CARE HOME ADULTS 18-65
Allan House 53 Uttoxeter Road Blythe Bridge Stoke On Trent Staffordshire ST11 9JG Lead Inspector
Jane Capron Unannounced Inspection 12th November 2005 10:30 Allan House DS0000004906.V265656.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 Allan House DS0000004906.V265656.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. Allan House DS0000004906.V265656.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Allan House Address 53 Uttoxeter Road Blythe Bridge Stoke On Trent Staffordshire ST11 9JG 01782 397018 01782 399244 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) Mrs Grace Jeffries Mr Ronald Jeffries Mrs Grace Jeffries Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Allan House DS0000004906.V265656.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 13th June 2005 Brief Description of the Service: Allan House is an eight-bedded care home for service users that have a learning disability. The home is one of two homes owned by Mrs Jeffries and her son. The home is located on the main road in Blythe Bridge and blends in with the surrounding properties. The home is a two-storey large family type house although all bedrooms and lounges are on the ground floor. The home provides six single bedrooms and one double bedroom. The environment internally is of a high standard and outside at the front is a car park and at the rear a large garden. The service users access local health resources and seven of the service users attend college, day centres or day services. The service users generally have low needs although the home is able to respond to some challenging behaviour. Service users assist around the home. Service users take care of their own personal care needs with the support of staff. Staff support service users to undertake food and clothes shopping. The aim of the home is to promote and develop the independence skills of the service users and if appropriate to move them to a more independent living environment. Allan House DS0000004906.V265656.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on a Saturday and lasted approximately three and a half hours. During the inspection discussions took place with seven of the eight residents, the staff on duty and the owner of the home. The arrangements for the administration of medication were examined as well as a sample of residents support plans. The communal areas were seen. Five of the bedrooms were seen in the company of their occupants. Since the last inspection there has been no complaints and no additional visits have taken place. This is good home, providing residents with a full and varied lifestyle. The current owner/care manager is due to step down as care manager and currently the deputy manager is going through the registration process to be the care manager. What the service does well:
The residents liked living at the home. They said that they liked the staff and that they provided them with help and support. The residents had a busy and varied lifestyle. They attended college undertaking a range of courses or day services. Two of the residents had work placements. The residents undertook a wide range of social and leisure activities. Some attended the dolphins club, played basketball, went to a dance group and one went to the gym. The residents went to the pub regularly, went shopping and out for day trips. The home organised holidays and the residents paid for these. Residents were supported and encouraged to take part in a range of daily living activities around the home including helping with meal preparation, laying and clearing the table and washing up. They helped to keep their bedrooms and communal areas clean and tidy. Residents felt that they were listened to and that the staff organised activities that they wanted to do. Residents were provided with choice over their daily lives. The home had a relaxed and informal atmosphere where residents and staff got on well with each other. Staff treated residents with respect and dignity and respected their privacy.
Allan House DS0000004906.V265656.R01.S.doc Version 5.0 Page 6 The residents’ health and personal care needs were being met and the home had developed working relationships with relevant health care professionals. The home provided the residents with a good standard of accommodation. Communal rooms and bedrooms were well decorated and furnished. Bedrooms were lockable and provided residents with a private area which they could make their own with their own belongings. The home staffing levels were suitable to meet the needs of the current residents. The home had a high level of staff that had qualifications in care practices. What has improved since the last inspection? What they could do better:
Although the home was providing residents with a good standard of care there were areas that needed to be improved. The home had developed individual care plans but there were some areas that the plans did not cover and some of the plans needed to be reviewed. These aspects needed to be addressed to ensure that staff have all the up to date information available in order to be able to meet the needs of the residents. Similarly there were some gaps in the risk assessments particularly relating to residents being able to manage hot water and some risk assessments had not been reviewed recently. The home also needed to ensure that it had a photograph of each resident on file. Whilst the home was decorated and furnished to a good standard on the day of the inspection some rooms were quite cold. This was due to a problem with one of the central heating boilers, which was waiting to be repaired. The home needs to pursue this matter urgently as the days are now getting colder. The home’s procedures relating to health and safety in general met the standards but there were some instances when opened food had not been labelled and this needs to be attended to. Allan House DS0000004906.V265656.R01.S.doc Version 5.0 Page 7 The home was still in the process of developing a more formal system for the review of quality within the home. This was outstanding from the last inspection and must be implemented in the near future. 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. Allan House DS0000004906.V265656.R01.S.doc Version 5.0 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 Allan House DS0000004906.V265656.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3,4 The home undertook assessments and admissions on a trial basis ensuring that both the home and the residents were able to make a decision over whether the home could meet a resident’s needs. The residents’ needs were being met through the staff having the necessary knowledge and skills and through the involvement of relevant health and social care specialists. EVIDENCE: The home had admitted two residents over the last few weeks. Files showed that the home had undertaken an assessment of these residents covering the areas of health and personal care, educational and leisure needs, social history, financial issues and any communication needs. Residents said that they had visited the home prior to making a decision over whether they wanted to move to the home. All placements to the home were made on a trial basis that was not confirmed until a review of significant people had taken place approximately six weeks after admission. The home was aware of the needs it was able to meet. The home had developed working relationships with relevant health care professionals as well as educational establishments. The home placed a high emphasis on staff training and staff had undertaken training in specific relevant conditions as well as general care practices. The home was aware of any special communication needs and involved such specialists as speech and language therapists to
Allan House DS0000004906.V265656.R01.S.doc Version 5.0 Page 10 provide any necessary advice. The home consulted residents over their likes and dislikes and looked to provide educational and social activities to meet the residents’ wishes. Allan House DS0000004906.V265656.R01.S.doc Version 5.0 Page 11 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 Whilst the home had developed individual support plans these needed to be further developed and all regularly reviewed to ensure that staff have the necessary current information to be able to meet the needs of the residents. The home consulted with residents, and residents participated in a range of tasks around the home providing them with control over their lives and the opportunity to take decisions and choices over their lives. The home’s risk assessment process supported residents to take reasonable risks however there were areas of risk that needed to be assessed and all risk assessments should be reviewed. EVIDENCE: The home had developed individual support plans for the residents. These covered their health and personal care needs and independent living skills. Support plans were not present for the social, educational and financial budgeting needs of the residents. There was evidence that some plans had been reviewed. Residents stated that they were involved in the developing of their support plans and this was evidenced in the files.
Allan House DS0000004906.V265656.R01.S.doc Version 5.0 Page 12 Residents stated that they were consulted over aspects of their daily lives. They were able to get up and go to bed when they chose depending on their agreed individual weekly schedule. They had meetings to discuss such issues as meals, trips out and holidays. Individual discussions took place over attending college. Residents were involved in a range of independent living tasks. These included making their breakfast, meal preparations, laying and clearing the tables, washing up and keeping the home clean and tidy and cleaning their bedrooms. The level of assistance and involvement depended on each resident’s abilities. The home had developed risk assessments covering a number of areas but not all had been recently reviewed and there were certain areas of risk not assessed. Allan House DS0000004906.V265656.R01.S.doc Version 5.0 Page 13 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): 11,12,14,15,16 The home provided residents with the opportunity for personal development supporting them to develop independent living skills and social skills. Residents enjoyed a full and varied lifestyle through the staff supporting residents to undertake educational and social activities. The home supported residents to maintain and develop appropriate relationships with family and friends. The residents benefited from flexible routines enabling them to make choices and decisions over their daily life. EVIDENCE: Residents confirmed that they took part in a range of independent living tasks around the home. The home was aware of any special communication needs involving the speech and language therapist when needed. Residents were encouraged to support each other and to develop social relationships both in and out of the home. The residents had a varied and busy lifestyle. They either attended college, day services or undertook work placements.
Allan House DS0000004906.V265656.R01.S.doc Version 5.0 Page 14 Residents had busy social lives and they stated that some attended the dolphins club, went to basketball sessions and one went to the gym. They said that they went out locally, to the shops and the pub and that the home organised day trips out. The home paid for paid for day trips out. The home organised holidays that were paid for by the residents. This year there had been holidays to Pontins, the Isle of Wight and to Blackpool. Within the home residents watched TV and videos and played a range of board games. The home along with its sister home organised parties to celebrate special occasions and birthdays. Resident’s individual wishes were taken into account when organising activities. The home has its own transport and residents contributed to use it. The home had a relaxed atmosphere and residents were supported to decide how to spend their time when in the home. They could spend time in their bedrooms or in the communal areas. Breakfast was taken when residents got up and other meals tended to be taken together within a time framework. Residents were able to get up and go to bed when they chose taking into account their agreed weekly schedule. The home supported residents to visit family and friends and most residents had regular contact with family members. Friends and family were able to visit the home at any reasonable time and were often invited to join in the home activities. One resident stated that the home invited her friend to the recent fire display they went to. The home was aware of the rights of residents to have intimate relationships and were supportive of this and were aware of issues relating to sexual health and where to gain specialist advice. Allan House DS0000004906.V265656.R01.S.doc Version 5.0 Page 15 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 The personal care and health care needs of the residents were being met with evidence of good multi disciplinary working taking place. The medication administration was well managed with clear arrangements being in place to ensure that the residents’ medication needs were being met. EVIDENCE: Support plans identified the personal support and health care needs of the residents. Whilst most residents did not need physical support to attend to their personal care needs the home provided residents with verbal prompts and encouragement. Residents said they went shopping to buy their own clothes and staff went with them to help them. Residents’ appearance showed their individuality and reflected their personality and residents were wearing age and weather appropriate clothing. The home had developed working relationships with a range of health care specialists including psychiatric staff, speech and language therapists, community nurses and staff from behavioural services. The residents were receiving primary health care services. They attended the dentist, the optician and the chiropodist. The residents confirmed these appointments. The diet and weight of residents were being monitored.
Allan House DS0000004906.V265656.R01.S.doc Version 5.0 Page 16 Medication was being stored appropriately. The home operated a monitored dosage system for the administration of medication. Medication records showed no gaps and showed that medication was being administered correctly. Staff had received training in the administration of medication and staff were assessed prior to administering medication alone. Allan House DS0000004906.V265656.R01.S.doc Version 5.0 Page 17 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): EVIDENCE: These standards were not assessed as the home fully met the standards on the last inspection. Allan House DS0000004906.V265656.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,30 The home provided residents with a well-decorated and well maintained homely environment but the home did need to ensure that the boiler was repaired to ensure that the home was adequately heated in all rooms. The residents benefited from communal areas that were decorated and furnished to a good standard and private bedroom accommodation that enabled residents to have a private space that they could make their own. The home provided residents with suitable toilet and adequate bathroom facilities but would benefit from the installation of additional bathing facilities. The residents benefited from a home that was clean and tidy and where staff undertook actions to prevent the spread of infection. EVIDENCE: The home was located within walking distance of the centre of Blythe Bridge and close to a local pub. A large supermarket was within walking distance. The home was a large domestic style house in keeping with other properties in the area. The home was well decorated and maintained throughout. At the time of the inspection part of the home was quite cold due to one of the central
Allan House DS0000004906.V265656.R01.S.doc Version 5.0 Page 19 heating boiler awaiting repair. The boiler repair company had visited and the home was awaiting a particular part to be delivered and fitted. The home had provided residents with extra bedding. All the resident accommodation was on the ground floor. The home had suitable communal areas with a large lounge and a smaller lounge. The home had a kitchen/ diner where meals were taken. The office and main kitchen were upstairs. The home had six single bedrooms and one double room. Bedrooms had ensuite facilities. All bedrooms were lockable although the residents chose not to lock their rooms. Bedrooms had suitable furnishings and furniture and all were personalised. Residents stated that they liked their bedrooms and that they could put things up on the walls and could go to their bedrooms when they wanted to. The bedrooms all had toilets ensuite. The home had adequate toilet and bathing facilities having a separate toilet downstairs as well as a toilet within the bathroom. The home had one bathroom with a bath with shower over. The home was clean and tidy and had procedures in place to prevent the spread of infection. The home had a small laundry which washed laundry at a suitable level .The home had no need for a sluicing facility. Allan House DS0000004906.V265656.R01.S.doc Version 5.0 Page 20 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 The level of staffing and the knowledge and skills of the staff provided residents with the type and level of care they needed to have their needs met. EVIDENCE: The home provided a staffing level of a minimum of two staff although one staff may be the owner or the deputy. This was at times increased particularly to support residents to access leisure activities during the evening and weekend. The care staffing levels were lower during the day as during the week most of the residents were out of the home attending college or day services. The home had two staff sleeping in at night. This level of staffing was suitable to meet the needs of the current staff whose main needs were for support, encouragement and supervision. The home had a high level of staff qualified to at least NVQ level 2. All staff except the newest staff member had achieved NVQ or had a relevant qualification. Staff spoken to were aware of the individual needs of the residents and had developed positive relationships with them. Observation showed them to be well motivated and interested in the residents and that they treated them with respect. The residents stated that they got on well with the staff and that they supported them to undertake tasks around the home and talked to them about what they wanted to do. Allan House DS0000004906.V265656.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38 The residents were benefiting from a home that was well run and that listened to the views of residents and staff. The home had an informal system for the review of quality and was in the process of developing a more structured approach which will provide the residents with a home that has good methods of self evaluation that includes their views and the views of significant others. Whilst the home had health and safety procedures in place there were some issues that should be attended to in order to increase the protection of the residents. EVIDENCE: The owner at the time of the inspection was the Care Manager but she was in the process of stepping down with the deputy taking over. The deputy had submitted an application for registration as the Care Manager. The owner/ Care Manager has gradually reduced her role in the management of the home but has maintained a big role in day-to-day activities and support of the
Allan House DS0000004906.V265656.R01.S.doc Version 5.0 Page 22 residents. She is well liked and respected by staff and has positive relationships with the residents. She works as a care staff member regularly. The owner/ Care Manager and deputy work closely together in the interests of the residents. The owner/ Care Manager has a background in nursing and lengthy experience in working with people with a learning disability. The home had a very open atmosphere with staff feeling supported and valued. Both staff and residents views were sought and residents felt that the staff listened to their views. The home had a number of informal systems in place to review the quality of the service and was in the process of developing a more formal system of self review. The home did undertake a number of surveys of residents and relatives. The home had health and safety procedures at the home and staff had undertaken the necessary training. Risk assessments were in place in respect of hot surfaces but not in respect of hot water. Procedures were in place for the safe storage and handling of hazardous substances. The necessary servicing had been completed. The staff at the home had completed training in food hygiene but it was noted that there were some products in the fridge that were not labelled with the date of opening. Allan House DS0000004906.V265656.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 3 3 X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 3 2 X Standard No 24 25 26 27 28 29 30
STAFFING Score 2 X 4 3 3 X 3 LIFESTYLES Standard No Score 11 3 12 4 13 X 14 4 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 4 3 X X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Allan House Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 3 2 X X 2 X DS0000004906.V265656.R01.S.doc Version 5.0 Page 24 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 YA6 Regulation 15(1)(b) Requirement To provide a care plan that contains all relevant elements and is kept under review.(At least monthly) To maintain a photo of all residents on file. To ensure that individual risk assessments are fully developed and are kept under review To ensure that all areas of the home are suitably heated To further develop the system for the review of quality and development. To ensure that all food safety standards are correctly applied Timescale for action 01/01/06 2. 3. 4. 5. 6. YA41 YA9 YA24 YA39 YA42 17(1)(a) 13(4)(b) 23(2)(p) 24 13(4) 01/12/05 01/01/06 17/01/05 01/01/06 13/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Allan House DS0000004906.V265656.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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. Extracts may not be used or reproduced without the express permission of CSCI Allan House DS0000004906.V265656.R01.S.doc Version 5.0 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
