Inspection on 15/08/05 for Beech Hill, 230 Spotland Road

This inspection was carried out on 15th August 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Beech Hill, 230 Spotland Road 22/01/08

Beech Hill, 230 Spotland Road 30/10/06

Beech Hill, 230 Spotland Road 15/02/06

Beech Hill, 230 Spotland Road 24/01/05

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Beech Hill, 230 Spotland Road, Rochdale, OL12 6QD. Lead Inspector Diane Gaunt Unannounced 15 August 2005 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. Beech Hill, F06 F56 S62677 Beech Hill V230376 Stage 4 15.08.05.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Beech Hill Address 230 Spotland Road, Rochdale, OL12 6QD. 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) 01706 651702 Pendleton Care Limited Care Home 3 Category(ies) of Learning Disability 3 registration, with number of places Beech Hill, F06 F56 S62677 Beech Hill V230376 Stage 4 15.08.05.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 3 service users to include:up to 3 service users in the category of LD (Adults with learning disabilities). 2. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection 15th August 2005 Brief Description of the Service: Beech Hill is a large stone semi-detached property, which provides twenty-four hour care for 3 young adults with learning disabilities on a long term basis. Care is provided by Pendleton Care Ltd – a company that specialises in the care of young adults with autism. The property is owned by a private landlord and comprises of 3 large bedrooms, lounge, dining room and dining kitchen. The house is indistinguishable from other properties in the surrounding area. It is situated in a residential area and is in close proximity to local shops, services etc and within easy reach of Rochdale town centre. A bus service passes the house. There is a lawned garden area to the rear of the house. A car park is not provided although on-street parking is available. Access to the main door is via one step. A lift is not provided in the house as none of the service users require such facility. Beech Hill, F06 F56 S62677 Beech Hill V230376 Stage 4 15.08.05.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over five and a half hours. The Inspector looked around parts of the building, checked care plans and some records. The inspector also spoke with two service users, two support workers and the acting manager and spent a short time watching how staff worked with residents. Before the inspection 2 service users, 3 relatives and 2 care managers filled in comment cards about the care given at Beech Hill. Their comments are included in the report. All the service users had lived at the house for 4 months. A new manager had also come to work at the home. She had applied to be registered as manager with the Commission for Social Care Inspection (CSCI). What the service does well: What has improved since the last inspection? What they could do better: Beech Hill, F06 F56 S62677 Beech Hill V230376 Stage 4 15.08.05.doc Version 1.40 Page 6 Beech Hill must provide better written information about the home for service users, their relatives and CSCI and keep care plans up to date. They must provide a bathroom door lock that works and get rid of the damp in the basement. A new landing carpet should be bought. More staff should be found to work at Beech Hill permanently. These staff should all work in the same way with service users and the manager should check that there are enough staff hours to support service users. Staff should have more training especially about what to do in a fire and with regard to learning disability and autism spectrum disorders. 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. Beech Hill, F06 F56 S62677 Beech Hill V230376 Stage 4 15.08.05.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 Beech Hill, F06 F56 S62677 Beech Hill V230376 Stage 4 15.08.05.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) 2 and 4. Service users all received a full assessment prior to moving to the house. This included their wishes and feelings and ensured their health, social, emotional and personal care needs could be met on admission. Opportunity to visit and ‘test drive’ the house was provided. EVIDENCE: The files of each of the service users were inspected. Each moved to Beech Hill from other houses in the Pendleton Care group. Assessments undertaken by care managers prior to them moving into the care of Pendleton Care were held at Beech Hill. In addition, transition plans were held on file and included service users’ wishes and feelings regarding the move to Beech Hill. Records showed that each service user had expressed a wish to move and indicated a preference for an all female household. Transition plans addressed areas of communication, increasing familiarity, introducing change, managing anxiety and potential problems. Where appropriate, the plans were supported by behavioural psychologist reports. Strategies to address some of the issues raised in the plans were recorded and included introductory visits, spending time with staff and each other, choosing bedrooms, colour schemes and active involvement in decoration of the premises. Discussion with service users indicated they were satisfied with the level of their involvement in the move and were pleased they made the move. Beech Hill, F06 F56 S62677 Beech Hill V230376 Stage 4 15.08.05.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, and 9 Detailed care plans which encompassed service users’ aspirations and needs were written but required updating in some areas. Service users made decisions about their lives and were supported to take responsible risks within a risk management framework. EVIDENCE: Care plans were in place for each service user. Whilst they were detailed and up to date in most areas they were in need of amending/updating in others as they contained interventions in use at service users’ previous homes, which in some instances conflicted with those written for Beech Hill. However, attention had been given to writing new interventions, risk assessments and management strategies in order that staff knew the approach they should be taking at Beech Hill. The plans covered a wide area including: personal profile, daily living skills, communication abilities, social interaction, leisure/social activities, independence, behavioural profile and identified any potential adult protection safeguards. Detailed behavioural and management strategies for challenging behaviour were also in place and included input from the organisation’s behavioural psychologist. One service user spoken with had knowledge and clear understanding of interventions in place, including expectations of her. All strategies and interventions in place at Beech Hill had Beech Hill, F06 F56 S62677 Beech Hill V230376 Stage 4 15.08.05.doc Version 1.40 Page 10 been reviewed by the keyworker after 3 months, and service users, relatives and care managers had been involved in the process as part of the home’s quality assurance strategy. In addition keyworkers had reviewed with service users on a monthly basis. These meetings were seen to be focussed on the service users’ aspirations and individual goals planned around Essential Skills. Observation and discussion with one service user provided evidence that staff were acting upon these aspirations. Discussion with an agency worker and a worker seconded to Beech Hill from another Pendleton Care house showed that they were both aware of the support required by service users and risk/management strategies in place. Social Services Department reviews with care managers had been requested in respect of each service user. Two service users spoken with said they were satisfied with their care at Beech Hill – one service user described it as ‘brilliant’. Comment cards completed by relatives and care managers endorsed this and recorded satisfaction with care provided. On the day of the inspection service users were seen to be making decisions about their lives although in some instances these decisions were contrary to planned care, and challenged strategies in place. Staff were seen to respect service users wishes in these instances whilst ensuring they had the information they needed to make informed choices. It did create tensions however. Inspection of Incident Reports showed an increase in challenging behaviour within the house over the previous 6 weeks and raised questions with regard to boundaries and consistency of approach. Staff considered that to some extent this was related to the newness of the setting and testing of boundaries. None of the service users were involved in local advocacy groups although one person had joined a youth group which provided peer support for people with the same disability. One service user received their personal allowance on a weekly basis and chose how to spend it, along with her pay from a part-time job. She also managed her own bank account. This arrangement marked progress from her financial management when living at the previous house. Personal allowance monies in respect of the two other service users were held in the office and service users were supported to spend it as and when they wished. Essential skills goals were set to encourage development in this area. Detailed risk assessments and behaviour management strategies were in place for the protection of service users/others. The strategies had been discussed and agreed with service users and relatives. They had also been regularly reviewed. Appropriate recordings were in place when staff had used agreed intervention techniques. Beech Hill, F06 F56 S62677 Beech Hill V230376 Stage 4 15.08.05.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13 and 15. Service users were supported by staff to take part in appropriate activities of their choosing, the majority of which were community based. Relationships with family and friends were actively encouraged and maintained with staff support. EVIDENCE: One service user had a part time job and another told the inspector she had registered with an agency which was seeking work on her behalf. In the interim she was undertaking work experience one day a week with Pendleton Care. Essential Skills files were held for each service user and contained specific developmental goals which each service user was working towards with the support of staff. The goals were seen to be focussed, realistic and achievable. In order to achieve some of the goals service users attended the Pendleton Care Development Centre, although two service users were actively choosing not to attend as regularly as planned at the time of the inspection. Pendleton Care issued certificates on achievement Beech Hill, F06 F56 S62677 Beech Hill V230376 Stage 4 15.08.05.doc Version 1.40 Page 12 Community activities enjoyed by the service users included visits to the cinema, supermarkets, shops, parks, discos, and local snooker hall. Arrangements were being made for one service user to go motor bike scambling. Going for drives around the area was also enjoyed by one of the service users and all service users enjoyed days out in Blackpool. None of the service users routinely used public transport although on occasion staff supported two service users to do so. One service user was looking forward to travelling by train, supported by a staff member, to meet relatives for a holiday. Another was to spend a week abroad with family. Inspection of files and discussion with service users provided evidence of the staff support to service users to maintain links with family and friends. This was further endorsed by comment cards completed by relatives all of whom said they were made to feel welcome when they visited and could see service users in private. All relatives said they were kept informed of important matters and consulted appropriately. One relative considered communication was excellent and any phone calls were returned promptly. As none of the relatives lived locally the acting manager said she maintained telephone contact with family members on a regular basis. Beech Hill, F06 F56 S62677 Beech Hill V230376 Stage 4 15.08.05.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standards were assessed. EVIDENCE: Beech Hill, F06 F56 S62677 Beech Hill V230376 Stage 4 15.08.05.doc Version 1.40 Page 14 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) None of these standards were assessed. EVIDENCE: Beech Hill, F06 F56 S62677 Beech Hill V230376 Stage 4 15.08.05.doc Version 1.40 Page 15 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 and 30 The home was decorated to a good standard and provided a homely, attractive environment for service users. The home was clean and hygienic, although the basement was very damp. EVIDENCE: Beech Hill is a large terraced house situated close to Rochdale town centre and near to local amenities i.e. Post Office, shops, takeaway restaurants. It was in keeping with the locality and provided good access to local transport and amenities. A spacious lounge, dining room and large kitchen were provided along with 3 service user bedrooms. The house had been closed whilst it was redecorated and refurbished prior to the present service user group moving in and was generally seen to be in good order. It was seen to be accessible, safe, clean, comfortable, roomy, and free from offensive odour. However, it was noted the landing carpet was in need of replacement and the basement was very damp, with the damp spreading up the building. The building is leased and the inspector was informed negotiations were ongoing with the landlord. Beech Hill, F06 F56 S62677 Beech Hill V230376 Stage 4 15.08.05.doc Version 1.40 Page 16 There have been no inspections by GM Fire officers or Environmental Health Officers since the house reopened. The manager was pursuing the matter. The laundry was sited in the basement away from food preparation areas. A toilet was located in this area. A washbasin was provided for hand washing, and paper towels and liquid soap provided throughout. The washer had a prewash programme and was able to wash at temperatures in excess of 65°C. A service user was using the washer with ease during the inspection. Staff had received training in basic hygiene practices. They were not involved in providing intimate personal care for service users. Beech Hill, F06 F56 S62677 Beech Hill V230376 Stage 4 15.08.05.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 and 35 The staff team was too small to provide the consistent care needed by service users. Permanent staff had the collective skills, training and expertise to undertake their roles efficiently and effectively. EVIDENCE: The ratios of support staff to service users was agreed with their individual care managers following assessment. A reduction had recently been agreed in respect of one service user to 5 hours 1 : 1 per day. During the inspection this service user required 1 : 1 care throughout, although the inspector was informed this was not always the case. Whilst sufficient staff were provided to meet the agreed ratios, the permanent staff team at Beech Hill was small and insufficient to staff the rota. Agency staff and workers from other Pendleton Care houses worked at the house to ensure required hours were provided. However, this created inconsistency for service users at a time when they were still settling into the house. Incidents requiring physical intervention at the house had increased; inconsistent staffing could be a contributory factor. Posts had been advertised widely but no suitable applicants found. Further interviews were to be held the week following the inspection. All staff were female in keeping with service users’ wishes. An up to date training matrix was provided for the inspector and showed training provided. As the house re-opened in April 2005 the amount of training per year could not be checked. The manager will monitor over the remaining Beech Hill, F06 F56 S62677 Beech Hill V230376 Stage 4 15.08.05.doc Version 1.40 Page 18 year. A 2½ day induction course addressed values and principles of care; learning disability and autism spectrum disorders and an introduction to challenging behaviour. The matrix showed that most of the staff had received training in challenging behaviour, and physical intervention but not in learning disability and autism spectrum disorders. In order to provide some input in this area, the manager provided books for staff which they could access easily. The agency staff member found this to be particularly helpful. In addition, Pendleton Care have a library which staff can access at Salford. The majority had completed the range of health and safety training, but there were some exceptions. The manager had completed NVQ level 4/Registered Managers Award and was studying for an MA in Autism on a part-time basis. All the support workers had attained at least NVQ level 2 qualifications. The inspector was informed that Pendleton Care were supportive with regard to training and responded to requests for attendance on relevant short courses. Beech Hill, F06 F56 S62677 Beech Hill V230376 Stage 4 15.08.05.doc Version 1.40 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 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) None of these standards were assessed. EVIDENCE: Beech Hill, F06 F56 S62677 Beech Hill V230376 Stage 4 15.08.05.doc Version 1.40 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 x x Standard No 31 32 33 34 35 36 Score x x 1 x 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Beech Hill, Score x x x x Standard No 37 38 39 40 41 42 43 Score x x x x x x x F06 F56 S62677 Beech Hill V230376 Stage 4 15.08.05.doc Version 1.40 Page 21 Yes 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 32 Regulation 18 Requirement That specific autism and mandatory health and safety training is provided for all new staff. (Original timescale: 14.09.2004) That the Statement of Purpose and Service User Guide are amended and circulated as required by legislation, including copies provided to CSCI. (Original timescale: 14.10.2004) That fire training is provided for all staff. (Original timescale: 14.10.2004) That the safety lock to the bathroom door is repaired/replaced. (Original timescale: 17.03.2005) That care plans are updated to ensure they fully reflect the current situation. That action is taken to eradicate the dampness in the basement. That Beech Hill is fully staffed by permanent employees recruited to work at the house. Timescale for action 31.10.2005 2. 1 4&5 30.09.2005 3. 4. 42 27 23 12 30.09.2005 30.09.2005 5. 6. 7. 6 24 33 15 23 18 30.09.2005 31.10.2005 30.09.2005 Beech Hill, F06 F56 S62677 Beech Hill V230376 Stage 4 15.08.05.doc Version 1.40 Page 22 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 6 24 33 Good Practice Recommendations That staff work consistently with service users to planned and agreed interventions. That the landing carpet is replaced. That the need for 1 : 1 care for service users is montiored to ensure it is sufficient. Beech Hill, F06 F56 S62677 Beech Hill V230376 Stage 4 15.08.05.doc Version 1.40 Page 23 Commission for Social Care Inspection Turton Suite, Paragon Business Park, Chorley New Road, Horwich, Bolton, BL6 6HG. 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