Inspection on 18/04/07 for Beaufort Street (112)

This inspection was carried out on 18th April 2007.

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.

Other inspections for this house

Beaufort Street (112) 21/11/05

Beaufort Street (112) 18/11/04

Beaufort Street (112) 14/05/04

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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 Beaufort Street (112) 112 Beaufort Street Nelson Lancashire BB9 0BT Lead Inspector Mrs Susan Hargreaves Unannounced Inspection 18th April 2007 12:30 Beaufort Street (112) DS0000009628.V331322.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 Beaufort Street (112) DS0000009628.V331322.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. Beaufort Street (112) DS0000009628.V331322.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Beaufort Street (112) Address 112 Beaufort Street Nelson Lancashire BB9 0BT 01282 690703 01282 690703 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) Pendle Residential Care Limited Mrs Ann Suleman Care Home 2 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (2) of places Beaufort Street (112) DS0000009628.V331322.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection The service may accommodate up to a maximum number of 2 service users in the category mental disorder, excluding learning disability or dementia (MD) 21st November 2005 Date of last inspection Brief Description of the Service: 112, Beaufort Street (accommodating 2 younger adults) is part of Pendle Residential Care Ltd. Dispersed Homes Scheme. This is a semi-independent living scheme for younger adults who have mental health problems. This dispersed house has staff support according to the assessed need of the residents. A designated house key worker visits at least once a day and care support is available in the evening and at weekend as needed. A senior member of staff is on call at night and 24-hour emergency support is provided from the core house at Pendleview. Further support is provided by visits from the registered manager and provider. Beaufort Street is an end-terraced house, located in a quiet residential area near to Nelson town centre shops and other amenities. The house has onstreet parking, a small front garden area and a private back yard. There is a large outside utility/store room. Transport in staff cars is provided for residents. Upstairs are 2 single bedrooms and a house bathroom. Downstairs are a kitchen, dining/living room and front lounge. The current fees charged at Beaufort Street are £368 to £377 per week. There are no additional charges. A statement of purpose and service user guide was available to prospective residents and their relatives on request. Beaufort Street (112) DS0000009628.V331322.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key unannounced inspection, which included a visit to the home, was conducted at Beaufort Street on the 18th April 2007. No additional visits have been made since the last inspection. At the time of this inspection 2 residents were living at the home. During this visit the residents discussed the support they received from members of staff and their lifestyle. Care records and the premises were inspected. A visit was also made to Pendleview, the core home, where staff files and records were inspected. Discussions also took place with the manager and a member of staff who was responsible for carrying out some visits to the residents at Beaufort Street. What the service does well: What has improved since the last inspection? What they could do better: It was evident during the inspection that the manager was constantly looking to improve the quality of the service provided. This is good practice and should be continued. Beaufort Street (112) DS0000009628.V331322.R01.S.doc Version 5.2 Page 6 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. Beaufort Street (112) DS0000009628.V331322.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 Beaufort Street (112) DS0000009628.V331322.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 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Comprehensive assessments ensured the needs of the residents were identified and met. Residents understood the terms and conditions of residency at the home. EVIDENCE: The two residents had shared the house at Beaufort Street for several years. Both residents said they were happy with this arrangement and got on well together. The care records for each resident contained detailed needs assessments based on the mental health Care Programme Approach. These provided useful information for the care plans. The resident’s contracts had been up dated and contained information about insurance. This included the amount payable for the loss of those personal belongings covered by the policy. Beaufort Street (112) DS0000009628.V331322.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. Independence was encouraged and each resident was supported by designated care workers to make decisions about their lifestyle. EVIDENCE: Residents gave their permission for the inspection of their care plans. These plans contained detailed information about the needs of each resident and explained how these needs were to be met. A diary sheet was included in the records, which was completed by the support worker at the morning visit everyday. Care plans were reviewed every six months or when the needs of the resident changed. These reviews involved the resident, mental health professionals and the homes staff. Residents managed their own finances although Support was required from members of staff when claiming benefits. Information about advocacy services was available. The manager explained Beaufort Street (112) DS0000009628.V331322.R01.S.doc Version 5.2 Page 10 that residents would need and be given support to access these services if requested. Appropriate risk assessments had been carried out relating to the mental health needs of each resident and for safety in the home. Risk management plans were also in place. A policy & procedure for the action to be taken in the event of resident reported missing was in place. Beaufort Street (112) DS0000009628.V331322.R01.S.doc Version 5.2 Page 11 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. Residents were supported to have an active and fulfilling lifestyle. Healthy eating and independent living skills were promoted. EVIDENCE: The manager explained that residents were supported to pursue their own interests and hobbies. One resident said he went to Greenspace a gardening scheme for three days a week and to relaxation on one afternoon a week. The other resident attended a weekly walking club for people with mental health problems. He said he enjoyed the short walks and was doing a sponsored walk the following week. He also enjoyed reading and said he visited a number of different libraries in the area. Residents were able to travel independently to these activities by public transport or taxi. Beaufort Street (112) DS0000009628.V331322.R01.S.doc Version 5.2 Page 12 One resident said he liked watching TV and listening to CDs. He said he went to Woolies to buy CDs. The manager explained the residents had the opportunity to vote in elections if they wished and a member of staff would take them to the polling station if necessary. Visiting was unrestricted but residents were asked to respect their neighbours by not being too noisy. The residents determined the daily routine. One of the residents was responsible for doing the shopping and the cooking and the other resident did most of the cleaning. Both residents said they were happy with this arrangement. Both residents said they got on well with the staff and had the help they needed to be independent. The residents planned their own menus although staff encouraged and gave advice on healthy eating. Staff also checked the contents of the fridge and freezer daily and recorded the temperatures. Both residents were aware of hygiene issues when preparing and cooking food. Beaufort Street (112) DS0000009628.V331322.R01.S.doc Version 5.2 Page 13 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. Members of staff supported both residents to meet their own personal and healthcare needs. EVIDENCE: Personal care was monitored by staff and appropriate support given when necessary. One resident said that staff took him shopping for new clothes. Residents were registered with a GP and seen regualrly by a psychiatrist. The social worker also visted the residents regularly. Care plans were reviewed every six months and when the needs of the resident changed. Policies and procedures for the management of medication were in place. Residents had given signed consent for medication to be administered by members of staff. Medication for one day was put into dosette boxes by the member of staff who visited the house in the morning. Residents then took their medication at the appropriate time. Residents were discouraged from using homely remedies without asking staff for advice. Medication administration charts were up do date and records of medication received into Beaufort Street (112) DS0000009628.V331322.R01.S.doc Version 5.2 Page 14 the home were kept. Members of staff responsible for the administration of medication had received suitable training and advice from the pharmacist was readily available. Medication was reviewed six monthly or when the needs of the resident changed. Beaufort Street (112) DS0000009628.V331322.R01.S.doc Version 5.2 Page 15 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 excellent. This judgement has been made using available evidence including a visit to this service. Residents felt able to express their concerns. Staff had a good understanding of protection issues. EVIDENCE: No complaints have been to the home or the commission since the last inspection. Residents have been given a copy of the complaints procedure. One resident explained how he trusted his key worker and would tell her if he was unhappy with anything. Training on safeguarding vulnerable adults is included in the induction programme for all new members of staff. A Whistle Blowing policy is in place to enable members of staff to report poor practice. Beaufort Street (112) DS0000009628.V331322.R01.S.doc Version 5.2 Page 16 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. The house was well maintained and provided a comfortable and ‘homely’ environment for the residents. EVIDENCE: At the time of the inspection the home was clean, comfortable and well maintained. Since the last inspection the front lounge has been redecorated, refurnished and a new carpet fitted. The kitchen has also been redecorated and new floor covering fitted. Residents used a domestic style washing machine in the utility room for their laundry. An infection control policy was seen at the core house. Beaufort Street (112) DS0000009628.V331322.R01.S.doc Version 5.2 Page 17 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 excellent. This judgement has been made using available evidence including a visit to this service. Members of staff had the skills and knowledge necessary in order to meet the needs of the residents. Recruitment procedures were thorough. EVIDENCE: Residents received support from members of staff. The key worker usually visited the home every morning. When the key worker had days off or holidays another member of staff who the residents knew and trusted visited the home. The manager explained that the residents could ring the core house at anytime of day or night if they needed help. One resident said he had phoned late one night when he needed someone to talk to and had received the appropriate support. Training for all members of staff was actively encouraged. An organisational training plan was displayed in the office at the core house. Training included, basic food hygiene, health and safety, first aid, de-escalation and break away, fire safety and medication. In addition to this four out of seven staff had NVQ qualifications at level 2 or above. The manager explained that mental health Beaufort Street (112) DS0000009628.V331322.R01.S.doc Version 5.2 Page 18 issues were discussed at staff meetings and case histories analysed. Induction training was in place for all new employees. This programme took three months to complete and followed the skills for care syllabus. Mental health problems were also included in induction training and members of staff were made aware of the signs of deteriorating mental health for each resident. The manager was responsible for induction training but external training providers were used for health and safety, first aid training etc. Beaufort Street (112) DS0000009628.V331322.R01.S.doc Version 5.2 Page 19 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, 41 and 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home was effectively managed and provided person centred care for both residents. EVIDENCE: The registered manager has completed management training and is currently studying for a certificate of education. This will support the training and education of staff that is considered by the management to be important in maintaining standards at the home. The manager maintains an up to date knowledge of mental health issues by attending PCT mental health meetings, reading care journals and using the internet. One resident commented that the manager was a nice person. The home has achieved the nationally accredited Investors in People award. Beaufort Street (112) DS0000009628.V331322.R01.S.doc Version 5.2 Page 20 Questionnaires are distributed to residents annually. The last one was done in March 2007 and completed copies of the questionnaire were seen. An annual development plan was in place and due to be up dated. The proprietor visited the home monthly to check if the residents needed anything or had any problems. Residents were also encouraged to express their views about the home to their key worker at any time. Policies and procedures for safe working practices were in place. Fire alarms and emergency lighting were tested weekly. Fire drills involving the residents also took place weekly. A fire risk assessment was in place and reviewed annually or when necessary. Residents attended fire awareness training with members of staff. Certificates of attendance were seen in the residents care records. Records of the routine servicing of equipment were seen. This included the testing of small electrical appliances and up to date gas safety and electrical installation certificates. The kitchen was clean and tidy. The temperatures of the fridge and freezer were checked and recorded daily. Beaufort Street (112) DS0000009628.V331322.R01.S.doc Version 5.2 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 Standard No Score 1 X 2 3 3 X 4 X 5 3 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 4 33 X 34 3 35 4 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 4 13 4 14 X 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 X 3 X 3 3 X Beaufort Street (112) DS0000009628.V331322.R01.S.doc Version 5.2 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. 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 Beaufort Street (112) DS0000009628.V331322.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 © 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 Beaufort Street (112) DS0000009628.V331322.R01.S.doc Version 5.2 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. 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