CARE HOME ADULTS 18-65
Adalena House 186 Reads Avenue Blackpool Lancashire FY1 4JD Lead Inspector
Unannounced Inspection 26th May 2007 10:00 Adalena House DS0000009809.V330538.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 Adalena House DS0000009809.V330538.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. Adalena House DS0000009809.V330538.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Adalena House Address 186 Reads Avenue Blackpool Lancashire FY1 4JD 01253 391655 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) ADALENA.READS@TISCALLI.CO.UK Mrs Susan Lesley Clayton Mrs Susan Lesley Clayton Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Adalena House DS0000009809.V330538.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 21/01/06. Brief Description of the Service: Adalena House is registered for six young adults over 18 with learning disabilities. The home is situated near the centre of Blackpool in a residential area close to local amenities and bus routes. The home is a large semidetached house with ramp access at the rear of the property and seating is provided. There are single and double rooms available with a shower provided in one of the single rooms. There are two lounges with a dining area and separate kitchen. There is a statement of Purpose/Service user Guide, which is given to all prospective residents/relatives. This written information explains the care service that is offered, who the owners and staff are and what the resident can expect if he or she decides to live at the home. The fees at the home range from £311.30 to £367.50 per week. There are no additional costs. Adalena House DS0000009809.V330538.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced visit undertaken over a period of approximately 5 hours on the 19/05/07 and 26/05/07. The Inspector spoke to the homeowner; two care staff, and six residents. Some time was spent with the residents in a group sat in the lounge area. As part of the inspection process the inspector used case tracking as a means of assessing some of the National Minimum Standards. The process allows the inspector to focus on a small number of people living at the home. All records relating to these persons are examined and the rooms they occupy are looked at. Prior to the visit the homeowner completed a survey form, which provided information about how the home is run. Residents and staff views were sought which assisted in assessing how the home operated and was meeting National Minimum Standards. Comment cards had been sent out prior to the visit to residents of which three were returned all positive in relation to the care and support provided. There are no new staff employed at the home since the last inspection, however training development records were examined. A tour of the premises was also undertaken. Examination of the homes documentation, policies and procedures formed the basis of the inspection process. What the service does well:
The homeowner and staff encourage residents to pursue outside interests through education, employment and social opportunities. This was confirmed through examination of daily programmes, discussion with staff and residents and general observation of interaction between staff and residents. During the visit one resident was preparing to go out to use public transport and visit relatives alone. When spoken to he said, “I am going to the pictures after”. One staff member spoken to said, “We encourage independent living as much as possible”. The home has comprehensive and easy to follow recording systems of the residents care needs, general health and reviews of care ensuring daily events are accurately recorded and residents health needs are continually monitored. Observation of staff talking to and supporting residents was excellent ensuring the relationships develop and the homeowner and staff are fully aware of all the residents needs. It was clear following discussion with the homeowner and staff that they know what each resident likes and dislikes are and know when there is a problem and can deal with it. One staff member said, “The gang
Adalena House DS0000009809.V330538.R01.S.doc Version 5.2 Page 6 (Residents) have been with us for years. Its our home together we know each other that well we know if there are any problems”. The building is furnished, decorated and maintained to a very high standard, which provides a lovely home and creates a good atmosphere for the residents. Two residents spoken to say, “I love it here”. And, “We have a lovely home”. The senior carer is currently undertaking a recognised qualification in management and care, which is required for homeowners and managers to undertake. This will provide an extra member of staff to have the skills and knowledge to manage the home. There is a small staff team that has not changed for nearly five years ensuring stability, development of good relationships, a mutual understanding of the needs of individuals and good communication to ensure the persons feels listened to and are respected. One resident said, “They are all great”. A staff member spoken to said, “We all get along fine its one big family”. The homeowner owns a large caravan in on the island of Bute in Scotland, which has been specially adapted for the residents so that they can take a few holidays a year. Residents spoken to enjoy going up to Scotland many times in the year, comments included, “I love going to the caravan”. And, we choose to go when we like”. What has improved since the last inspection? What they could do better:
The home meets minimum standards in all areas checked on this site visit and documentation examined found the following advice will improve the way the home is run further: Reviews of care plans completed would be better signed by all parties to evidence agreement of any changes and the continuing care and daily programmes of each resident. Adalena House DS0000009809.V330538.R01.S.doc Version 5.2 Page 7 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. Adalena House DS0000009809.V330538.R01.S.doc Version 5.2 Page 8 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 Adalena House DS0000009809.V330538.R01.S.doc Version 5.2 Page 9 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission and assessment process is clear and precise to make sure the care needs of the residents are met. EVIDENCE: There have been no new residents admitted for a number of years however records of two residents were examined and had comprehensive assessment information recorded in detail to ensure a thorough care plan has been developed. The written assessments seen confirmed there is involvement of the resident’s social workers, other professionals and where possible relatives, to ensure the welfare and health needs of the residents are recorded in detail with as much information as possible. Discussion with staff, the homeowner and examination of documentation confirm residents are admitted to the home when a comprehensive assessment has been carried out by qualified staff so that the every person knows that they will be able to meet individual needs and ensure they will be well cared for and able to reach there potential. A staff member spoken to said, “The residents would be the ones to choose any body new”. Adalena House DS0000009809.V330538.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9.Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are helped to make decisions, which supports them in their day-today lives, whilst taking into account risks. EVIDENCE: Two resident’s records were examined and included detailed information about their personal, social, emotional, welfare and healthcare needs to ensure staff know exactly what is needed to provide and promote good quality care to the individual. One member of staff said, “ We have worked hard on the care plans and reviews”. Records examined confirmed risk assessments are completed, regularly reviewed and updated to ensure residents independence and living skills are developed in line with their care plans. Examination of care plans and discussion with staff and residents confirm each individual has a daily programme of education; social, or day centre activity chosen by themselves with help from the homeowner and staff. One resident
Adalena House DS0000009809.V330538.R01.S.doc Version 5.2 Page 11 spoken to said, “I love the rock centre”. The homeowner said, “Whatever they want to do we support them and encourage their independence”. Adalena House DS0000009809.V330538.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Opportunities for development and community participation are addressed in the care plans, to ensure residents have opportunities for personal development. EVIDENCE: The home is relatively small and all the residents have lived at the home for a number of years. The homeowner is aware of making sure individual lifestyles are reflective of their needs. This is achieved through recognising individual need, and ensuring support to achieve recognised goals that have been identified on care plans. The owner said, “We always encourage the residents to do whatever they choose and help as little or as much as they want”. Residents have a range of activities available to them, which include television, music, videos and board games. At the time of the visit two residents were knitting, one had recently returned from an outside activity and one was getting ready to go out alone. When spoken to he said, “I go on the bus”. Activities are arranged to meet individual wishes and abilities, so that nobody
Adalena House DS0000009809.V330538.R01.S.doc Version 5.2 Page 13 feels they are being left out. One resident spoken to said, “I love going to the caravan”. Meal times are flexible and cater for individual tastes. There was evidence of fresh fruit and vegetables in the kitchen to ensure residents receive a balanced nutritious diet. One resident spoken to said, “I love the food and having Sunday lunch together”. Adalena House DS0000009809.V330538.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents health care is taken seriously and needs are closely monitored ensuring health issues are met. EVIDENCE: There is evidence the home has good access to specialist healthcare services in individual records examined, for the benefit of residents using the service, so that their healthcare needs are met and health needs are continuously monitored. It was evident talking to the owner and residents this is a family run home with flexible routines and the residents making there own decisions on how to run their lives. Medication practices were safe and records are kept ensuring residents health is maintained. The homeowner spoken to said, “Medicine is administered by myself or Sue the manager”. As a course of good practice the medication records have individual residents photographs attached to the record to ensure safe practice and medicines are administered correctly. Adalena House DS0000009809.V330538.R01.S.doc Version 5.2 Page 15 Adalena House DS0000009809.V330538.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for recording and reporting of complaints are good ensuring people feel listened to. The management and staff have good knowledge and understanding of safeguarding adult issues, which ensure any safeguarding matters are dealt with properly. EVIDENCE: Adalena House has a detailed complaints procedure, which is made available to all residents and relatives on admission and displayed in the Statement of Purpose and Service User Guide. There have been no complaints since the last inspection or over the last five years. The surveys returned from residents and there families all stated they would know what to do and speak to if they had any complaints. The small staff team have been employed at the home for a number of years and have received safeguarding adults training and are aware of abuse issues. One staff member spoken to said, “I have completed the management and care award which covers abuse and complaints”. Adalena House DS0000009809.V330538.R01.S.doc Version 5.2 Page 17 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment is safe and clean maintained to a good standard providing comfortable surroundings for the residents. EVIDENCE: A tour of the building found the home to be clean and tidy. Observation walking around the premises found the decoration and furnishings are maintained to a high standard ensuring the residents live in pleasant and safe surroundings. A new kitchen has been fitted and bathroom refurbished with a shower room for the residents to provide new purpose built bathing facilities with aids and walk in shower to support residents with mobility problems. One resident spoken to said, “The shower room is great”. Bedrooms are individually decorated and furnished well. All rooms had good lighting and personalised by the families and residents to make it feel homely. Adalena House DS0000009809.V330538.R01.S.doc Version 5.2 Page 18 The home has a laundry facility with policies and procedures in place to control the risk of infection. Adalena House DS0000009809.V330538.R01.S.doc Version 5.2 Page 19 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Recruitment procedures are robust to make sure residents are safe and protected. Training provided for staff is good ensuring they have the skills and competences to carry out their roles. EVIDENCE: This small home has had the same staff for over five years and are very experienced and competent to provide the care and support required by the residents. Staff spoken to said, “With everyone knowing each other for years we have built great friendships with each other and the gang”. One resident spoken to said, “ I love them all”. Although only one full time and two part time staff are employed training for staff is good. Records shows the target of 50 of care staff to complete National Vocational Qualification (NVQ) level 2 in care has been achieved and one staff member has completed the registered managers award (RMA). A member of staff spoken to said, “Yes any training needed we can go on”. Staff records examined show training and supervision is taking place to ensure development of personnel is ongoing.
Adalena House DS0000009809.V330538.R01.S.doc Version 5.2 Page 20 Comments received through resident surveys about the staff included. “All caring”. And, “A lovely home to live with caring people”. Adalena House DS0000009809.V330538.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42.Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed well and systems, policies and procedures are in place for the protection of staff and residents. EVIDENCE: The homeowner has the necessary skills and qualifications required to support the staff and residents and enable the home to meet its stated purpose and objectives. All comments from staff and residents spoken to were positive and included, “We all get on so well”. And, “One big family”. The homes owner approach is relaxed so that there is no formality in the dayto-day management of the home. Residents are encouraged to follow their individual routines supported by the owner and small staff team. Sitting in the lounge with the residents who were watching TV, two were knitting and one
Adalena House DS0000009809.V330538.R01.S.doc Version 5.2 Page 22 reading, confirmed a relaxed homely atmosphere with the homeowner and one member of staff interacting with the residents and planning the day with each individual. All the residents have lived at Adalena House for a number of years and contributed to a family household and pleasant atmosphere. The home has an annual development plan in place in order to continue to develop the home to ensure the safety and comfort of the residents. Regular staff and resident meetings are held informally and any important issues are recorded. Examination of records for residents confirmed they are comprehensive, well written and up to date. Records of money being handled by the homeowner for residents were up to date, explaining the reason for any expenditure and the balance of the money that was being retained. Adalena House DS0000009809.V330538.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 X 2 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X X X X X 3 Adalena House DS0000009809.V330538.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Adalena House DS0000009809.V330538.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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
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