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Inspection on 07/01/09 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 7th January 2009.

CSCI found this care home to be providing an Good service.

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.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Anna S Proctor House 23/24 Summerhill Shotley Bridge Durham DH8 0NQ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Hilary Stewart     Date: 0 7 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Anna S Proctor House 23/24 Summerhill Shotley Bridge Durham DH8 0NQ 01914881057 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Sheila Kelly Type of registration: Number of places registered: Rayson Homes Limited care home 14 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home 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. 11 Over 65 3 Care Homes for Adults (18-65 years) Page 4 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. How the inspection was carried out. Before the visit we looked at the information we have received since the last visit on 9th January 2007. How the service dealt with any complaints and concerns since the last visit. Any changes to how the home is run. The providers view of how well they care for people and the views of people who use the service and the staff. An unannounced visit was made on 7th January 2009. Care Homes for Adults (18-65 years) Page 5 of 27 During the visit we talked with people who use the service staff and the manager.We looked at information about the people who use the service and how well their needs are met. We looked at other records which must be kept and checked that staff had the knowledge, skills and training to meet the needs of the people they care for.We also looked around the building to make sure it was clean safe and comfortable. We checked what improvements had been made since the last visit. Then we told the manager what we found. We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future if a requirement is repeated it is likely that enforcement action will be taken. Fees at the time of the visit were 407 pounds and 50p. What the care home does well: What has improved since the last inspection? What they could do better: More homely furniture would make the environment more pleasant for the people who live and look more like an ordinary home. If all applicants completed an application form with a work history this would show that the staff have been properly vetted and would demonstrate that the organisation have made sure that they only employ suitable people to work at the home and therefore safeguard the people who use the service. If peoples ability to self medicate was risk assessed this would show that home is taking seriously each person rights to live a normal a life as possible. Care Homes for Adults (18-65 years) Page 7 of 27 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are assessed before people receive the service, so plans can be devised to make sure they get the care and support they need. Evidence: The manager said that the people who live at the home have had their needs assessed before and after they move in. A person can only move into the home if they are certain that their needs can be met there. The manager said that the assessment of the peoples needs is on going and they up date the care plans if necessary. If a person decides to move into the home they can visit before they move in permanently, so they can be gradually introduced to the other people who live there. Care Homes for Adults (18-65 years) Page 10 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People at the home have their own care plan which porvides staff with the information they require to meet each persons needs. People are supported to become more independent but at the same time staff look at the risks to keep them as safe as possible. Evidence: The manager said that the people who live at the home are consulted as much as possible about their care plans. Records showed that each person has a care plan. Any significant events are recorded in each individuals records sheets. Staff use a cardex file that has brief information about each persons daily routines and other important information such as emergency contact numbers. The individual files have more detail for staff about how they need to support each individual. Each persons care plan contained information for staff about areas such as the persons physical health personal care needs social skills and daily timetable. The staff could describe how they work consistently with the people. Records showed that the care plans are monitored Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: and updated. Staff said that the people who live at the home are given choices as much as possible. They take part in planning the activities. Their timetables showed that they had different individual activities. The manager and staff said that they consult the people who live at the home as much as possible about their interests and which activities they would like to try. The home has some general risk assessments about the home itself and also individual ones to support the people to have a more independent lifestyle. Records showed that risk assessments had been carried out on daily living and activities for each person.The manager said that they update them regularly. Care Homes for Adults (18-65 years) Page 12 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service experience healthy stimulating activities, supported by staff who value them, while maintaining links with their families and friends. This means they can have new experiences and interests and do not become isolated. Evidence: The manager said that they make sure that the people who live at the home take part in activities such as going to day centres. Most people attended them before they moved into the home. Staff said that the people are given choices as much as possible. They have different activities and go out most days some people were out that morning. One person when asked said I like going to woodwork and another said I am retired I stay in or go out. The manager said that all of the people who live at the home use local amenities such Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: as pubs, clubs, cinema and shops. They are well known in the local community. Some people go to church and others go to a club with their friends and one with their parents. The people at the home said that they choose their own activities. For example one person said that they liked going out to a particular pub for lunch. Records showed that people discuss activities and trips out during the residents meetings. They go on trips with staff the Metro centre, out for Sunday lunch and trips to the coast. The manager said that people go to the local pub and out for meals. One person said I like going to the club and church, I help with the Sunday School another person said I go out to the club with my mam and dad. Each person who lives at the home has their own bedroom and their privacy is respected. They are supported to give their views about what takes place in the home and who should visit. Staff said that they respect the peoples privacy and they are aware of their rights. The people looked relaxed and comfortable with the staff. A good humoured rapport was observed between them. One person when asked about the home said I like my home another said all of the staff treat me well. Staff were also observed talking to the people and asking their opinions before they went out for the day. People said that they all take part in the domestic routines in the home. The manager said that the meals served are what the people who live there are known to like. Staff are supporting them to become more aware of the importance of having a healthy diet. If they are able, people help with menu planning, shopping and preparation of food. Staff said they choose menus either during conversations with individuals or the residents meetings. They have a choice of meals and there is a written menu. The manager said that a record of food served to each person is keep so they can make sure that their diet is satisfactory. Stocks of food were adequate and there was fresh fruit and vegetables. People who live at the home can have snacks and drinks at any reasonable time. Staff said that they get an adequate amount of money to buy food. One person said when asked about the meals I like the food another said that they could eat what they wanted. People visit their family and friends and have visitors to the home. The people at the home are supported to maintain contact with their families and friends. Records showed that peoples families visit the home. One person said I like Fridays, I go to see my friend another person said I got out with my befriender on Thursday. Care Homes for Adults (18-65 years) Page 14 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have personal support when they need it so they can be as independent as possible. Health care needs are met, which ensures that people stay healthy. Evidence: The care plans identify the personal support that the people need with everyday tasks. They had enough detail for staff to know how to meet their personal and emotional needs. The manager said that the home has a key worker system which enables individuals to identify with a particular member of staff. Staff could describe how they meet the care needs of the people at the home.The manager said that staff respect peoples privacy and dignity by only assisting with personal care when requested. Staff will offer guidance and support around peoples hygiene and well being for example advice on what to wear for certain occasions. Specialist support from psychiatrists and community nursing services is available to people when they need it. The manager said the well being of the people at the home is constantly monitored by staff. Records showed that a person had been referred to this service recently. Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: The manager said that peoples ability to self medicate has been assessed by their care managers. However this was not recorded in the care plans. The manager said that all staff have completed training and have been assessed as competent in the safe administration of medication. A photograph of each person is on their medication care plan as a safety measure. The medication records were up to date and complete. Staff were familiar with the homes procedures and one member of staff demonstrated how they could safety administer medication. Care Homes for Adults (18-65 years) Page 16 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A satisfactory complaints procedure is in place. This means that complaints should be dealt with effectively so people know that their comments are taken seriously. Satisfactory protection procedures are in place to protect the people at the home from risk of harm. Evidence: Policies and procedures are in place that demonstrates how the home responds to complaints. The manager said that the home had not had any complaints since the last visit. Staff actively encourage the people who live at the home and their families to tell them their opinions of the service as much as possible. Records showed that the complaints procedure is discussed in the staff and residents meetings. One person said when asked what they would do if they were concerned about something said tell the boss another person said they wouldfill a form in. The service currently has policies and procedures on safeguarding adults to inform staff what to do if they think a person at the home could be suffering from abuse.The manager said that staff are more aware of the signs and symptoms and the need to report suspicions of danger harm or abuse immediately. The manager could describe what actions they would take to safeguard the people who live at the home from potential abuse and they have a copy of the Local Authorities safeguarding procedure. When asked if they felt safe at the home one person said yes and another said I Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: like the staff. The manager and staff said that they have received training in how to manage peoples behaviour. Physical intervention is not used at the home. Care Homes for Adults (18-65 years) Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe and clean home, although some repairs and improvement are necessary. Evidence: The home is comfortable, warm and clean. There are enough bathrooms and showers for the people who live at the home. The manager said that there are plans to improve the bathrooms. In the communal bathrooms paper towels are not used as some people block the toilets with them. The manager said that hand towels are changed every time they are used. Each person has their own bedroom and they looked comfortable and clean. They were all personalised and made very individual. Most of the chairs at the home looked worn and institutional. Although the manager and staff said that the people who live at the home like them. The laundry is organised and clean. The backyard was being resurfaced at the time of the visit. Some of the paintwork on the doors and skirting boards was chipped and damaged. Care Homes for Adults (18-65 years) Page 19 of 27 Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sufficient numbers of staff are in post to meet the diverse needs of the people who live at the home and they have opportunities for training so they know how to give them good care and meet their needs. Furthermore the home has a recruitment procedures in place, which help to prevent risk of harm to the people who live there. Some records did not show that all checks had been carried out. Evidence: Staff said that they receive training, which helps them with their work. The manager said that all staff receive the training and support they need. Staff said and records showed that they all have mandatory training such as first aid food hygiene and safeguarding adults training. The manager said that over three quarters of the staff have vocational qualifications. Sufficient staff were on duty at the time of the visit. Staff said and records showed that sufficient staff had been on duty in the home the previous week.The manager said that they always work with more staff so they can cover sickness and holidays. Staff said that sufficient staff work at the home. The manager said that all staff have been CRB Criminal Records Bureau checked at an enhanced level to make sure they are suitable people to work at the home. All staff go Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: through a recruitment process and they cannot not start to work at the home until this is completed. They are interviewed and are only successful when they have two satisfactory references. Copies of staff records showed that checks had been carried out. The manager said that they had not had to recruit staff for some time. When they did they usually go through the job centre. This has meant that they had not required applicants to complete an application form with all of their details and work history. It was not clear from the records whether the work history of staff had been examined during the recruitment process. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The registered person is qualified and experienced and runs the home in the best interests of the people who live there and there are procedures in place that make sure they are protected as much as possible. Evidence: The manager is qualified and has worked at the home for some years. Staff said that they felt supported by the manager and that they are always available if they need to speak to them. It was observed during the visit that the home had a relaxed and friendly atmosphere and their was a pleasant rapport between the manager, staff and the people who live there. Information from the surveys returned was all positive about the management of the home. One health care professional said that the people at the home receive excellent care from staff . Some of the people at the home have lived there for some time and have are now over 65 years. This means that the home may have more people over this age than they are registered for, the manager said that they would deal with this immediately. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: People and their families are asked their views about the running of the home as much as possible. Staff said and records showed that the people have key workers who monitor their care at the home. One person said the staff are nice to talk to and another said I like all of the staff. Safety checks have been carried out on the equipment in the home such as testing electrical equipment and the servicing the central heating boiler. Fire safety risk assessments had been completed. The fire logbook showed that fire drills and fire instruction take place but fire instruction was not as regular as it should be. The manager said that this has taken place but had not been recorded. Staff said that they have fire drills and instruction. Records showed that regular training is provided for staff in fire safety and first aid. The home has procedures for staff when they deal with the peoples money so it is kept safe. Records showed that staff sign records when any of the residents money is used and the manager checks them regularly Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 34 19 Applications forms must be 28/02/2009 used for staff that are employed and their work history examined and a copy kept on their file. The records at the home must show that staff have been properly vetted. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 20 Copies of risk assessments carried out to assess whether people can safely administer their own medication should be kept in their care plans. Some of the furnishing should be more domestic ,comfortable and homely. 2 24 Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - 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. 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