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Inspection on 11/07/05 for Anna S Proctor House

Also see our care home review for Anna S Proctor House for more information

This inspection was carried out on 11th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Anna S Proctor House offers care in a relaxed and friendly style. It was interesting that in separate interviews the inspector had with staff, residents, and a resident`s relative, the word "family" was used a lot. People said, " I know it isn`t a family but that`s what it`s like." and "We`re like a family here." What the inspector also found was that this relaxed friendly "family" style of care is actually very professionally organized, managed, and conducted. People living at Anna S. Proctor House benefit from the fact that the home knows them, their needs, their preferences, and what they want out of life. People living at Anna S Proctor House also benefit from the fact that their care is well directed, provided by well trained staff, based on good planning, and good recording. The use of a team made up of indoor care staff and outdoor activity staff works very well for residents. It means a lot of flexibility can be built into the care provided and into the daily living arrangements. If people don`t want to go somewhere with the others, or they want to do something else, or just stay at home, it isn`t a problem.

What has improved since the last inspection?

Since the last inspection in January 2005, the percentage of staff holding the NVQ 2 in care has risen from 60% (6) to 100% (100). The home`s manager told the inspector that although staff were already mature and skilled carers who worked well together and worked well with residents, the very high level of recent training seems to have made them more thoughtful about their practice, and keen to be involved in making improvements. The home`s manager thought staff now have a sense of achievement, and an air of confidence that has had a good effect on how well care has been delivered, and this has been a big benefit to residents. In support of this view, the inspector noted that in the planning and provision of care and the organization, development and deployment of staff, the home was showing some important extra features that help provide residents with a more flexible, thoughtful and personalized package of care.

What the care home could do better:

The home`s own ambitions are to make sure staff practice is maintained and improved through a combination of back to basics refresher training combined with more specialist training, and use of that training, to develop practices such as risk assessment. The home would like to extend the options open to its residents and for them to have more life experiences and gain more skills, which would also require staff to have more skill in using of risk assessments, so that this can be done safely.

CARE HOME ADULTS 18-65 Anna S Proctor House 23/24 Summerhill Shotley Bridge County Durham DH8 0NQ Lead Inspector Gavin Purdon Unannounced 11th July 2005 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 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 Stationary 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. Anna S Proctor House v232442 b54 s60994 anna s proctor house v232442 110705 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Anna S Proctor House Address 23/24 Summerhill Shotley Bridge County Durham DH8 0NQ 01207 502818 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Rayson Homes Limited Mrs Sheila Kelly CRH 14 Category(ies) of LD (11 registration, with number LD(E) (3) of places Anna S Proctor House v232442 b54 s60994 anna s proctor house v232442 110705 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 27th January 2005 Brief Description of the Service: Anna S Proctor House provides care for 14 people with learning disabilities, of which 3 may also be over the age of 65. The home is well established in the community of Shotley Bridge, and occupies a substantial end of terrace site on the edge of the village. It has a small rose garden to the front and a sitting area that residents can use, to the rear. There are 2 shared bedrooms, 8 single bedrooms, and 2 flats which provide opportunities for residents at Anna S Proctor House to experience greater levels of independence, whilst still receiving support and care from the staff team. Bedrooms have their own distinct character. Residents are encouraged to personalise them, and do so to good effect. The home provides a dining room and 2 separate comfortable lounges on the ground floor. There are 2 separate staircases leading to the first floor, one having a stairlift for those residents who may need to use it. Anna S Proctor House v232442 b54 s60994 anna s proctor house v232442 110705 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was intended as unannounced, but because the owners and manager were on holiday and no residents were available at the time of the first unannounced visit, a second visit took place shortly after, on 11 July 2005. On that day, 13 residents were being cared for at the home. The inspection lasted 5 and a half hours, during which time the inspector spoke with 2 resident’s at length, and briefly with 4 other residents. The inspector also spoke to the 2 owners of the home, the registered manager, 2 experienced members of the care team, an external training assessor and the relative of a resident visiting the home at the time of the inspection. Anna S Proctor House has no history of unmet requirements, complaint, or enforcement action. Previous inspection has identified a stable home with a good reputation providing a decent standard of care for its residents. This inspection looked at care practices and staffing arrangements, and found that how staff plan, provide, and record care makes sure that residents’ needs are understood and met in a way that suits residents personally. There was ample evidence of good outcomes for residents based on mature practice that consistently meets the national minimum standards and occasionally exceeds them. What the service does well: Anna S Proctor House offers care in a relaxed and friendly style. It was interesting that in separate interviews the inspector had with staff, residents, and a resident’s relative, the word “family” was used a lot. People said, “ I know it isn’t a family but that’s what it’s like.” and “We’re like a family here.” What the inspector also found was that this relaxed friendly “family” style of care is actually very professionally organized, managed, and conducted. People living at Anna S. Proctor House benefit from the fact that the home knows them, their needs, their preferences, and what they want out of life. People living at Anna S Proctor House also benefit from the fact that their care is well directed, provided by well trained staff, based on good planning, and good recording. The use of a team made up of indoor care staff and outdoor activity staff works very well for residents. It means a lot of flexibility can be built into the care provided and into the daily living arrangements. If people don’t want to go somewhere with the others, or they want to do something else, or just stay at home, it isn’t a problem. Anna S Proctor House v232442 b54 s60994 anna s proctor house v232442 110705 stage 4.doc Version 1.30 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. Anna S Proctor House v232442 b54 s60994 anna s proctor house v232442 110705 stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Anna S Proctor House v232442 b54 s60994 anna s proctor house v232442 110705 stage 4.doc Version 1.30 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 standard(s) 2. Anyone thinking about coming to live at Anna S Proctor House can be sure that the home will look very carefully at what that person’s needs and wishes are, for now, and for the future. Anyone thinking about living at Anna S Proctor House can also be sure that the home will only agree to them living there if the home thinks that it is in a good position to help them. The home then makes sure that it is always clear to people why a resident is there and what is actually being done to help them. EVIDENCE: The inspector discussed the care needs of 3 residents with the home’s manager and looked at the home’s written plans for meeting those needs. These plans are very good examples of their kind. There are very strong links between the resident’s need for care as outlined in their basic assessment, and the best way to go about providing that care, as outlined in their care plan, and the daily recording of what care they have actually received. A very good feature of these documents, seen by the inspector, was the way home reduces big plans into accurate “at a glance” summaries so that that the care staff completing the daily record can look at what has happened that day that has helped meet the assessed needs of the resident. Anna S Proctor House v232442 b54 s60994 anna s proctor house v232442 110705 stage 4.doc Version 1.30 Page 9 Staff at Anna S Proctor House, spoken to by the inspector, showed a very high regard for record keeping as an important part of the good communication needed to support the giving of good care. Anna S Proctor House v232442 b54 s60994 anna s proctor house v232442 110705 stage 4.doc Version 1.30 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 standard(s) 6, 7, & 9. Each person living at Anna S Proctor House can be sure that they have a well thought out and up to date plan for their day to day care, based on what they have said they need and want for themselves as well as what the professional assessments say. People living at Anna S Proctor House are encouraged to make their own decisions about everyday matters, and the home will do its best to make sure these are understood and supported. People living at Anna S Proctor House are helped to lead a more independent lifestyle, if that is what they want to do, and if they are quite comfortable about taking that step. EVIDENCE: The inspector saw how well resident’s care plans are set out, with clear guidance for staff on the best way to work with residents in particular situations. Anna S Proctor House v232442 b54 s60994 anna s proctor house v232442 110705 stage 4.doc Version 1.30 Page 11 The inspector saw how the numbers of staff available, and the use of staff as specialist indoor carers and outdoor activity providers, makes sure that the different needs of residents can be dealt with in different ways and that there was always a choice open to residents. The inspector saw that the home is very interested in working with families, and working with other organizations in the community to give residents plenty of opportunity and choice about where they might go, who they might go with, and what they might want to do. The view of staff, residents, and a resident’s relative who spoke to the inspector, was that there was a lot on offer to people at Anna S Proctor House, but that people were not pressured into doing things that they were not happy about. There is a careful consideration of people as individuals, and a very careful consideration of the point of particular activities, and the benefits and risks involved for particular residents. Whether someone leads a busy life or a quiet one at Anna S. Proctor House seems a matter of individual choice. Whatever the choice, it will be clear from the records whose choice it is, how safe it is, and what the benefits might be for the resident concerned. Anna S Proctor House v232442 b54 s60994 anna s proctor house v232442 110705 stage 4.doc Version 1.30 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 standard(s) 12, 13, 15, 16, & 17. If people who live at Anna S Proctor House want to be out and about in the community, and go to places they like, with people they want to be with, to do things they enjoy, the home is very good at supporting this. Likewise the home is very good at supporting people who don’t want to go out or who might want to do something different. EVIDENCE: From the inspector’s discussion with the residents, a resident’s relative, the manager, and 2 of the care staff, it was very clear that the life residents lead outside the home is seen as important as the life they lead in the home, and a lot of effort goes into making sure that this is provided for in a way that residents are happy with. One of the residents told the inspector, “ I like to go places. We go to the Metro Centre, we go shopping, and down to the coast, but I like to be here where I live as well.” Another resident told the inspector, “ We are going to Blackpool, and that will be good. I please myself, sometimes I’ll eat up in my flat, sometimes I’ll come down and eat with everybody else.” Anna S Proctor House v232442 b54 s60994 anna s proctor house v232442 110705 stage 4.doc Version 1.30 Page 13 Talking to residents gave the inspector the impression that people living at Anna S Proctor House enjoy what they were doing and like to do things well. They are some good cooks, good gardeners, and good artists living there. Staff spoken to by the inspector were very much aware that they had to work well with a lot of people outside the home, to help make sure that residents had good experiences in the community and that things went as smoothly as possible for them. The food at Anna S. Proctor House is enjoyable. One of the residents told the inspector, “ We had cauliflower Cheese tonight, that’s one of my favourites. I like that, and had some more.” In food, as with other details of care, the home seems quite casual and relaxed in what it does, getting in Chinese or Indian takeaways, or going out to McDonalds, getting fish and chips at the seaside, or not having what’s on the menu at home and having something else instead. Whatever is on offer, it will be well planned, well recorded, and provided on the basis of a good understanding of what each resident needs and likes. Anna S Proctor House v232442 b54 s60994 anna s proctor house v232442 110705 stage 4.doc Version 1.30 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 standard(s) 18, 19, & 20. People who live at Anna S Proctor House are well cared for, and cared for in a way that they are comfortable with. The home does not deal with extreme levels of need, but tries hard to provide for the many individual differences in needs and preferences that its residents have. EVIDENCE: It was noted from discussion, and from the care records seen, that some residents at Anna S Proctor House do have some health care needs that require particular attention, but theses are well understood and controlled by prescribed medication. 9 of the 10 care staff are trained in the safe handling of medicines, and good links with local GPs and district nurses were mentioned by the manager and care staff. Residents benefit from the fact that their needs and preferences are very well understood and very well recorded. Staff have easy access to this key information and use it on a daily basis, as what each resident can safely do themselves, or with assistance, and how they prefer to do things, varies a lot. There is a good understanding of residents’ needs among staff, and changes are recognized, responded to, and carefully recorded. 2 of the residents who spoke with the inspector said they decided what they wanted to do. Staff did ask them what they thought about things. The residents said that there were big meetings with everybody there and small Anna S Proctor House v232442 b54 s60994 anna s proctor house v232442 110705 stage 4.doc Version 1.30 Page 15 meetings with just them and one of the staff to talk about things that were happening or being planned. Anna S Proctor House v232442 b54 s60994 anna s proctor house v232442 110705 stage 4.doc Version 1.30 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 standard(s) 22, & 23. People living at Anna S Proctor House expect their views to be taken notice of, and do have people they can tell if something is bothering them or if they want help with something. The home is very much aware of, and believes in, the need to protect vulnerable adults from abuse. EVIDENCE: The 2 residents who spoke with the inspector said that there are people they could speak to if they are worried about something. The manager and care staff commented on how they are alert to the need to protect residents. Examples discussed ranged from alleged financial abuse and the formal processes that had to be gone through, down to the need to ensure that all residents, and not just some, have a choice and a say and are helped to have these. The manager described how the home will co operate with the investigation of any concern and will plan and provide day to day care in a way that protects residents and staff of the home. Care staff who spoke to the inspector are aware of policies and procedures for the protection of vulnerable adults, and understand what “whistle blowing” is, and their duty to take action themselves if allegations are not properly dealt with. Anna S Proctor House v232442 b54 s60994 anna s proctor house v232442 110705 stage 4.doc Version 1.30 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 standard(s) Not assessed on this occasion. EVIDENCE: Anna S Proctor House v232442 b54 s60994 anna s proctor house v232442 110705 stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33,35 & 36. People living at Anna S Proctor House are very well supported by a well lead, well organized, and well trained care team. EVIDENCE: The 2 Care staff interviewed by the inspector were confident, mature, and competent carers. They showed a good understanding of the needs of individual residents. They showed a lot of respect for those residents in how they talked about them. These care staff were clearly committed to providing a good standard of care for those residents. The care staff also showed a high regard for their fellow workers, their manager, and their employers. The manager and the home’s owners also spoke with the inspector, and they were clearly proud of what the residents and staff of the home had achieved together. All 10 care staff now hold the NVQ 2 in care qualification, which is a major achievement. Anna S Proctor House has a particularly strong and well organized care team. Its in house care staff team is supplemented by outside activity staff, which allows a wider range of choice for residents who might want to go out or stay at home, as the case may be. Many residents attend various college and day Anna S Proctor House v232442 b54 s60994 anna s proctor house v232442 110705 stage 4.doc Version 1.30 Page 19 care placements elsewhere throughout the working week, and are not present in the home on a 24 hour basis. However, the weekly care/activity staffing allocation of 365 hours is still 49 hours above those expected to be line with current guidance, where 13 residents are present 24 hours a day. Care records seen by the inspector were well kept, and staff spoken with thought up to date easy to read records that showed what care was needed, how that care should be provided, and that it had been provided, were essential to the smooth running of the home and providing a good standard of care. At the time of the inspection, an external training assessor was present in the home, and told the inspector that staff at Anna S Proctor House showed a strong interest in training and that the work they produced for assessment was of a particularly high standard. 2 residents who spoke with the inspector, and one relative of a resident, said, “I like the staff here”, “they’re nice”, and “really good”. The inspector discussed staff training, supervision, and support, with the manager and with 2 care staff. Plans and records were also looked at. One member of care staff showed the inspector their most recent annual appraisal record. The inspector also looked at the homes training and development plan with the manager. The manager’s view is that residents benefit from a high standard of care, which owes a lot to the good general knowledge and skill of the staff team, their success in working together, and to the individuals in that team with particular strong points and personal interests that benefit the team and the residents as a whole. Care staff considered themselves to be very well supported, and helped in every way to do a good job for the residents. Anna S Proctor House v232442 b54 s60994 anna s proctor house v232442 110705 stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Not assessed on this occasion. EVIDENCE: Anna S Proctor House v232442 b54 s60994 anna s proctor house v232442 110705 stage 4.doc Version 1.30 Page 21 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 4 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 x 3 4 x 3 3 3 Standard No 31 32 33 34 35 36 Score x 4 4 x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Anna S Proctor House Score 4 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x x x v232442 b54 s60994 anna s proctor house v232442 110705 stage 4.doc Version 1.30 Page 22 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. 1. 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. 1. Refer to Standard 9 Good Practice Recommendations Should the home wish to follow through with its own plan to develop its use of risk assessments, the CSCI would consider this an appropriate way to further develop good care practice within Anna S Proctor House. Anna S Proctor House v232442 b54 s60994 anna s proctor house v232442 110705 stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection No 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Anna S Proctor House v232442 b54 s60994 anna s proctor house v232442 110705 stage 4.doc Version 1.30 Page 24 - 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. 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