Inspection on 11/07/07 for Alderson Road 12

This inspection was carried out on 11th July 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Alderson Road 12 18/07/06

Alderson Road 12 05/01/06

Alderson Road 12 19/05/05

Alderson Road 12 02/11/04

Alderson Road 12 14/04/04

Similar services:

Larch Avenue

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

Muston Road (70)

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

CARE HOME ADULTS 18-65 Alderson Road 12 12 Alderson Road Harrogate North Yorkshire HG2 8AS Lead Inspector Chris Taylor Unannounced Inspection 11th July 2007 1:00 Alderson Road 12 DS0000007877.V343602.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 Alderson Road 12 DS0000007877.V343602.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. Alderson Road 12 DS0000007877.V343602.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Alderson Road 12 Address 12 Alderson Road Harrogate North Yorkshire HG2 8AS 01423 520251 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) Northern Life Care Limited T/A U.B.U. Post vacant Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Alderson Road 12 DS0000007877.V343602.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered for 6 residents with Learning Disabilities some of whom may also have Physical Disabilities Date of last inspection 18th July 2006 Brief Description of the Service: 12 Alderson Road is a large Victorian terrace house situated close to Harrogate town centre. The home provides accommodation and personal care to six adults with a learning disability some of who have a physical disability. The home is owned by UBU formerly Northern Life Care. The house is on three floors. There is no passenger lift. All of the bedrooms are single; one of them has an en-suite facility. The Statement of Purpose and Service User Guide are provided upon enquiry. The Cost of a placement at the home is dependent on individuals needs. Information about the cost of placements were not available. Alderson Road 12 DS0000007877.V343602.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is what was used to write this report. • • • Information about the home kept by the Commission for Social Care Inspection. Information asked for before the inspection, this is called Annual Quality Assurance Assessment. Information from surveys that were sent to out. Five were sent to peoples’ care managers, none were sent back. Five were sent to peoples’ relatives and two were sent back. An unannounced visit to the home. This lasted four hours and included talking to support staff about their jobs and the training they have completed. And checking some of the records polices and procedures the agency has to keep. Some time was spent with people who live at the home. • • What the service does well: The information kept about people is good and is the right kind of information needed. This helps staff support people properly all of the time. The way that it is decided that staff get a job with UBU means that staff have the right qualities to work with people with learning disabilities. This also means people will be helped to be independent, treated kindly and with respect. The training staff does means they understand what people need, that people are treated properly and it helps to keep people safe from harm. This home is accredited with the National Autistic Society, which means the home has to demonstrate they have expert knowledge and training about providing support for people with autistic spectrum disorder. Staff think it is important that people have plenty to do through the day and they have helped people do this. This has given people the chance to learn new skills and meet new people. Alderson Road 12 DS0000007877.V343602.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Alderson Road 12 DS0000007877.V343602.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Alderson Road 12 DS0000007877.V343602.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2. People who use this service experience excellent quality outcomes in this area. Peoples’ needs are properly assessed prior to admission this helps make sure that staff know they will be able to meet all of the person’s needs when they moves into the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There have been no new admissions for a number of years. People are admitted following a local authority care management assessment and the home’s pre admission assessment “getting to know you”. The getting to know you assessment includes all aspects of the person’s life and how they want support to be provided for them. Completion of the document includes meeting and gathering information from the person, family and other professionals and is particularly useful for those people who have complex needs and/or difficulties with communication. This document supports staff in making the admission for the people as smooth and as comfortable as possible. Following completion of the document if the home believes they could offer a service then introductory visits commence. These are taken at a pace set by the person. Compatibility between people is given considerable Alderson Road 12 DS0000007877.V343602.R01.S.doc Version 5.2 Page 9 thought and people’s views are included in this. New placements are under review and further assessments are completed. Usually after a six week settling in period a review is held to confirm that the person and other people in the house are happy with the arrangements. Records and discussion with staff confirm that the process described had been followed. People are provided with and assisted in understanding the service user guide which is produced pictorially. Alderson Road 12 DS0000007877.V343602.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): Standards 6, 7 and 9. People who use this service experience good quality outcomes in this area. Peoples’ needs are assessed and are met promoting independence, choice and respect for individuals. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Only one person and one member of staff were at home at the start of the inspection. Other people were out on different day trips. When everyone came home staff supported people sensitively and supported them to make choices. There were clearly elements of risk around the home. Staff handled these discreetly and safely. Specific guidance and interventions recorded in case records were observed in practice. Staff were seen using makaton (a form of sign language) and physical prompts to support people. Staff discussed individual needs and demonstrated imaginative ways to make sure people have as much choice and control over their lives. Alderson Road 12 DS0000007877.V343602.R01.S.doc Version 5.2 Page 11 Records about people are kept on computer. There is a paper copy used as daily referencing and for new staff who are not allocated a password to access the computer records. Individual Support Specifications identify personal routines and are documented step by step to make sure support is provide exactly how the person wants and needs. Person centred plans contain information about every aspect of people’s lives including areas for developing new skills. These plans are reviewed every six months or as necessary and these reviews focus on achievement and improving opportunities for individuals. Also present were risk assessments with the purpose of supporting people to live as independently as possible with safeguards in place, these were reviewed regularly. People are included in developing the plan, however, the format and language used for this and review documents are not easy to read plain English or supported by pictorial prompts. For instance headings such as targeted ambitions, having a meaningful network of communication and personal control and greater opportunities are difficult concepts to grasp. UBU are actively reviewing and making amendments to this document in order that information is more accessible to people. UBU provide a good induction and ongoing training for staff which makes sure people are treated with respect, dignity and are supported to make choices in their lives. This was reflected in the observations of staff working with people throughout the visit. For instance in choosing what people wanted to do when they arrived home and in choosing what snacks to have before the evening meal was prepared. Staff discussed individual needs and demonstrated ways to make sure people have as much choice and control over their lives. Alderson Road 12 DS0000007877.V343602.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): Standards 12, 13, 15, 16 and 17. People who use this service experience excellent quality outcomes in this area. People are supported by the staff to make choices about their lifestyle, in developing new skills and to participate in activities. This supports them to lead full and active lives. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People have the opportunity to attend specialist day centres or college and have days at home to participate in personal shopping, laundry and household tasks. There are also opportunities go to the pub, cinema, and church, into town to shop or have a meal or coffee. Some additional staffing has been secured to ensure people have the opportunity to participate in activities of their choice on a one to one. However, there are occasions when people’s choice is compromised because of the ratio of staff required to take people out. This isn’t unusual in a residential care setting where staff are responsible Alderson Road 12 DS0000007877.V343602.R01.S.doc Version 5.2 Page 13 for more than one person. Plans to re locate people into smaller units will improve the lifestyle for people particularly in terms of their daily choices and opportunities, and with whom they share their living space. There was written information in people’s support plans about how people spend their days and these arrangements are discussed with people’s representatives and staff. Details about family, friends and significant events are recorded in people’s plans. Examples of how people are supported to maintain relationships with family and friends were given. Staff said they learnt about respecting people and providing support to develop new skills during induction and subsequent training. Menus provided detail of variety and choice. Specialist advice from the dietician was recorded for specific service users. Alderson Road 12 DS0000007877.V343602.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): Standards 18, 19 and 20. People who use this service experience excellent quality outcomes in this area. People’s personal and healthcare is provided appropriately and sensitively according to individual needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People’s health needs were recorded in people’s plans with additional step-bystep instruction in individual service specifications. Sometimes a person’s choice is restricted because of safety and evidence of this was seen in individual service specifications. Where ever possible and if specified personal care is provided by a member of staff of the same sex. People can access psychology, physiotherapy, and art therapy, speech therapy and specialist community nursing from the local learning disability team. Staff said they have a good working relationship with this team. Good relationships with the local GP practice and dentist were also reported. Alderson Road 12 DS0000007877.V343602.R01.S.doc Version 5.2 Page 15 Medication is stored in a locked cabinet and medication is stored individually according to day and time (nomad system) this reduces the risk of error. All staff have received accredited training. The dispensing pharmacist checks medication storage and administration systems every three months. Alderson Road 12 DS0000007877.V343602.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): Standards 22 and 23. People who use this service experience excellent quality outcomes in this area. People have access to an effective complaints procedure. There are sufficient effective systems in place to safe guard people from harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People are provided with a complaints procedure which is produced pictorially. Because of the complexity of people’s needs and difficulties with communication it is unlikely that an individual would make a complaint in the usual manner. Staff, therefore, need to have the skills to interpret people’s behaviours to identify whether they are unhappy about something. Advocates are used to provide an independent voice for people. No formal complaints have been made directly to the Commission for Social care Inspection. There is a comprehensive policy and procedure with regard to safe guarding adults and the procedure to take if there is a suspicion of abuse and staff demonstrated a good awareness of this. Staff receive training in adult protection and safeguarding issues during induction and foundation training and as part of National Vocational Qualifications (NVQ) level 2 and 3. Alderson Road 12 DS0000007877.V343602.R01.S.doc Version 5.2 Page 17 Some people take care of their own spending money and others need staff to do this on their behalf. Money is locked away and there is a recording sheet to record when money is spent and this is receipted. These records are audited by UBU externally and are checked as part of shift change routine. Alderson Road 12 DS0000007877.V343602.R01.S.doc Version 5.2 Page 18 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): Standards 24 and 30. People who use this service experience good outcomes in this area. People live in a clean, comfortable and safe home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home provides spacious accommodation for people. This includes a lounge, music room and a large kitchen/diner on the ground floor. There is a sensory room in the basement. The home is clean and comfortable. It is decorated and furnished to a very good standard. The décor and furnishings reflect a “young persons” type of household. The plans to relocate people into two smaller units take into account the changing physical needs of people. A range of checks is completed on a regular basis to make sure that the house is safe and secure. Alderson Road 12 DS0000007877.V343602.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): Standards 32, 34 and 35. People who use this service experience excellent quality outcomes in this area. Staff are properly vetted and trained to ensure people receive the care and support they need. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Prospective staff complete an application form and attend formal interview where any gaps in employment are explored. UBU generally include people in their interview process but because of the complexity of needs of those people living at Alderson Road this cannot take place in the traditional manner. However, prospective staff are asked to spend two or three hours at the home meeting and spending time with people and being observed by staff. Observations are used as a formal part of the interview scoring. Written references and POVA (Protection of Vulnerable Adults) first checks are made and staff are not permitted to work in the home until they have a CRB (Criminal Records Bureau) check. Alderson Road 12 DS0000007877.V343602.R01.S.doc Version 5.2 Page 20 Staff training records examined showed a comprehensive training programme. All staff complete a home specific induction programme followed by Learning Disability Award Framework accredited induction within the first 6 weeks. A range of other training including health and safety training is provided. This provides staff with the knowledge and skills to perform their duties in a competent manner. The training staff receive and evidence required to maintain accreditation with the National Autistic Society means people receive care from a staff team with expertise in providing care for people with autism. Staff spoken to thought that the training provided is good and equips them to work with people with learning disabilities. There is usually three or four staff on duty, with additionally funded hours for specific people to attend with specific activities. There are two members of staff on duty at night one asleep and one awake. There is a key worker system in place and staff said they are allocated specific time to spend with individuals. The acting manager carries out individual staff supervision every four to six weeks, each session has an agenda and is recorded and signed by both parties. Staff confirmed this. Staff meetings are held regularly. Alderson Road 12 DS0000007877.V343602.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): Standards 37, 39, 41 and 42. People who use this service experience good quality outcomes in this area. The home is managed in such a way that promotes the best interests of people. Staff take proper precautions to ensure the health and safety of everyone. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Although the registered manager has left to work in another service, the acting manager has worked at Alderson Road for a number of years. Staff reported that her management style is similar to the previous manager and she is well organised and delegates responsibility to other team members. Alderson Road 12 DS0000007877.V343602.R01.S.doc Version 5.2 Page 22 The home has a formal quality assurance system which relates directly to national minimum standards and is measured against the home’s improvement plan. People are surveyed once a year with a questionnaire which is easy read, supported with pictures and responses given using smiley faces, (happy and unhappy). The percentage of returns for this questionnaire is good and information provides a good cross section of people’s opinions. Parents and family members are asked for their views individually and a part of the Friends Forum. The home is audited every month and a report of this audit is forwarded to the CSCI. Records were seen which confirmed that equipment is maintained and serviced appropriately. Fire detection and fire fighting equipment is tested and maintained regularly. Staff receive training with regard to all health and safety matters and there is an effective system to ensure updates are completed. Alderson Road 12 DS0000007877.V343602.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 4 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 4 23 4 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 4 33 X 34 4 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 4 X 4 X 4 X X 4 X Alderson Road 12 DS0000007877.V343602.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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 Alderson Road 12 DS0000007877.V343602.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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