CARE HOME ADULTS 18-65
Boroughbridge Road (67) 67 Boroughbridge Road Knaresborough North Yorkshire HG5 0ND Lead Inspector
Maggie Coxon Unannounced 17 May 2005 15:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Boroughbridge Road (67) J53 JO4 S7902 Boroughbridge Road V225357 170505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Boroughbridge Road (67) Address 67 Boroughbridge Road Knaresborough North Yorkshire HG5 0ND 01423 869343 N/A N/A St Annes Community Services Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Malcolm Harston Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Boroughbridge Road (67) J53 JO4 S7902 Boroughbridge Road V225357 170505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 13/12/04 Brief Description of the Service: 67 Boroughbridge Road is a care home registered by St Annes Community Services to provide personal care and accommodation to up to three adults with learning disabilities. The home consists of a two-storeyed, end of terrace house located on a busy road in the market town of Knaresborough. Local community facilities include shops, cafes and a post office. Each of the three bedroooms is for single accommodation, one of which has en suite facilities. These are situated on the first floor. Whilst the home does not have a passenger or stair lift, all areas are accessible to those residents currently living there. There are very well maintained garden areas to the front and side of the home with hard standing for parking to the rear. Boroughbridge Road (67) J53 JO4 S7902 Boroughbridge Road V225357 170505 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was the first to be undertaken between April 2005 and March 2006. It was done on 17th May 2005, at a time when all of the people living in the home would be present. It took 2.5 hours plus 2 hours preparation time. Discussions were held with the three people currently living in the home, with the care staff on duty and with the registered manager. A number of records were looked at and most areas of the home including bedrooms and shared areas were seen. What the service does well: What has improved since the last inspection?
A new mini-plan has been developed for the home following the recent issue of a new annual development plan produced by St Annes Community Services. Residents’ individual plans have been reviewed and updated and a new staff appraisal format has been introduced, in line with to the objectives set out in the mini plan. Staff have undertaken more training and have made further progress with their NVQ awards. The garden shed is being converted for use as a woodwork room and residents have already begun to make some garden furniture. The staff member who is overseeing the project explained that they hope to develop this activity further and the registered manager explained that he has applied for additional funding for the project. Boroughbridge Road (67) J53 JO4 S7902 Boroughbridge Road V225357 170505 Stage 4.doc Version 1.30 Page 6 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. Boroughbridge Road (67) J53 JO4 S7902 Boroughbridge Road V225357 170505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Boroughbridge Road (67) J53 JO4 S7902 Boroughbridge Road V225357 170505 Stage 4.doc Version 1.30 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None. EVIDENCE: Boroughbridge Road (67) J53 JO4 S7902 Boroughbridge Road V225357 170505 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8 and 9. People living in the home make as many decisions and choices as possible. They also live as independently as possible, taking into account any risks that have to be considered, with the full encouragement and support of staff. EVIDENCE: Each resident has a care plan produced by their care manager and an individual life plan developed by the resident and staff team. Each individual life plan had recently been reviewed and updated to incorporate the objectives outlined in this year’s plans for the organization and the home. Residents lead interesting and active lives with the support of a committed staff team. They can choose from a number of activities organized on a daily basis and are as involved in the running of the home as much as possible and can attend all of the house meetings if they want to. Residents have independent lifestyles and can take calculated risks subject to the outcome of a risk assessment undertaken by the staff team. Boroughbridge Road (67) J53 JO4 S7902 Boroughbridge Road V225357 170505 Stage 4.doc Version 1.30 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13,15,16 and 17. Residents have a varied and interesting lifestyle and are fully involved in their local community. They enjoy a wide choice of home cooked, good quality food. EVIDENCE: Each resident has a weekly programme of varied activities, some organized by the home others accessed through a local day centre and a local college. The staff team is keen to identify new activities that the residents might enjoy; one of them is currently developing a woodwork scheme and is supporting those residents who want to, to make garden furniture. The registered manager explained that he has asked St Annes Community Services for extra funding for the project. All of the residents have active lives within their local community and enjoy a variety of outings and holidays arranged throughout the year by the home. Staff were seen to communicate well with residents and to respect their rights, they did not go into individuals’ bedrooms without their permission. Boroughbridge Road (67) J53 JO4 S7902 Boroughbridge Road V225357 170505 Stage 4.doc Version 1.30 Page 11 Staff have found out what foods the residents like and meals are based on this The information. Menus showed that meals are varied and interesting. registered manager explained that staff were planning to develop a food picture book so that people living in the home can have even more choice and a greater say in menu planning. Boroughbridge Road (67) J53 JO4 S7902 Boroughbridge Road V225357 170505 Stage 4.doc Version 1.30 Page 12 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19 and 20. Residents’ personal and health care needs are fully met. EVIDENCE: All of the people living in the home are registered with a local GP through whom specialist health services are accessed as and when needed. None of the residents is able to take their own medication but individuals were seen to be satisfied with staff administering it to them. There is a monitored dosage system in operation, which is securely stored. Medication administration records are well maintained and all staff have received some medication training that the registered manager explained, is to be expanded on in future months. Bedroom and bathroom doors have locks fitted and staff were seen to give support to residents with personal care needs in a way that respected the individual’s dignity. Boroughbridge Road (67) J53 JO4 S7902 Boroughbridge Road V225357 170505 Stage 4.doc Version 1.30 Page 13 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22. Residents’ concerns are appropriately dealt with and their interests safeguarded. EVIDENCE: There is a comprehensive complaints procedure in operation that is available in various formats and is made available to anyone who wishes to see it. Whilst the residents might not use the formal procedure they can all make any dissatisfaction known to staff, who attempt to address this promptly and appropriately. Staff have developed very good relationships with the residents and were seen to communicate well with them. No complaints have been made to the home or to the C.S.C.I. within the last twelve months. The home has however, received two compliment letters from residents’ relative since the last inspection. These both thanked the manager and staff team for their commitment and caring attitude and highly praised the service being provided. Boroughbridge Road (67) J53 JO4 S7902 Boroughbridge Road V225357 170505 Stage 4.doc Version 1.30 Page 14 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28,29 and 30. The standard of the environment of the home is good and provides residents with a comfortable, clean and homely place in which to live. EVIDENCE: The home is well maintained and pleasantly decorated and furnished. Residents indicated that they are happy with their bedrooms all of which are for single accommodation, are of a suitable size and are situated on the first floor. One bedroom has en suite facilities. Appropriate aids and adaptations are fitted throughout the home. A good standard of cleanliness is maintained throughout. The registered manager explained that the outside of the premises is soon to be redecorated. Boroughbridge Road (67) J53 JO4 S7902 Boroughbridge Road V225357 170505 Stage 4.doc Version 1.30 Page 15 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33 and 35. The residents receive a good standard of care from a highly skilled and motivated staff team. EVIDENCE: Three of the care staff are working hard towards achieving their NVQs in care to level 3. Once completed, the target of having 50 of care staff trained to NVQ level 2 or above by 2005 will be achieved. Staff have also attended other training within the last year covering topics including Abuse Awareness, Makaton, Positive Ageing, promoting communication, Emergency Aid and Health and Safety. More training has been arranged for individuals in the forthcoming year covering topics including Lone working and Managing Oneself. The duty roster for the week including the inspection shows that staffing levels have been increased and that staff are employed in sufficient numbers and are deployed in such a way as to ensure that the needs of the residents are met at all times. Boroughbridge Road (67) J53 JO4 S7902 Boroughbridge Road V225357 170505 Stage 4.doc Version 1.30 Page 16 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,39 and 42. The residents benefit from a well managed home in which their needs and wishes are put first. EVIDENCE: The registered manager has considerable management experience and is currently undertaking an appropriate qualification. Staff described him as a very approachable manager with good management and leadership qualities. They said that he is very supportive and gives staff regular supervision. St Annes Community Services has a quality assurance and monitoring system in place that includes regular unannounced visits by the service manager to check on quality issues. It has previously been recommended that this system be further developed to include ascertaining the views of people who have contact with the home. The registered manager explained that this has yet to be done. The registered manager and staff have recently developed a new mini plan for the home, based on the objectives set out in the new organizational
Boroughbridge Road (67) J53 JO4 S7902 Boroughbridge Road V225357 170505 Stage 4.doc Version 1.30 Page 17 corporate plan. This mini plan sets out the objectives to be achieved in the forthcoming year and is aimed at further improving residents’ quality of life. Comprehensive systems and procedures to ensure the safety and well being of residents are in place within the home. These include regular health and safety checks of the premises and of equipment. Staff are appropriately trained in health and safety matters including Emergency Aid, Fire Safety and Food Hygiene. Boroughbridge Road (67) J53 JO4 S7902 Boroughbridge Road V225357 170505 Stage 4.doc Version 1.30 Page 18 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 x Standard No 22 23
ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 3 3 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x 2 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Boroughbridge Road (67) Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 3 2 x x 3 x J53 JO4 S7902 Boroughbridge Road V225357 170505 Stage 4.doc Version 1.30 Page 19 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. 1. Standard Regulation None. 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. Refer to Standard 32 37 39 Good Practice Recommendations A minimum of 50 of care staff should be qualified to NVQ level 2 or above. The Registered Manager should complete an appropriate management qualification. The views of families, friends, advocates and other people involved with the home, in respect of the quality of services, sould be ascertained and incorported into the quality assurance system currently in operation. Boroughbridge Road (67) J53 JO4 S7902 Boroughbridge Road V225357 170505 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection York Area Office Unit 4, Triune Court Monks Cross York, YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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