Inspection on 17/08/06 for Bleak House

This inspection was carried out on 17th August 2006.

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 13/08/07

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 Unannounced Inspection 17th August 2006 2:00 Bleak House DS0000019649.V304264.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.V304264.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.V304264.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.V304264.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th December 2005 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. The standard fee charged by the home is £332.50 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.V304264.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A Pre Inspection Questionnaire asking for information about home was sent out before this visit and information from this was included as part of the inspection process of this service. During this visit, a tour of the building was carried out and time was spent talking with service users in the lounge areas and seeing how they lived. Further time was spent reading care plans and files and talking to staff. The home’s manager was away on a group holiday at the time of this visit, but staff and service users assisted with the inspection. A request was made for further information that could not be checked at the time of this visit and these were found to acceptable. Twelve service users returned comment cards about the home as did seven of their relatives. Eight social services staff and two doctors also replied to a similar request Service users said that they “like living here” and that “this is a good home and the staff look after me” What the service does well: What has improved since the last inspection? What they could do better: Service users’ money should be checked by someone who does not work for the home to make sure it is right. Service users should be given information about the home in a way that that they can understand it. Bleak House DS0000019649.V304264.R01.S.doc Version 5.2 Page 6 Lists of service users’ activities should be available and the cost of a holiday should be included in the cost of living in the home. Some parts of the home should be redecorated and more staff training should be given so that that they can do their jobs well. 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. Bleak House DS0000019649.V304264.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.V304264.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The Quality in this outcome area is good. Service users had been assessed, in order to ensure that the home could meet their needs. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Inspection of the case file of a recently admitted service user confirmed that an assessment of his needs had been carried out, in order to confirm that the home could meet his needs. Other case files examined contained similar documentation that had been undertaken by both the home and Social Services staff. Bleak House DS0000019649.V304264.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 The Quality in this outcome area is good. The service users individual needs and choices were being met and they were involved in decisions about their lives. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Service Users confirmed that they were aware of their care plans and that they were included in the development and reviewing of these. Case files contained evidence of this, together with assessments of known areas of risk and their management strategies, which had been agreed with the service user and their representatives. Service Users stated that they were involved in decisions about their lives and that staff helped them with this. Information provided by the manager confirmed that the home had policies about service users’ right to independence and other related areas of practice. The minutes of resident meetings contained evidence of discussions about various aspects of the home, as well decisions about future activities and events that service users had been consulted about. Some staff had received training to help in communicating with service users with specialist needs and Bleak House DS0000019649.V304264.R01.S.doc Version 5.2 Page 10 a recommendation is made that information about the home is developed into alternative formats to assist with this process. The manager of the home looks after the service users’ money, and a random check of their finances showed that these were correct. However, a recommendation is made that the service users’ financial records are independently audited, in order to make sure that their financial interests are safeguarded. Bleak House DS0000019649.V304264.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 16 and 17 The Quality in this outcome area is good. The service users were being supported to participate in a variety of appropriate lifestyle opportunities. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Discussion with service users and observation on the day confirmed that a range of appropriate activities were available for them to do. A newly moved in resident was out attending a college at the time of this visit, whilst others showed the inspector writing and drawing work that they had been doing earlier in the day. Staff stated that service users regularly used the mobile library service that visited the village on a weekly basis, in order to obtain materials of interest. Service users were observed being contentedly involved in listening to music, reading magazines, knitting and participating in other activities of their choice. Service users confirmed that they were able to be part of the local community and questionnaires returned from them included comments that “I like going out in the bus” and “going to Hornsea”. One service user talked about the Bleak House DS0000019649.V304264.R01.S.doc Version 5.2 Page 12 local church groups that she went to, whilst others showed photographs and spoke about different trips out that they been on. A BBQ had been held at the home the previous weekend, which friends, family and local people had been invited to. At the time of this visit a group of service users were away on a group holiday and discussion with others confirmed that they had previously been away to stay on a farm. A recommendation is made in this matter. Service users stated that they were able to choose to make their own friends and that their family members could visit freely. Relative questionnaires returned contained positive comments about the home and confirmed that their involvement was welcomed. One relative commended the way that staff had assisted her son to visit her when she was ill, whilst another stated that “after 20 years of visiting….I have no qualms about the service”. The home had policies on the service users’ rights to independence and observation of the staff confirmed that these were being respected. Observation indicated that service users could choose when to spend time joining in with others or be alone, and discussion with them indicated that their responsibilities towards each other were met by helping with various jobs around the home. Service users said that the food was “good” and inspection of the home’s menus indicated that a healthy and balanced diet was being provided. Case files contained evidence of nutritional assessments being carried out with evidence that service users were being monitored for their weight as appropriate. Service users confirmed that a choice of main meals was available and inspection of the training log indicated that staff had received training in food safety and hygiene. Bleak House DS0000019649.V304264.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 The Quality in this outcome area is good. The service users’ emotional, health and personal care needs were being met. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Discussion with the service users indicated that the personal care they received was delivered in a way that was right for them and inspection of the home’s records confirmed that staff had been given training in a variety of areas relevant to the service users’ needs. Case files contained good evidence of appropriate liaison and joint work with members of the community health services and comments received from 2 GP’s confirmed that arrangements were satisfactory in this respect. The medication supplies were randomly inspected and correct and discussion with staff indicated them to be knowledgeable about matters relating to this aspect of practice. Further training in the safe use and handling of medication was currently underway. Bleak House DS0000019649.V304264.R01.S.doc Version 5.2 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 the following standard(s): 22 and 23 The Quality in this outcome area is good. The service users were being safeguarded from abuse and their concerns and complaints were being taken seriously. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Service users indicated they were happy with the service and comments returned from them before the visit included statements such as “I like living here” and “this is a good home and the staff look after me”. The home has an acceptable complaints policy, which most service users were aware and indicated that they would “tell the manager or staff” about any concerns they may have. The complaints book had no entries in it since 2001 and contained two thank-you cards from relatives that had been received since that last inspection. Evidence was seen of consultation with service users at regular resident meetings. The home had policies and procedures in order to safeguard the service users from abuse and inspection of the training log indicated that staff had received training in this aspect of practice. Discussion with staff members confirmed that they were aware of these and that they would act appropriately should they have any concerns in these matters. Bleak House DS0000019649.V304264.R01.S.doc Version 5.2 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 the following standard(s): 24 and 30 The Quality in this outcome area is good. The service users’ environment was clean, comfortable and safe. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The home was warm, homely and comfortable and provided the service users with a safe environment. Inspection of the building confirmed that adaptations had been installed in the bathrooms to assist with delivering of personal care to service users. The maintenance book contained evidence of regular entries and work undertaken in respect of these. However, some parts of the building were beginning to show some signs of a need of refreshment and upgrading and a recommendation is made in these matters. The training records provided evidence that infection control training had been given to some staff and the building was found to be clean, hygienic and free of offensive odours. Bleak House DS0000019649.V304264.R01.S.doc Version 5.2 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 The Quality in this outcome area is good. Staff were committed to meeting the needs of the service users and had been provided with training to help them do their jobs. The home’s recruitment practices safeguarded the service users from abuse. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Staff confirmed that they had been provided with training to help them do their jobs and inspection of the training plan indicated that a range of topics relevant to the needs of the service users had been delivered and that 46 of the staff had obtained a qualification at NVQ level 2 or above. Some of the staff had had undertaken Learning Disability Award accredited training and discussion with them indicated that all those newly employed in the home would follow this route. Staff indicated that they received supervision about their jobs and that this included an annual appraisal of their performance and training needs. The mixed gender staff group employed in the home reflected the needs of the service users and staff were enthusiastic, motivated and committed to meeting the needs of the service users. A relative comment received stated that the “staff have the best interests of the service users at heart” and observation of the care practices confirmed this, with good levels of understanding and warmth demonstrated towards those accommodated in the home Bleak House DS0000019649.V304264.R01.S.doc Version 5.2 Page 17 The home had a recruitment policy and procedures in order to safeguard the service users, but staff files were not available to verified at the time of this visit. Examination of the material submitted by the manager as part of the inspection process indicated that Criminal Records Bureau checks had been completed for all staff members and that no new staff had been employed in the home since the previous inspection. A request that evidence to confirm that Criminal Records Bureau checks for the last two staff members to be employed be submitted to the Commission for Social Care Inspection was therefore made and these were later found to be acceptable. Bleak House DS0000019649.V304264.R01.S.doc Version 5.2 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 The Quality in this outcome area is good. The home was being well managed with maintenance checks appropriately carried out to ensure the health and welfare of service users and staff. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: Discussion with service users and staff indicated that the home was being well managed and a relative comment received reflected this. In the absence of the manager who was away on holiday with a group of service users, staff were forthcoming, helpful and knowledgeable about the home’s operation. Staff indicated they were given individual responsibility for various aspects of the service and a range of health, safety and maintenance records were inspected, including fire, gas and water and found to be satisfactory and in good order. Service users indicated that they were consulted about the running of the home and the minutes of resident and staff meetings confirmed this, with topics recently discussed including a recent BBQ, service users’ holidays and Bleak House DS0000019649.V304264.R01.S.doc Version 5.2 Page 19 amendments to the programme of activities on offer. The home has a quality assurance programme to monitor and assess its performance against its stated aims, which includes feedback from service users and visiting professionals. Bleak House DS0000019649.V304264.R01.S.doc Version 5.2 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 Standard No Score 1 X 2 3 3 X 4 X 5 X 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 X 32 3 33 X 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Bleak House DS0000019649.V304264.R01.S.doc Version 5.2 Page 21 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. 1 2 3 4 5 6 Refer to Standard YA7YA7 YA9YA9 YA14YA14 YA14YA14 YA24YA24 YA32YA32 Good Practice Recommendations The registered person should to provide information to service users in a format that is understandable to them The registered person should ensure that the records of service users’ finances are audited independently to the service The registered person should ensure that a record of the activities which service users enter into is available The registered provider should include the cost of a service users holiday within the basic contract price of residing in the home The registered person should redecorate those parts of the building that are beginning to show signs of disrepair The registered person should ensure that 50 of staff hold an NVQ 2 or above Bleak House DS0000019649.V304264.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Bleak House DS0000019649.V304264.R01.S.doc Version 5.2 Page 23 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!