Inspection on 05/09/05 for Barkerhouse Road (123)

This inspection was carried out on 5th September 2005.

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

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

Other inspections for this house

Barkerhouse Road (123) 27/01/05

Barkerhouse Road (123) 10/08/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 123 Barkerhouse Road 123 Barkerhouse Road Nelson Lancs BB8 0JL Lead Inspector Keren Nicholls Unannounced 5 September 2005 9.40am th 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. 123 Barkerhouse Road F57 F07 S43990 Barkerhouse Rd V247815 5.9.05 Stage 2.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 123 Barkerhouse Road Address 123 Barkerhouse Road Nelson Lancs BB8 0JL 01282 449647 01282 690703 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) Pendle Residential Care Ltd Mrs Ann Suleman Care Home 1 Category(ies) of MD Mental Disorder, excluding learning registration, with number disability or dementia of places 1 123 Barkerhouse Road F57 F07 S43990 Barkerhouse Rd V247815 5.9.05 Stage 2.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 2. The service may accommodate up to a maximum of 1 service user in the category mental disorder, excluding learning disability or dementia (MD) Date of last inspection 15 June 2005 Brief Description of the Service: 123, Barkerhouse Road (accommodating 1 younger adult) is part of a residential dispersed homes’ scheme in Nelson. This is a semi-independent living scheme for younger adults who have mental health problems, with a staffed ‘core’ house at Pendle View. This dispersed house has staff support according to the assessed need of the service user. The home has a designated house keyworker. Further support is provided by visits from the registered manager and provider and care workers as needed. The home has an arrangement with the staffed ‘core’ house nearby to provide 24 hour emergency support. Designated senior persons are on-call at night. Barkerhouse Road is a terraced house, located in a residential area near to local shops. Nelson town centre shops and other amenities are a short distance away. The house has small front and back gardens. There is one good sized single bedroom, with a further bedroom (currently used as office storage) and a first floor house bathroom. There is a kitchen/dining room, utility area and living room on the ground floor. The house has on-street parking. There are good local transport links, or transport in staff cars is provided for the service user. 123 Barkerhouse Road F57 F07 S43990 Barkerhouse Rd V247815 5.9.05 Stage 2.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second of two statutory inspections to be conducted between April 2005 and April 2006. This unannounced inspection took place between 09:40 and 11:45am. During this time the inspector spoke to the service user and a care support worker, looked at written information and records and with the permission of the service user, viewed the premises. What the service does well: What has improved since the last inspection? What they could do better: In order to clarify the rights and responsibilities of all parties, the contract/terms and conditions of residence agreed with the service user should specify the arrangements for the annual weeks’ holiday and what is meant by the term ‘shopping’. 123 Barkerhouse Road F57 F07 S43990 Barkerhouse Rd V247815 5.9.05 Stage 2.doc Version 1.40 Page 6 To promote health and safety and protect the service user from harm the manager should make sure, through risk assessment and staff support that the service user understands how to use the complaints procedure and fully understands how to put into practice health and safety procedures such as fire safety, safe use of cleaning products etc. The responsibility for purchasing cleaning products and household goods should be clarified. The manager and staff should support the service user to fully understand and put into practice health and safety policies and procedures, especially those relating to moving objects, fire safety, first aid, food hygiene, infection control, safe use and storage of cleaning products and maintaining a safe environment. The manager should also ensure that the identity of visitors is ascertained before inviting them in. To protect and represent his best interests, the manager should ensure that the amended policies and procedures are made available to and discussed with the service user. Every member of staff should receive training in the protection of vulnerable adults, based on ‘No Secrets’ guidance and related to the needs of the service user and the aims of the home. 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. 123 Barkerhouse Road F57 F07 S43990 Barkerhouse Rd V247815 5.9.05 Stage 2.doc Version 1.40 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 123 Barkerhouse Road F57 F07 S43990 Barkerhouse Rd V247815 5.9.05 Stage 2.doc Version 1.40 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) 1, 2, 3, 4 and 5 The service user had been consulted about needs and wishes prior to admission. He had visited and been given written information about the home, which had enabled him to make an informed decision about whether Barkerhouse Road was the right place to live. Trained people had helped to assess needs, to ensure that they could be met by the home. A contract/ terms and conditions of residence had been drawn up, to ensure that everyone’s rights and responsibilities were known. EVIDENCE: The new person had been given a copy of the ‘service user’s guide’, which explained the aims and objectives of the home and relevant information about complaints, the premises and staff team. This and the home’s ‘Statement of Purpose’ were available in the lounge. These were under review by the manager, to make sure they are easy to read and understand. The admission procedure was designed to ensure that prospective residents needs and wishes could be met by the home. The service user had the support of his social worker and had been involved in a needs assessment as part of the mental health Care Programme Approach (CPA) arrangements. Following his initial visit and trial period, the service user was in the process of agreeing a contract / terms and conditions of residence (to ensure that both parties’ rights and responsibilities are protected) and in drawing up his care plan. It was recommended the contract makes explicit what is meant by ‘shopping’ and clarifies holiday arrangements. 123 Barkerhouse Road F57 F07 S43990 Barkerhouse Rd V247815 5.9.05 Stage 2.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8, 9 and 10 There were good arrangements to draw up and regularly review care plans with the service user, based on the Care Programme Approach. The service user was enabled to look after his house. Staff supported the service user to be independent and take responsible risks. Confidentiality was understood within a risk assessment framework and was respected by staff. EVIDENCE: The way of life at Barkerhouse Road promoted participation in decision-making and supported independence. The service user lived alone and said he made decisions about running his home and how he occupied his time. Staff support was given within a risk-assessed framework, in order for him to be safe and feel confident. The service user said he liked being able to telephone for assistance or to talk to staff whenever he needed. The service user said he had been discussing his care plan with the manager and staff and allowed inspection of his plan. Aims for care were explicit and included the involvement of others, such as mental health professionals. Risk management strategies were identified. Staff respected confidentiality within the boundaries of the home’s policy. Confidential information was kept locked away safely and securely, but the service user knew he could look at files if he wanted. 123 Barkerhouse Road F57 F07 S43990 Barkerhouse Rd V247815 5.9.05 Stage 2.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15, 16 and 17 The home provided a supportive environment for the service user to maintain family links and participate in appropriate leisure and social activities of his choosing. Staff respected rights and helped the service user with personal development, community and social inclusion. Healthy eating was promoted. EVIDENCE: The service user said he felt “better” since living at Barkerhouse Road and was settling in following life changes. He had opportunities to keep in touch with family and friends nearby and with family further afield by telephone. He enjoyed hobbies and interests such as TV, videos and going for walks and made use of the local drop in resource centre. Lapsed interests were discussed and the support worker and service user said they were considering how his range of social and community interests could be extended with staff support, as part of his care plan. The service user explained that he was quite a good cook and was looking at healthy eating plans when food shopping. He said he liked to keep the house clean and tidy, did his own laundry and enjoyed the supported independence. 123 Barkerhouse Road F57 F07 S43990 Barkerhouse Rd V247815 5.9.05 Stage 2.doc Version 1.40 Page 11 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 and 20 Personal and healthcare support was provided in a flexible and individual manner, which respected the service user’s dignity and independence. There was a good system for safe administration and service user self-administration of medicines. EVIDENCE: The service user explained that he made choices about personal routines, such as getting up/going to bed times, bathing, clothes choice, going out etc. Personal care needs were recorded in a care plan with staff help as needed. Healthcare was monitored by the service user’s assessment of need and staff observation. The service user explained that the manager was helping him to change to a GP of his choice. Appropriate professionals oversaw mental healthcare needs and the service user said he could have staff support to attend hospital and other appointments (including routine checks by dentist, optician, chiropodist etc.) if he wished and he had continuity of support throughout his move to Barkerhouse Road. Consent to medication was recorded as part of the CPA and in the home’s care plan. Daily self-administration was risk-assessed and agreed with the individual. There were safe medication storage, recording and administration policies and procedures, which were followed by staff who had accredited training. 123 Barkerhouse Road F57 F07 S43990 Barkerhouse Rd V247815 5.9.05 Stage 2.doc Version 1.40 Page 12 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 and 23 The service user was unaware of the home’s complaints procedure and this should be properly explained. The amended adult protection procedures were not available and those at the home did not detail an appropriate response to suspicion or evidence of abuse. Staff had a good understanding of how to protect residents, but insufficient training in how to respond to an allegation of abuse. EVIDENCE: The service user had a copy of the complaints procedure in the service user’s guide, but was not aware of how to make a complaint. It was recommended that the manager should ensure that the procedure is effective by being understandable to this person. The service user said that he had no complaints at present and was satisfied that he could talk to a care worker if he had a problem. The manager had started to review and amend the policies on the protection of vulnerable adults based on the ‘No Secrets in Lancashire’ guidance, a copy of which was on hand in the home. The service user said he felt safe but the procedure available at the home did not adequately protect the service user. The care worker had a good understanding of how to protect residents by following financial and care practice procedures but had no formal training in protection of abuse and did not know how to respond to allegations or suspicion of abuse in accordance with ‘No Secrets’. The manager had revised the policy regarding referring unsuitable staff for consideration of inclusion on the Protection of Vulnerable Adults (POVA) register and brought this to the attention of staff. 123 Barkerhouse Road F57 F07 S43990 Barkerhouse Rd V247815 5.9.05 Stage 2.doc Version 1.40 Page 13 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) 24, 25, 26, 27, 28, 29 and 30 The house was small, non-institutional and suitable for its stated purpose of supported semi-independent living for one younger adult who has a mental health problem. The house was comfortable, ‘homely’ and had good standards of maintenance, décor and cleanliness. There was no assessed need for aids or adaptations at present. EVIDENCE: Barkerhouse Road provides very spacious accommodation, with a large front bedroom, lounge and dining room/kitchen. The furniture, fittings and decoration were domestic in style and of suitable quality. The service user kept the house very clean and commented that he liked his house very much. The property was comfortable, bright and cheerful and provided sufficient and suitable light, heat and ventilation. There was a pleasant house bathroom, with a shower over the bath. The house is near to local transport, shops and other amenities and was in keeping with other houses in the locality. The registered provider visited once a month in accordance with the requirements of legislation and ensured that the premises were satisfactory, and that planned and recorded maintenance, renewal and refurbishment requirements were carried out in a timely fashion. 123 Barkerhouse Road F57 F07 S43990 Barkerhouse Rd V247815 5.9.05 Stage 2.doc Version 1.40 Page 14 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) 35 Suitably qualified, experienced, competent and well-motivated staff were available to ensure that the service user’s needs were met at all times. EVIDENCE: A qualified and experienced house keyworker oversaw care at the home, under the direction and supervision of the registered manager. The care worker on duty had received appropriate induction and foundation training, had completed mental health courses and was undertaking NVQ level 2. Training had included health and safety issues, fire safety, first aid and basic food hygiene. To reduce risk, it was recommended that all staff supporting the service user at Barkerhouse Road should receive protection of vulnerable adults training, as identified in the home’s aims. The service user said that he liked all the staff and particularly liked being able to contact staff at any time during the day and night, which lessened anxiety and gave him confidence and security, whilst promoting independence. 123 Barkerhouse Road F57 F07 S43990 Barkerhouse Rd V247815 5.9.05 Stage 2.doc Version 1.40 Page 15 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) 39, 40 and 42 A qualified and experienced registered manager, who ensured that the home was run in the best interests of the service user and who provided appropriate leadership for the staff team, was in charge of Barkerhouse Road. Generally sound and comprehensive policies and procedures underpinned care and health and safety practices, ensuring that risks to service users were minimised. The manager was updating policies and procedures and record keeping, to ensure these properly supported residents’ care. Systems that encouraged and enabled residents to express their views and opinions were in place. EVIDENCE: A good system for quality assurance and seeking the views of service users and others was in place. This included an annual service user satisfaction survey (the results published in an a newsletter for service users), formal gathering of individual’s views through care planning meetings and informal discussion with the service user and the registered persons and staff. Action in response to the Commission’s requirements and recommendations following inspection had been progressed. 123 Barkerhouse Road F57 F07 S43990 Barkerhouse Rd V247815 5.9.05 Stage 2.doc Version 1.40 Page 16 The service user had met the registered persons, the house keyworker and other staff and said he liked everyone and thought they were approachable. He felt confident in contacting staff and thought he was listened to. He had been consulted about his care plan and about living at the home. The manager had been conducting a review of the policies and procedures, but the amended ones were not available at Barkerhouse Road. The care worker said that staff and residents at the core house (Pendle view) had been discussing the new policies. The service user was not aware of the policies and procedures file, although it was available in the lounge. It was recommended that the staff discussed relevant policies and procedures with the service user, such as fire safety, complaints and health and safety issues. The service user had a general knowledge of safety issues. He said he felt safe and followed appropriate security of the house. However, to protect the health and safety of the service user, the manager and staff should also support this person in understanding how to put policies into practice, for example fire safety, food hygiene, first aid, infection control, health and safety and ascertaining the identity of visitors. Risk assessments regarding cleaning products should be specific to the service user. 123 Barkerhouse Road F57 F07 S43990 Barkerhouse Rd V247815 5.9.05 Stage 2.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 2 Standard No 22 23 ENVIRONMENT Score 2 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 N/A 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 123 Barkerhouse Road Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 2 x x 2 F57 F07 S43990 Barkerhouse Rd V247815 5.9.05 Stage 2.doc Version 1.40 Page 18 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 There were no requirements from this inspection 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. 2. 3. Refer to Standard 5 22 23 Good Practice Recommendations That the contract/terms and conditions of residence makes explicit was is included in shopping and clarifies the contractual holiday arrangments of the individual (5.2 (iv)) That the homes complaints procedure is explained to the service user (22.3) That the manager ensures the amended policy (protection from abuse policy/procedure) is made available to the service user and staff (23.2) and that staff receive instruction in how to follow procedures which are based on No Secrets guidance (23.1) That every staff member receives training in the protection of vulnerable adults, based on No Secrets guidance and related to the needs of the service users and the aims of the home (35.7) This recommendation was carried forward from the last inspection: It is recommended that the ways in which service users are formally involved in determining staff training needs and perhaps being involved in training themselves should F57 F07 S43990 Barkerhouse Rd V247815 5.9.05 Stage 2.doc Version 1.40 Page 19 4. 35 123 Barkerhouse Road 5. 40 6. 42 be clarified with the service user (35.7). That the amended policies and procedures are made available to the service user and staff at the home and that relevant policies are explained to the service user (40.4) That the manager and staff ensure that staff support the service user to fully understand how to put into practice health and safety policies and procedures, especially those relating to moving objects, fire safety, first aid, food hygiene, infection control, safe use and storage of cleaning products and maintaining a safe environment. The manager should also ensure that the identity of visitors is ascertained before inviting them in (42.2 and 42.3) 123 Barkerhouse Road F57 F07 S43990 Barkerhouse Rd V247815 5.9.05 Stage 2.doc Version 1.40 Page 20 Commission for Social Care Inspection Unit 4 Petre Road Clayton-le-Moors Accrington BB5 5JB 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 123 Barkerhouse Road F57 F07 S43990 Barkerhouse Rd V247815 5.9.05 Stage 2.doc Version 1.40 Page 21 - 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. 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