Inspection on 29/06/07 for Berrishill Grove, 26

This inspection was carried out on 29th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Berrishill Grove, 26 02/10/08

Berrishill Grove, 26 30/10/06

Berrishill Grove, 26 11/01/06

Berrishill Grove, 26 23/05/05

Berrishill Grove, 26 07/01/05

Berrishill Grove, 26 29/09/04

Berrishill Grove, 26 04/02/04

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

CARE HOME ADULTS 18-65 Berrishill Grove, 26 26 Berrishill Grove Red House Farm Whitley Bay Tyne And Wear NE25 9XU Lead Inspector Karena M Reed Key Unannounced Inspection 29th June 2007 10:30 Berrishill Grove, 26 DS0000000367.V338284.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 Berrishill Grove, 26 DS0000000367.V338284.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. Berrishill Grove, 26 DS0000000367.V338284.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Berrishill Grove, 26 Address 26 Berrishill Grove Red House Farm Whitley Bay Tyne And Wear NE25 9XU 0191 2537212 F/P 0191 2537212 GM.E.NTAWNT.Berrishill@nhs.net 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) Northumberland, Tyne & Wear NHS Trust Karen Anne Wilkinson Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Berrishill Grove, 26 DS0000000367.V338284.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The number of persons for whom residential accommodation with board and care is provided at any one time shall not exceed 4 men or women 30th October 2006 Date of last inspection Brief Description of the Service: 26 Berrishill Grove provides residential care for four adults with a learning disability under the age of sixty-five years. Nursing care is not provided. The home is a modern, spacious bungalow on a quiet housing estate in Monkseaton. There are good road and transport links and the house is close to local shops and amenities. Each resident has their own bedroom and there is a bathroom and lavatories. The house has a garden at the rear and an area for parking to the front. Berrishill Grove is part of Northgate and Prudhoe NHS Trust. A Statement of Purpose and service user guide are available for prospective residents and their relatives to give them information about the services provided by the home and the relevant charges. Fees payable for living at the home at the time of inspection in June 2007 are £1169.65p weekly. Additional charges are payable for hairdressing, toiletries and eating out. Berrishill Grove, 26 DS0000000367.V338284.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. How the inspection was carried out Before the visit: We looked at: • • • • • Information we have received since the last inspection on 3oth October 2006. How the service dealt with any complaints and concerns since the last visit. Any changes to how the home is run. The provider’s view of how well they care for people. The views of people who use the service and their relatives, staff and other professionals. The visit • An unannounced visit was made on June 29th 2007 During the visit we: • • • • • • Talked with people who use the service, relatives, staff, the manager and visitors. Looked at information about the people who use the service and how well their needs are met. Looked at other records that must be kept. Checked that staff had the knowledge, skills and training to meet the needs of the people they care for. Looked around the building to make sure it was clean, safe and comfortable. Checked what improvements had been made since the last inspection. We told the provider what we found. What the service does well: The home offers prospective residents whatever length of time they need to decide if they wish to live at the home. There is a good level of staff training to give staff more understanding about the different needs of residents. There is an excellent standard of hygiene around the home. Berrishill Grove, 26 DS0000000367.V338284.R01.S.doc Version 5.2 Page 6 The home is comfortable and well maintained. There is a very good standard of record keeping. Detailed information is collected about a new resident to ensure staff can provide the necessary levels of care and support to the person. What has improved since the last inspection? 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. Berrishill Grove, 26 DS0000000367.V338284.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 Berrishill Grove, 26 DS0000000367.V338284.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): 1,2,3,4,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information about the resource is available to give to prospective residents before they move in. The home collects enough information about the needs of prospective residents before they move in to help ensure staff are aware of the amount of care and support needs of the resident as they settle in. Staff receive a variety of training to give them the knowledge and insight to help understand the needs of residents and to provide the necessary levels of care and support to individual residents. EVIDENCE: Records for four of the residents showed that when they were admitted to the home an assessment of their care needs had been carried out before their admission. The resident and relevant people who knew them were involved in the initial assessment. This information and the care manager’s assessment of the resident’s care needs were used to ensure all the needs of the resident could be met by staff. The records contained a range of information. Berrishill Grove, 26 DS0000000367.V338284.R01.S.doc Version 5.2 Page 9 Staff receive training so that they know how to meet the specialist needs of the residents. Staff have received the necessary statutory training: Fire Training, Food Hygiene, First Aid, Protection of Vulnerable Adults and National Vocational Qualifications. Staff have also received training about; behaviour support planning, conflict resolution, risk assessment, Learning Disability Awareness and Person centred planning. Residents have the opportunity to visit the home as often as they need in order to decide if they want to live there. A resident may come for meals, have overnight stays and be introduced to other residents at the home at a pace suitable to the individual. Contracts are available on each residents’ file they were detailed and outlined terms and conditions for living at the home. Berrishill Grove, 26 DS0000000367.V338284.R01.S.doc Version 5.2 Page 10 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): 6,7,8,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are very good arrangements in place to ensure that residents’ health and social care needs are met. There is a system of reviewing the changing care needs of residents. Residents are well supported by staff and care plans show the amount of care and support that staff are providing to residents. Residents are encouraged to be involved in decision-making and to communicate and make their views known. Staff support residents to take risks as part of independent living. EVIDENCE: There are detailed assessments in the residents’ care plans. Care and support needs are documented and give instructions to staff on how to support people that require support with tasks and carrying out any Berrishill Grove, 26 DS0000000367.V338284.R01.S.doc Version 5.2 Page 11 assessed tasks to help promote the independence of the person. Care plans are being updated three monthly or earlier if required if a resident’s care and support needs change. Residents care records showed that they have access to external health care services. GPs and Community Psychiatric Nurses were regularly consulted for advice and treatment. Records show residents are assisted to access chiropody, dental and optical services at least annually or as often as required. Residents are asked individually and consulted about decisions involving themselves and the running of the home. Meetings are held weekly with service users about the running of the home. Observations showed service users were involved and consulted about decisions involving themselves. The home supports residents to remain independent and take risks in order to live a more fulfilled lifestyle and up to date risk assessments were present in residents care records. Berrishill Grove, 26 DS0000000367.V338284.R01.S.doc Version 5.2 Page 12 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): 11,12,13,14,15,16,17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents take part in age, peer and culturally appropriate activities. Residents are part of the local community during the day. Residents enjoy appropriate leisure activities. Residents are encouraged to have appropriate personal, family and sexual relationships. Residents’ rights and responsibilities are not always recognised in their daily lives. Residents are offered a healthy diet. Berrishill Grove, 26 DS0000000367.V338284.R01.S.doc Version 5.2 Page 13 EVIDENCE: Conversation with staff and observation showed staff support residents to acquire skills and become more self sufficient in aspects of every day living. Residents may attend college or enjoy individual therapeutic and social activities within the community. Residents all pursue their own individual hobbies and interests. Usually staffing levels due not allow total choice to residents to go out as they may wish with support. Staffing levels do not allow evening and weekend activities to take place due to the needs of residents and the low staffing levels. When residents can go out they attend discos, football matches, concerts, walking, cookery, hydrotherapy, snoezellen, trampolining, swimming, shopping, cinema pub and theatre trips. Residents also holiday in this country and abroad and take day trips. Within the home residents bedrooms are equipped with their own televisions, music centres, books and whatever is of interest to the resident. Residents care plans and case records detail any family involvement. Conversation with staff also provided evidence that residents are encouraged to maintain contact with family and friends, staff providing the necessary levels of support for them to do so. Residents’ rights are usually recognised and respected apart from: the right to go out into the community at any time during waking hours. Due to the higher dependency levels of some residents and current staffing levels residents have to remain in the house after 5.00pm and at weekends. Two residents also are deprived of the right to bath which they enjoy as a specialist bath has failed to be replaced after 1 and a half years. Residents’ rights should be respected that they do not pay from their own money for items which should be provided by the home e.g protective clothing for staff. Residents are asked individually daily what they wish to eat. A light snack is available at lunch times and a cooked meal is served in the evening. The menus are revised with the help of the residents. There were some pictorial aids to show some residents what different foods looked like and so help them to make more informed choices about what they would like to eat, this could be extended to increase residents choice. Residents may eat out. Berrishill Grove, 26 DS0000000367.V338284.R01.S.doc Version 5.2 Page 14 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): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents do receive support in the way they prefer and require. There are good arrangements in place to ensure that residents’ health care needs are met. Systems are in place for residents to retain and administer their own medication where appropriate. EVIDENCE: Four care plans and case records were inspected. The daily records detailed the care and support required for different needs. They reflected the changing needs of service users. The care plans accurately recorded the needs and the care and support provided by staff. Berrishill Grove, 26 DS0000000367.V338284.R01.S.doc Version 5.2 Page 15 Records showed when residents had seen health professionals, for example, doctors, consultants and community psychiatric nurses. An occupational therapist has assessed two residents for the use of the current bath in the home. Assessments prove that it does not meet the needs of two of the residents who have difficulty getting in and out of it due to poor mobility and high levels of physical dependency. Records also showed when residents had seen opticians and dentists. Staff receive training before they administer medication to residents. A system is in place to oversee the medication of residents if they should retain and administer their own medication. Berrishill Grove, 26 DS0000000367.V338284.R01.S.doc Version 5.2 Page 16 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): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure was available to remind people coming into the home of their right to complain. Residents are protected from abuse. EVIDENCE: There is a complaints procedure to inform people visiting the home of how they could complain if necessary. Residents have access to a complaints procedure that assists and supports them to bring any matters to the attention of staff outside of the home in case they felt uncomfortable bringing any complaints or concerns to the attention of staff within their home. The home keeps a record of complaints. Staff have received training about Protection of Vulnerable Adults and Prevention of Abuse. Staff have also received training about behaviour that may be difficult to work. Berrishill Grove, 26 DS0000000367.V338284.R01.S.doc Version 5.2 Page 17 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): 24,27,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in quite a homely, comfortable and safe environment. Bathrooms of service users do not contain the specialist equipment to meet their individual needs. There is a good standard of hygiene around the home. EVIDENCE: Since the last inspection some communal areas of the home have been decorated. Floor coverings have been replaced in several areas. The home is clean, well furnished, decorated and well maintained. Berrishill Grove, 26 DS0000000367.V338284.R01.S.doc Version 5.2 Page 18 A specialist bath is available but it does not meet the needs of all the residents. Two residents have to shower when they enjoyed a bath for therapeutic as well as the usual reasons of hygiene. A more appropriate bath has apparently been on order for over one and a half years. There is a good standard of hygiene around the home. Berrishill Grove, 26 DS0000000367.V338284.R01.S.doc Version 5.2 Page 19 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): 32,33,34,35,36 Quality in this outcome area is Adequate. This judgement has been made using available evidence including a visit to this service. Residents’ needs are not all met by the numbers and skill mix of staff. Systems are in place to ensure residents are in safe hands. There are sound recruitment policy and practices in place to protect residents. Staff are trained to meet the care needs of residents. A system of supervision is in place for all staff working at the home. EVIDENCE: Examination of staff rotas and discussion with the person in charge and members of the staff team showed that the numbers of staff are as follows: 8.00am- 6.00pm Berrishill Grove, 26 2 support staff and one enabler. DS0000000367.V338284.R01.S.doc Version 5.2 Page 20 6.00pm-8.00pm 8.00 pm-8. 00am 2 support staff following day 1 waking staff member. These numbers include the team leader. The home provides two support workers and one enabler to work with residents during the day. Staffing levels must be reviewed due to the increased physical dependency levels of some residents currently. Staffing levels at weekends and evenings usually provide only two members of staff when all the residents are in the house eg out of eight weekends there are only three weekends when three members of staff are available. This reduces the opportunities for residents to go out into the community and also reduces their choice as everyone would either have to stay in or go out due to only two members of staff being available. No ancillary staff are provided staff members carry out cooking and cleaning. Staffing files for the staff employed at the home were examined at Head Quarters and showed the necessary checks are being carried out prior to the workers being appointed. CRB checks are carried out before a person is appointed. Staff stated that they enjoyed working in the home and were observed to be kind, caring and respectful to residents. Staff receive LDAF Learning Disability Award Framework as part of their induction. Staff and their records showed that they also receive advice and /or training in other areas. Staff have received training in emergency First Aid, person centred care planning, challenging behaviour, Medication and Protection of Vulnerable adults. Staff receive regular supervision every two months. A system is in place for managers’ of the Organization to receive regular supervision from a member of the senior management team. Berrishill Grove, 26 DS0000000367.V338284.R01.S.doc Version 5.2 Page 21 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): 37,39,40,42,43 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ live in a home that is well run and managed for the benefit of residents. The standard of record keeping is very good. Service user’s rights and interests are safe guarded for the most part by the home’s policies and procedures. The health, safety and welfare of residents and staff are promoted and protected. Service users benefit from competent and accountable management of the service. Berrishill Grove, 26 DS0000000367.V338284.R01.S.doc Version 5.2 Page 22 EVIDENCE: The person in charge is off for a length of time from work. The home is being well run by the staff in her absence. Discussion and observation maintain that the needs of the residents are promoted by the staff team . Residents living at the home have lived there for several years and the staff advocate for residents. A listening device was in use in the bedrooms of residents who required it for their safety when ill. The person in charge was advised that a policy should be drawn up to ensure the privacy of the residents where it was used and so it was not intrusive and its use kept to a minimum. Documents detailing fire safety, risk assessments in the environment, water temperatures, financial records and statutory records were all up to date. Financial budgets are in place for the running of the home but I was informed that cleaning materials were part of the provisions budget and this had not been increased from £150 for several years. This was why it had been suggested that residents should pay for the protective clothing for staff. Berrishill Grove, 26 DS0000000367.V338284.R01.S.doc Version 5.2 Page 23 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 3 2 3 3 3 4 4 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 2 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 2 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 2 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 2 x 3 x Berrishill Grove, 26 DS0000000367.V338284.R01.S.doc Version 5.2 Page 24 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 YA16 Regulation 12(1)(2) Requirement Timescale for action 29/07/07 The rights of the residents must be respected. Their money must 25(3)(b)(c) not be used to buy equipment that must be provided by the home. 23 2. YA27 A specialist bath must be 28/09/07 provided to meet the reassessed needs of the two residents. This requirement remains outstanding. 3. YA33 18 Staffing levels must be reviewed 31/08/07 especially at evenings and week ends. This requirement remains outstanding. 4. YA40 12(4)(a) A policy must be provided for 30/07/07 the use of the listening device to ensure the privacy of residents as far as possible. Berrishill Grove, 26 DS0000000367.V338284.R01.S.doc Version 5.2 Page 25 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 YA24 YA16 YA43 Good Practice Recommendations To resurface the driveway. To continue to make information accessible to residents. To review the provisions budget . Berrishill Grove, 26 DS0000000367.V338284.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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. 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