate cover has been difficult to find, with the home using agency staff, in addition to permanent staff, to cover absences. The manager has endeavoured to maintain a continuity of care by using the same member of agency staff for cover, however the shortages have had a detrimental impact on some aspects of the residents quality of life and also placed existing staff under pressure for a prolonged period. The home has had a settled and committed staff team for some time, which has helped to minimise the disruption to residents during this period. Staff files were examined, which reflected that staff were receiving formal supervision in the required timescales. All the staff spoken to said “support was good and that the manager could be approached with any concerns”. Although on the whole training records were up to date, there was some frustration within the staff team that training courses were not being held locally, which was making it difficult, if not impossible, for some staff to attend. The manager has raised the issue with the appropriate departments in the 8 Yealand Drive DS0000022684.V253526.R01.S.doc Version 5.0 Page 19 organisation. The organisation has a central training department who plan and facilitate the training, based on feedback from home managers relating to the needs of individual staff. An “employee forum” was recently held, which the manager attended. The focus of the day was “customer service”. It was evident the staff had enjoyed the content of the day and felt motivated by it, however the use of the phrase “customer” to describe people living in their own homes was questioned. 8 Yealand Drive DS0000022684.V253526.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 41, 42. Despite the staffing difficulties currently being experienced by the home, the manager is aware of any shortfalls within the home and is supporting the staff team in maintaining the service. EVIDENCE: The new manager is Mrs Sue Millington. Mrs Millington has been employed as a support worker, working with adults with learning disabilities, for thirteen years. She worked in a senior support worker role for one year prior to being appointed to a service manager post in the Trust’s domiciliary agency. Mrs Millington gained her NVQ3 in care in 2002 and is currently working towards the registered manager award NVQ4, as part of the Trusts management development programme. Mrs Millington has successfully completed the Fit Person process, displaying a sound knowledge of her role and responsibilities. She came across as a competent and experienced manager, with a very person centred approach. At present the senior care staff is only working part of her hours in the home, which is proving difficult for her and the home. If her secondment is to continue a more permanent arrangement should be planned. 8 Yealand Drive DS0000022684.V253526.R01.S.doc Version 5.0 Page 21 Management visits to the home have been carried out in line with regulation 26. All other routine health and safety checks have been completed as required, with records up to date and accurate. 8 Yealand Drive DS0000022684.V253526.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 2 3 2 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 2 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 2 12 2 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 2 X 3 3 CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 8 Yealand Drive Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score X 3 X X 3 3 X DS0000022684.V253526.R01.S.doc Version 5.0 Page 23 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 5 Regulation 5 Requirement The organisation must supply residents with clear contracts of terms and conditions for residential care, in line with the Care Home Regulations 2001. (Previous timescale of 01/05/05 not met.) The home must provide suitable, wholesome and nutritious meals, which are varied and properly prepared. The home must ensure adequate numbers of suitably trained staff are on duty at all times. Timescale for action 01/01/06 2 17 16(2) i 13/10/05 3 33 18(a) 01/11/05 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 2 Good Practice Recommendations It is recommended the home liaise with the resident’s social worker, family/representative and their previous placement, to ensure all the necessary information is available. It is recommended risk assessments are reviewed to DS0000022684.V253526.R01.S.doc Version 5.0 Page 24 2 9 8 Yealand Drive ensure they are up to date and accurate. 3 4 17 24 All food stored in the home should be appropriately labelled and stored. It is recommended the manager explore alternatives for the maintenance of the gardens and grounds, ensuring they are safe and well maintained. 8 Yealand Drive DS0000022684.V253526.R01.S.doc Version 5.0 Page 25 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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