Inspection on 08/12/05 for Bleak House

This inspection was carried out on 8th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Bleak House 13/08/07

Bleak House 17/08/06

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 Sarah Sadler Unannounced Inspection 09:30 8th & 30 December 2005 th Bleak House DS0000019649.V271966.R01.S.doc Version 5.0 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.V271966.R01.S.doc Version 5.0 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.V271966.R01.S.doc Version 5.0 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.V271966.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th June 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. 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 en-suite. There is not a stair lift or hoist in the home. Car parking is on the main road or visitors may use the adjacent Church car park. Service users are supported with personal care and health needs by the staff team, with other agencies, for example, the community team learning disabilities accessed as necessary. Bleak House DS0000019649.V271966.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was undertaken over two separate days with a previous two hours preparation time completed. The inspection was undertaken as part of the routine programme of inspections for April 2005 to April 2006. At the first visit the registered manager was not available and the inspector spoke with staff and service users, and read service user and other documents. At the second visit the inspector spoke with the registered manager and service users, and read further service user and home information files. What the service does well: What has improved since the last inspection? What they could do better: All the details of the risk assessments should be held in the home to ensure all are able to read and fully understand these in ensuring service users safety. Recruitment checks should be improved upon; ensuring service users are protected. Bleak House DS0000019649.V271966.R01.S.doc Version 5.0 Page 6 Staff should undertake accredited medication training ensuring that service users are fully supported with medication 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. Bleak House DS0000019649.V271966.R01.S.doc Version 5.0 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.V271966.R01.S.doc Version 5.0 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): 5 Service users are provided with a contract and practices enable them to express their rights. EVIDENCE: The service user contract has been amended and covers the areas required within National Minimum Standard 5. This includes details of the expectations of the home upon the service user and the details of the individual service users’ care plan to be provided. The rights of both parties are included, but this is not in detail. However the registered manager described a recent occasion that when a service user’s rights were upheld; the service user was not be happy residing in the home, a care review was called to allow the service user to air these views and options for change to be discussed. Bleak House DS0000019649.V271966.R01.S.doc Version 5.0 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): 7,8 Service users are supported to live their lives as they choose and are included in the development of the home. EVIDENCE: Service users are supported by the staff team in decisions with their lives. For example, a service user asked advice regarding the sending of a get-well card. Service users are able to have free access around the home. Limitations on service users are discussed with the service user and agreed in the service user plan, which service users wherever possible sign to agree to. The care plans include details of risk assessments, which assist service users in their life choice, for example to smoke tobacco. The registered manager discussed how one service user has been proactively supported to decide to leave the home. Staff interviewed stated that service users choose “what to do for the day, activities, indoor or outdoor games. What to have for dinner and who is to be their key worker.” Bleak House DS0000019649.V271966.R01.S.doc Version 5.0 Page 10 Service users confirmed that they can “ do what they want to, they are helped by the staff to complete leisure activities and that they choose their key worker”. Information regarding advocacy services is on display within the home and the registered manager confirmed that service users are supported with their finances, with some service users having the development of financial skills as part of their plan of care. The quality assurance annual report includes service user feedback on the meeting of the aims of the home. Bleak House DS0000019649.V271966.R01.S.doc Version 5.0 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): 12,14,17 Service users are supported to meet their dietary needs. Service users are supported to meet their leisure needs. EVIDENCE: Service users are provided with a four weekly menu, which allows for different choices to be made. Service users were observed to be able to have different meals should they wish to, for example the lunch on the day of the inspection was beef casserole and dumplings, two service users were observed to be having a pie and jacket potatoes. Records are kept of all foods provided and of the individual choices of service users for example, no beans. Service users and staff sit together to eat their meals and lunch was observed to be a relaxed social occasion. Service users files included weight charts with up to date recordings. The registered manager confirmed that service users continue to be supported to undertake an annual holiday. However that this is not included as part of the basic contract price of residing in the home. Bleak House DS0000019649.V271966.R01.S.doc Version 5.0 Page 12 The registered manager confirmed that service users attend open learning, art and craft sessions and that one service user had recently completed a college course with two other service users applying for places at college. The registered manager confirmed that a form has now been developed for each service user to detail the activities they undertake, and that this would soon be implemented. Bleak House DS0000019649.V271966.R01.S.doc Version 5.0 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): 18,19,20 Service users are supported to meet their personal and health needs as they choose. Service users are on the whole supported with their medication needs. EVIDENCE: Service user files include details of the individual support required, this includes support for dignity and independence, and includes instructions on how this will be achieved, for example, ‘to suit his needs’, ‘allow time to talk’ and ‘give encouragement and praise’. Service users receive additional support from the Community Team Learning Disabilities (CTLD) and District Nursing Team as required. Service user files included weight monitoring charts, which had up to date recordings in place. The registered manager confirmed that service users are consulted as part of the staff recruitment process and are given options over wish staff are offered jobs. Also that service users choose which member of staff they wish to be their key worker. Bleak House DS0000019649.V271966.R01.S.doc Version 5.0 Page 14 The registered manager confirmed that staff have undertaken basic training relating to the handling of medicines, via a local pharmacist. However they have yet to undertake accredited medication training. Bleak House DS0000019649.V271966.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Policies in the home assist service users to be protected from harm. EVIDENCE: There is a policy within the home to support staff and service users should a service user be aggressive or display ‘challenging’ behaviours. Bleak House DS0000019649.V271966.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 30 Service users live in a clean and hygienic home. EVIDENCE: The registered manager confirmed that the home meets the Water Supply (Water Fittings) Regulations (1999) and forwarded written evidence of this to the CSCI. Bleak House DS0000019649.V271966.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35,36 Service users are supported by a staff team that are recruited and supervised adequately and with ongoing training to ensure that needs continue to be met. EVIDENCE: Two staff files included two written references and a Criminal records Bureau check (CRB). A third staff file reflected that this member of staff had recently commenced employment with no CRB or POVA first check and only one written reference was available within their file, with no reference from their last employer. The registered manager had not yet undertaken this persons CRB check, however they discussed this at the inspection and confirmed that this person was on induction only and would not work unsupervised, also that their check would be forwarded to the CRB office for completion within one week of the inspection. The registered manager confirmed in writing to the Commission when this was undertaken. There is a staff training plan for the forthcoming year, with individual staff records kept of previous training undertaken. The training plan detailed that staff are to undertake mandatory training, which includes first aid training. The registered manager confirmed that two members of staff have completed Learning Disability Award Framework (LDAF) training, and that two staff have completed TOPPS (Skills for Care) Training and are to commence LDAF training. Bleak House DS0000019649.V271966.R01.S.doc Version 5.0 Page 18 The registered manager confirmed that although the home had previously achieved the recommendations of 50 of the staff team trained to NVQ level 2 in care, this was now not the case as some staff had now left. The number of staff who currently hold an NVQ level 2 in care is 25 with further staff near to completion of this. Staff supervision records reflected that staff are receiving regular recorded supervision sessions that meet the recommendations of a minimum of 6 supervisions per year. The registered manager confirmed that although a form has been developed for annual appraisals of the staff these have yet to be undertaken. Bleak House DS0000019649.V271966.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Service users are supported by an experienced and well trained manager, and are able to express their views in the development of the home. Service users live in a safe environment. EVIDENCE: The registered manager confirmed that they have continued working to achieve the Registered Managers Award and that they now have only one unit left to complete to achieve this. They further confirmed that they already hold the City and guilds 3253 in care management and hold a National Vocational Qualification (NCVQ) level 4 in care. There is a quality assurance report for the home, which includes feedback from service users and visiting professionals. The report reflects how the home is meeting its stated aims and outlines the plans for the forthcoming year. The registered manager has completed risk assessments for safe working practices within the home and has developed a file, which includes the Bleak House DS0000019649.V271966.R01.S.doc Version 5.0 Page 20 management details for each risk. This was discussed with the registered manager and it was recommended that the full details of the assessment should be available for review. Bleak House DS0000019649.V271966.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X 3 Standard No 22 23 Score x 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 3 X X Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 X 14 1 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 2 X 3 1 2 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Bleak House Score 3 3 1 x Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 2 x DS0000019649.V271966.R01.S.doc Version 5.0 Page 22 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 YA14 Regulation 4,5,12,16 Requirement Timescale for action 29/05/04 2. YA20 3. YA35 The registered provider must ensure that service users receive an annual holiday as part of the basic contract price of residing in the home. This is an ongoing requirement with a previous compliance date of 29/5/04. 13,18 The registered provider must ensure that staff undertake accredited medication training. This is an ongoing requirement with a previous compliance date of 22/10/04. 4,10,12,17- The registered provider must 19,24,26 ensure that there is a staff training and development programme that meets the Skills for Care workforce training targets. This is an ongoing requirement with a previous compliance date of 21/2/04. 22/10/04 21/02/04 Bleak House DS0000019649.V271966.R01.S.doc Version 5.0 Page 23 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. Refer to Standard YA14 YA32 YA36 YA42 YA42 Good Practice Recommendations Appropriate records should be kept of the activities, which service users enter into. 50 of staff must hold an NVQ 2 or above in care by 2005 The registered provider must ensure that staff receive an annual appraisal. The registered person must ensure that full details of risk assessments are available at all times. The registered person should provide evidence that the staff induction meets the Skills for Care requirements. Bleak House DS0000019649.V271966.R01.S.doc Version 5.0 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: 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.V271966.R01.S.doc Version 5.0 Page 25 - 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!