CARE HOME ADULTS 18-65
Anna S Proctor House 23/24 Summerhill Shotley Bridge Durham DH8 0NQ Lead Inspector
John Trainor Unannounced Inspection 9th January 2007 11.00 Anna S Proctor House DS0000060994.V325318.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Anna S Proctor House DS0000060994.V325318.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Anna S Proctor House DS0000060994.V325318.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Anna S Proctor House Address 23/24 Summerhill Shotley Bridge Durham DH8 0NQ 0191 4881057 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) Rayson Homes Limited Mrs Sheila Kelly Care Home 14 Category(ies) of Learning disability (11), Learning disability over registration, with number 65 years of age (3) of places Anna S Proctor House DS0000060994.V325318.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 16th December 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. Fees at the time of inspection were £378.50. Anna S Proctor House DS0000060994.V325318.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The provider gave information to the Commission for Social Care Inspection before a site visit, which was unannounced and lasted 3 hours. This included feedback from people who live in the home, their relatives, a doctor and nursing sister. During the site visit records were inspected including care plans and health and safety records. People were spoken to including residents, staff and management. There was a tour of the building. What the service does well: What has improved since the last inspection?
The home had fitted door guards in order to make sure doors could be wedged open safely when people wanted them open. Several home improvements had been made. Some rooms had new windows and there were some new carpets and blinds. Improvements had been made to sitting area at the rear of the house. Anna S Proctor House DS0000060994.V325318.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Anna S Proctor House DS0000060994.V325318.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Anna S Proctor House DS0000060994.V325318.R01.S.doc Version 5.2 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People could choose to move into the home knowing their needs had been assessed and the home could meet them. EVIDENCE: All files inspected had pre admission assessments on them. A decision could be made as to whether the home could meet people’s needs based on these assessments. One person said of their relative, that they, “visited Proctor house on several occasions, for tea, overnight and weekend stays before the admission to see if he liked it.” Anna S Proctor House DS0000060994.V325318.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People had their needs met in a planned way with respect for their own choices. EVIDENCE: All files inspected had care plans. These included risk assessment and risk management. People said they had choice in the home and could choose diet and activities. Discussions with the manager confirmed people had access to independent advocacy if they needed it. One person said of furniture in their rooms, “ you can have what you want.” Another said of the food, “I have porridge for breakfast and toast and a banana, you can choose.” Another said, “The staff listen to what I say.” Anna S Proctor House DS0000060994.V325318.R01.S.doc Version 5.2 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People’s lifestyle met their expectation. EVIDENCE: People had activities to occupy their time as part of a multi disciplinary package. The home provided activity staff to do work with people individually and in groups. Records showed a variety of things to occupy people’s time. There was television and home entertainment. Some people attended day care, colleges and there were outings. Some people attended church and church groups. People enjoyed going into town and shopping. Pre inspection information was born out by feedback from service users in the home who enjoyed their lives and lifestyle. “Yes I like going out we get a choice of where to go, I like going to the library…..we can go to the café for a drink and have a look round the shops.” “I am happy doing what we do.” Family and friends could visit when they wished. Food was said to be good. People said they had
Anna S Proctor House DS0000060994.V325318.R01.S.doc Version 5.2 Page 11 a varied diet which they could choose. People had an annual holiday. People said at the site visit, “We’ve been to the metro centre for the sales and we went to see Peter Pan.” (a pantomime) Anna S Proctor House DS0000060994.V325318.R01.S.doc Version 5.2 Page 12 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People had their health and social care needs met in a planned way with regard for their individual preference. EVIDENCE: All care files inspected had care plans which identified peoples health needs and how they should be met. There was attention to detail. Care files showed access to both primary and secondary health services. The home manager reported a good relationship with local health services. There were local authority assessments and plans on file. Medicines were stored safely and administration was accurately recorded. The community pharmacist had confirmed in a letter the medication storage arrangements were acceptable. One GP fed back, “ I have always found the staff at Proctor House to be helpful, well informed about their residents and very caring.” Whilst a community nurse said, “always a warm welcome when entering the home. Clients always happy and well cared for. Home is always clean, tidy and homely. Any instruction given always followed….they will ring for advice and support…. A pleasure to deal with this home.”
Anna S Proctor House DS0000060994.V325318.R01.S.doc Version 5.2 Page 13 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s concerns were listened to and procedures were in place to deal with potential abuse. EVIDENCE: There were no formal complaints to the home since the last inspection. Concerns were dealt with as they arise through service user meetings. People reported the home management was approachable. The complaints process included timescales to deal with complaints. There were instructions how to proceed if unhappy with the response, up to the local authority complaints process. There were adult abuse procedures in place and staff had received training. On the day of inspection staff could identify processes for reporting abuse should the need arise Anna S Proctor House DS0000060994.V325318.R01.S.doc Version 5.2 Page 14 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People lived in a clean, safe and comfortable home and liked their surroundings. EVIDENCE: The home was clean and tidy. Various parts of the home had been refurbished including replacing windows and decorating and evidenced a commitment on behalf of the owners to improve things in a planned way. The home did not use paper towels as they had previously had problems with people trying to flush them down toilets. However hand towels were supplied and placed in the laundry after a single use. Anna S Proctor House DS0000060994.V325318.R01.S.doc Version 5.2 Page 15 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People were supported by a well qualified staff team deployed in sufficient numbers to meet needs. EVIDENCE: Staffing levels exceeded residential forum guidance so there were enough staff to look after people. 85 of staff were qualified to NVQ 2 or above. Feedback from service users, relatives and professionals said the staff were supportive knowledgeable and kind. All staff had been CRB checked to make sure people would be safe from abuse. Anna S Proctor House DS0000060994.V325318.R01.S.doc Version 5.2 Page 16 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was well managed in the interests of the people who live there. EVIDENCE: The home was well managed. The manager had been in post for several years and was qualified to NVQ level 4 in care management. Health and safety checks were conducted in line with recommended timescales. The home had been inspected by environmental health and fire safety. There was an annual quality assurance review. A recent audit by social services contracts department confirmed service user monies were looked after well and were accurately recorded. Anna S Proctor House DS0000060994.V325318.R01.S.doc Version 5.2 Page 17 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 4 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Anna S Proctor House DS0000060994.V325318.R01.S.doc Version 5.2 Page 18 Are there any outstanding requirements from the last inspection? No. STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Anna S Proctor House DS0000060994.V325318.R01.S.doc Version 5.2 Page 19 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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