Inspection on 13/08/07 for Bleak House

This inspection was carried out on 13th August 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

Bleak House 17/08/06

Bleak House 08/12/05

Bleak House 28/06/05

Bleak House 06/01/05

Bleak House 22/07/04

Bleak House 29/01/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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

CARE HOME ADULTS 18-65 Bleak House High Street Patrington Hull East Riding Of Yorks HU12 0RE Lead Inspector Rob Padwick Key Unannounced Inspection 13th August 2007 2.00 Bleak House DS0000019649.V347878.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 Bleak House DS0000019649.V347878.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. Bleak House DS0000019649.V347878.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bleak House Address High Street Patrington Hull East Riding Of Yorks HU12 0RE 01964 630383 01964 631243 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) Bleak House Limited Mrs Christine Linda Allen Care Home 19 Category(ies) of Learning disability (19) registration, with number of places Bleak House DS0000019649.V347878.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th August 2006 Brief Description of the Service: Bleak House is a care home providing care and accommodation for up to 19 people of either sex under the age of sixty-five who have learning disabilities. It is a privately owned home. The home is on the main street in the village of Patrington, close to local amenities and within easy access to public transport. Car parking is on the main road or visitors may use the adjacent Church car park. The home has been registered for a number of years and consists of a large two-storey Tudor style building. Internally the home retains many of its original features including a large wooden fireplace and panelled living room. There are a number of communal areas including the dining area, smoking area and large rear gardens. There are seven single rooms and six double rooms, none of which are ensuite. There is not a stair lift or hoist in the home and therefore the home would be unsuitable for wheel chair users or people with severe mobility problems. The standard fees charged by the home range from £338.37 to £381.37 with additional charges made for hairdressing, clothing, personal effects, toiletries, holidays and travel costs Bleak House provides information about the home to service users in its Statement of Purpose and Service User Guide. Bleak House DS0000019649.V347878.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection report is based on information received by the Commission for Social Care Inspection (CSCI) since the last key inspection of the home on 17th August 2006, including information gathered during a site visit to the home A questionnaire asking for information about the service was sent to the provider before the inspection visit and information from this was included as part of the inspection process. Other information used, included feedback from questionnaires sent out to people living in the home, their relatives and professional staff who know them well, together with official notifications received by the Commission for Social Care Inspection about the home. The inspection visit for this service lasted for 7 hours and during this period, time was spent talking with people living in the home and observing their daily lives. Other time was spent looking at their care plans and other records and talking to staff. The inspection visit also included a tour of the properties. At the time of writing this report, questionnaires had been returned from all of the people living in the home, together with eight from their relatives, two from health professionals and four from Social Services staff. What the service does well: What has improved since the last inspection? What they could do better: A person who is independent of the service should check the records of money looked after for people living in the home to make sure that they are right. Information about the service should be given to people living in the home in a format that they can understand. Staff should be given clearer information about what they should look out for and do concerning risks to people living in Bleak House DS0000019649.V347878.R01.S.doc Version 5.2 Page 6 the home. Areas in the home that need decorating should be carried out so that people living in the home have an environment that meets their needs. 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. Bleak House DS0000019649.V347878.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 Bleak House DS0000019649.V347878.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, 5 People who use this service experience good outcomes in this area. People living in the home had been involved in decisions about moving into the home and their needs were assessed before this, to ensure that the service was appropriate for them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The case files of the two most recently admitted people to the home were inspected and both contained evidence of an assessment of their needs, which the manager had obtained before they were admitted to the home, to ensure the service was appropriate for them. Information about the home was provided in plain and simple English to help people make decisions about moving into the home. The manager indicated she was intending to improve the quality of this information further, to make it easier to understand. People living in the home confirmed they had been involved in decisions about moving into the home and contracts between them and the service were included in those case files inspected. Bleak House DS0000019649.V347878.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 People who use this service experience good outcomes in this area. The staff are provided with a good standard of information about the needs of people living in the home to ensure they can support their individual needs and wishes. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information about the needs and choices of people living in the home were included in the two care plans that were inspected. These provided clear guidance to staff on how the emotional, psychological and health needs of the individual’s concerned were to be supported, whilst respecting their individual wishes and preferences. People living in the home confirmed they had contributed to the development of their care plans and staff were observed involving them in making decisions about their lives and providing sensitive support to enable them to be as independent as possible. The care plans were being regularly reviewed and updated to ensure they continued to reflect the needs of people living in the home and whilst good systems were in place for involving people living in the home, the manager stated she was looking into ways of making the care plans easier for people living in the home to Bleak House DS0000019649.V347878.R01.S.doc Version 5.2 Page 10 understand, as previously recommended. Information provided by the manager indicated that people living in the home were supported to take sensible risks that are consistent with everyday life and information on the management of these was contained in the care plans inspected. However, it is recommended these be further developed to provide clearer information for staff on what to look out for and do in these respects. Professional staff were universally positive about the quality of care provided, with a Care Manager commenting “Great care is taken to ensure every aspect of daily life in the home is meeting the needs of the service users” and a Learning Disability Nurse stating “detailed information is always available”. The records of money kept on behalf of people living in the home were being accurately kept although the previous recommendation that these are independently audited, in order to make sure that their financial interests are safeguarded, had not yet been implemented. Bleak House DS0000019649.V347878.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 People who use this service experience good outcomes in this area. People living in the home are involved and supported to make decisions and choices about their lives and staff sensitively enable them to be as independent as possible. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Routines in the home are kept flexible to meet needs of the people living in the home and staff were observed providing 1:1 support or sitting quietly chatting with others. Information provided by the manager indicated a good range of lifestyle opportunities were provided and people living in the home talked about college courses they attended, whilst others displayed items of craftwork and embroidery that they had made. The home has its own transport to help people living in the home get out and about and discussion with them confirmed they regularly went into the local town and go on holidays together. The home has an open visiting policy and welcomes the involvement of friends and family members and questionnaires returned from relatives spoke of the “family atmosphere” and the “Privacy and dignity always given to clients”. Bleak House DS0000019649.V347878.R01.S.doc Version 5.2 Page 12 People living in the home confirmed they were supported to be as independent as possible and that staff helped with things like cleaning their rooms or going shopping. A relative commented on this stating that staff “bring out their own skills”, whilst a proffesional commented possitively on the support provided to an individual to maintain their personal belief system. Another relative stated “…they are seen and treated as individuals”. A celebration birthday disco and buffet supper was being held on the evening of this inspection visit and people living in the home confirmed they were able to help choose what food was to be served. Records of food inspected confirmed a good range of healthy meals had been provided and case files inspected contained evidence that the nutritional needs of people living in the home were being appropriately monitored. Bleak House DS0000019649.V347878.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 People who use this service experience excellent outcomes in this area. People living in the home are treated with respect and dignity and staff ensure that their health and personal care is based on their individual needs and wishes. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans inspected documented individual health and personal support needs and discussion with people living in the home them indicated that these were being met in a manner that was right for them. People living in the home said they were supported to be as independent as possible and that staff helped them with things like going to see the Dentist or Optician when this was needed. A local Doctor commented that staff had a “good knowledge of clinical problems” and “involve the patient in discussions” whilst a Learning Disability Nurse stated “I was impressed when visiting how individualised the care is” and that “carers have a knowledge of individual need.” and that they are “not afraid to ask for help”. Relative and professionals contacted commented positively on the respect and dignity shown towards people living in the home and a comment received from a Care Manager stated that the service “treats people as individual’s….and attends to all needs”. Bleak House DS0000019649.V347878.R01.S.doc Version 5.2 Page 14 Information provided by the manager confirmed those responsible for the administration of medication to people living in the home had received training in this aspect of practice and a random inspection of the records for these indicated that these were being appropriately kept. Bleak House DS0000019649.V347878.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 People who use this service experience good outcomes in this area. The concerns of people living in the home are taken seriously and they are safeguarded from abuse by staff that have received training about the protection of vulnerable adults. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Appropriate policies and procedures were available to ensure the concerns of people living in the home were taken seriously and they were safeguarded from abuse. People living in the home confirmed they were very happy with the service and a comment received from a relative stated “If I have any concerns I speak to manager or staff”. The Commission for Social Care Inspection had received no complaints about the home since the last inspection visit and positive comments were contained in the service’s complaints and compliments log, which showed that none had been received by the home. The home’s records indicated that staff had been provided with training on the protection of vulnerable adults and certificates for these were contained in the staff files inspected. The records of money held on behalf of people living in the home were being accurately maintained, however the home has yet to have these independently audited, as previously recommended. Bleak House DS0000019649.V347878.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 People who use this service experience good outcomes in this area. People living in the home were being provided with an environment that was clean, and homely and which was safely meeting their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home was clean, homely and comfortably furnished with evidence of regular work being carried out to maintain the premises. The communal areas were large and spacious and provided people living in the home with ample room for a choice of activities. However, owing to the age of the building and the width of the corridors, access for wheelchair users is limited. A number of the bedrooms are for shared use but discussion with people living in the home indicated they were happy with this arrangement, as many of them have known each other for many years. Work was being carried out to repair the ceiling in one of the bedrooms, following damage to the roof in recent bad weather and some of the corridor areas were beginning to show signs of heavy use, with areas of wall paper peeling. Recommendations are made in these matters, in order to ensure the welfare of people living in the home. The home’s maintenance book contained regular entries relating to safety checks of Bleak House DS0000019649.V347878.R01.S.doc Version 5.2 Page 17 equipment and the training records evidence that various aspects relating to the health and safety of people living in the home had been provided to staff. An up to date certificate for the servicing of the fire alarm could not be found on the occasion of this visit, but a copy of this was subsequently forwarded to the Commission. Bleak House DS0000019649.V347878.R01.S.doc Version 5.2 Page 18 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): 31, 32, 34, 35 and 36 People who use this service experience good outcomes in this area. Staff are well trained and recruited safely to ensure people living in the home are protected from harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Throughout the inspection visit staff were observed interacting with people living in the home in a sensitive and friendly manner. The homes records indicated staff had received training about a range of topics relating to the needs of people living in the home and discussion with those on duty confirmed they were committed to doing their jobs. Comments received from relatives were universally positive and one stated “They work as a good team…I haven’t got a single bad word to say about Bleak House and the staff… Carers are very friendly and helpful…They are understanding and very caring…” Staff files inspected confirmed that regular professional supervision was provided to ensure staff were able to meet the needs of people living in the home and information provided by the manager indicted six of the eleven care staff had obtained an NVQ at level 2 and that five of these had been enrolled on a course to take them to a higher level of this award, which is to be commended. Bleak House DS0000019649.V347878.R01.S.doc Version 5.2 Page 19 Recruitment procedures were in place to ensure that staff were safe to work with people living in the home. The files of the two most recently employed staff confirmed these had been appropriately followed, with evidence of checks against the Criminal Records Bureau and Protection of Vulnerable Adults list, as well other required documentation. A further comment received from a relative stated “The staff are well selected.. friendliness and patience seem to be a key feature which they display in abundance… I can’t praise the staff too much”. Bleak House DS0000019649.V347878.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 People who use this service experience good outcomes in this area. Inclusive and effective management systems ensure that people living in the home can participate in decisions about the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager is well qualified and discussion with her confirmed she had a sound understanding of the needs of people living in the home. The minutes from meetings held in the home indicated that she adopted an inclusive approach to managing the home, which involved consulting with both staff and people living in the home on a regular basis. Staff were positive about the management style and inspection of their files confirmed that their individual training and development needs were being considered as part of the home’s business planning cycle. The service’s quality assurance systems included feedback from people living in the home together with others that have an interest in the home and plans were in place for the continued development of Bleak House DS0000019649.V347878.R01.S.doc Version 5.2 Page 21 the service. Individual staff were regularly monitoring various aspects of the home and inspection of a random selection of the maintenance records confirmed that that these were being checked, in order to ensure the health and safety of people living and working in the home. Bleak House DS0000019649.V347878.R01.S.doc Version 5.2 Page 22 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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 4 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 X 4 X 3 X X 3 X Bleak House DS0000019649.V347878.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA7YA7 YA9YA9 Good Practice Recommendations The registered person should provide information to people living in the home in a format that is understandable to them. The registered person should ensure that staff are provided with clear guidance on what actions to take and look out for in respect of the management of risk to people living in the home. The registered person should ensure that the records of money held on behalf of people living in the home are independently audited to ensure they are finances safeguarded. The registered person should ensure that repairs to the bedroom ceiling damaged by bad weather are completed and that corridor areas showing signs of wear are redecorated to ensure people living in the home are provided with an environment that meets their needs. 3. YA23YA23 4. YA24YA24 Bleak House DS0000019649.V347878.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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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