Inspection on 18/07/06 for Alderson Road 12

This inspection was carried out on 18th July 2006.

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 11/07/07

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 Key Inspection 18th July 2006 09:30 Alderson Road 12 DS0000007877.V305359.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.V305359.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.V305359.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. Miss Samantha Gill Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Alderson Road 12 DS0000007877.V305359.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 5th January 2006 Date of last inspection 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. On 18/08/06 charges range between £1145.64 to £1255.78 Alderson Road 12 DS0000007877.V305359.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The accumulated evidence used in this report has included: • • • • A review of the information held on the homes file. Information submitted by the registered provider in the Pre Inspection Questionnaire. Information gathered from questionnaires completed on behalf of service users by relatives and care managers. An announced visit which lasted five hours and included a tour of the premises, discussion with care staff and the manager. Examining some records and observing staff working with service users. What the service does well: What has improved since the last inspection? There are no longer any staff vacancies which means there is a stable staff team to support service users. With the exception of one new member of staff, all staff have completed induction and foundation training. There has been an extensive programme of redecoration; the home is now decorated to a high standard, is bright and cheerful. Alderson Road 12 DS0000007877.V305359.R01.S.doc Version 5.2 Page 6 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. Alderson Road 12 DS0000007877.V305359.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.V305359.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is excellent. Service users needs are properly assessed prior to admission. This judgement has been made using available evidence including a visit to the service. EVIDENCE: There have been no new admissions for a number of years. All service users 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 service users lives and how they want support to be provided for them. Completion of the document includes meeting and gathering information from the service user, family and other professionals and is particularly useful for those service users who have complex needs and /or difficulties with communication. This document supports staff in making the admission for the service users 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 service user. Compatibility between service users is given considerable thought and existing service user 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 Alderson Road 12 DS0000007877.V305359.R01.S.doc Version 5.2 Page 9 confirm that the service user and other service users in the house are happy with the arrangements. Service users are provided with and assisted in understanding the service user guide which is produced pictorially. Alderson Road 12 DS0000007877.V305359.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6.7 and 9 Quality in this outcome area is excellent. Service users needs are assessed and met promoting independence, choice and respect for individuals. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Whilst staff were supporting service users during the morning it was clear that they understood individuals needs. They supported people sensitively and supported people to make choices. There were clearly elements of risk for service users during the morning particularly in the kitchen area and staff handled these discreetly and safely. Staff were seen using makaton and physical prompts to support service users. Staff discussed individual needs and demonstrated imaginative ways to make sure service users have as much choice and control over their lives. Particularly with regard to supporting service users with communication, using pictures and recordings on a Dictaphone. Alderson Road 12 DS0000007877.V305359.R01.S.doc Version 5.2 Page 11 Records about service users are kept on computer with some supporting hard copies. Service users needs are assessed and provided using a person centred approach. Service user plans contain information about every aspect of the service user’s life including areas for developing new skills. Where specific support is required this is documented step by step to make sure the support is provide exactly how the service user wants and needs. Care plans are reviewed regularly. Also present were risk assessments with the purpose of supporting service users to live as independently as possible with safeguards in place, these were reviewed regularly. UBU provide a good induction and ongoing training for staff which makes sure service users are treated with respect, dignity and are supported to make choices in their lives. Alderson Road is accredited with the National Autistic Society (NAS) this means additional training for staff in meeting the needs of service users with autistic spectrum disorder. Alderson Road 12 DS0000007877.V305359.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,12,15,16 and 17. Quality in this outcome area is good Service users are supported to lead full and active lives This judgement has been made using available evidence including a visit to the service. EVIDENCE: One service user was attending a specialist therapy session, one service user had gone out for lunch, one was preparing to go out for a picnic and two service users were spending time at home. Service users 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. Alderson Road 12 DS0000007877.V305359.R01.S.doc Version 5.2 Page 13 Although some additional staffing has been secured to ensure service users have the opportunity to participate in activities of their choice on a one to one there are occasions when service users 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 for more than one service user. Plans to re locate service users into smaller units will improve the lifestyle for service users particularly in terms of their daily choices and opportunities, and with whom they share their living space. There was written information in service user plans about how service users spend their days and these arrangements are discussed with service user representatives and staff. Details about family, friends and significant events are recorded in service user plans. Examples of how service users are supported to maintain relationships with family and friends were given. Staff said they learnt about respecting service users 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.V305359.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20. Quality in this outcome area is excellent. Service users’ personal and healthcare is provided appropriately and sensitively according to individual needs. Arrangements for the storage and administration of medication are good. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Service users health needs were recorded in service user plans with additional step by step instruction in individual service specifications. Sometimes service users 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. Service users 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. The manager also reported good relationships with the local GP practice and dentist who Alderson Road 12 DS0000007877.V305359.R01.S.doc Version 5.2 Page 15 encourage staff to advise them in their approach with service users to ensure service users health needs are met. 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.V305359.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is excellent. Service users have access to an effective complaints procedure and are protected from harm. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Service users are provided with a complaints procedure which is produced pictorially. Because of the complexity of service users needs and difficulties with communication it is unlikely that a service user would make a complaint in the usual manner. Staff, therefore, need to have the skills to interpret service users behaviours to identify whether they are unhappy about something. An example of this is when the termination of an activity created changes in behaviour so additional funding was negotiated to support a service user to continue to attend an activity. Advocates are used to provide an independent voice for service users. No formal complaints have been received by the home or the Commission for Social Care Inspection. There is a comprehensive policy and procedure with regard to adult protection and staff have a good awareness of this. Staff receive training in adult protection issues during induction and foundation training and as part of NVQ level 2 and 3. There was evidence that the home has acted appropriately when a member of staff reported poor practice under whistle blowing procedures. Alderson Road 12 DS0000007877.V305359.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. Service users live in a clean, comfortable and safe home. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The home provides spacious accommodation for service users. 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 and each bedroom was individually decorated. There has been a significant programme of redecoration and refurbishment since the last inspection. A range of checks is completed on a regular basis to make sure that the house is safe and secure. Alderson Road 12 DS0000007877.V305359.R01.S.doc Version 5.2 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, 34 and 35 Quality in this outcome area is excellent. Service users receive support from staff who are properly recruited and vetted. Service users’ needs are met by a well-trained staff team. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Prospective staff complete an application form and attend formal interview where any gaps in employment are explored. UBU generally include service users in their interview process but because of the complexity of needs of those service users 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 service users and being observed by staff. Observations are used as a formal part of the interview scoring. Written references and POVA first checks are made and staff are not permitted to work in the home until they have a CRB check. Alderson Road 12 DS0000007877.V305359.R01.S.doc Version 5.2 Page 19 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 service users 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. Since the previous inspection the home now currently fully staffed and the need to use agency staff has reduced. There is usually three or four staff on duty, with additionally funded hours for specific service users 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 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.V305359.R01.S.doc Version 5.2 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, 39 and 42. Quality in this outcome area is excellent The management of this home ensures service users best interests are promoted and reflected in the service provided. Staff take proper precautions to ensure the health and safety of service users. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The manager has extensive experience in the field of learning disabilities and staff think highly of her. She places the service users’ needs as her first priority and she demonstrates enthusiasm and imagination in ensuring the best for service users. She is well organised and delegates responsibilities appropriately to all staff team members. Alderson Road 12 DS0000007877.V305359.R01.S.doc Version 5.2 Page 21 The home has a formal quality assurance system which relates directly to national minimum standards and an improvement plan. Previously service users had not been asked formally for their views on the running of the home. Given the complexity of service users needs staff in the home are working towards individual ways of obtaining this information with the use of pictures, objects and tape recordings. 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. There is a system in place to support service users with their personal monies which ensures every expenditure is documented, signed for and has a regular checks independent check. Records were seen which confirmed that equipment is maintained; gas and electricity supplies in the home are safe 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 Alderson Road 12 DS0000007877.V305359.R01.S.doc Version 5.2 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 Standard No Score 1 x 2 4 3 x 4 x 5 x 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 3 25 x 26 x 27 x 28 x 29 x 30 3 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 3 13 3 14 x 15 3 16 3 17 3 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.V305359.R01.S.doc Version 5.2 Page 23 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.V305359.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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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