Inspection on 22/10/08 for Boroughbridge Road (67)

This inspection was carried out on 22nd October 2008.

CSCI found this care home to be providing an Good service.

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

Boroughbridge Road (67) 23/10/07

Boroughbridge Road (67) 02/11/06

Boroughbridge Road (67) 20/03/06

Boroughbridge Road (67) 17/05/05

Boroughbridge Road (67) 13/12/04

Boroughbridge Road (67) 10/08/04

Boroughbridge Road (67) 26/02/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Muston Road (70)

Grayling

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Boroughbridge Road (67) 67 Boroughbridge Road Knaresborough North Yorkshire HG5 0ND     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Ray Burton     Date: 2 2 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Boroughbridge Road (67) 67 Boroughbridge Road Knaresborough North Yorkshire HG5 0ND 01423869343 P/F01423869343 ian.norris@st-annes.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) St Anne`s Community Services Type of registration: Number of places registered: care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 3 The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Learning disability Code LD, maximum number of places: 3 Date of last inspection Brief description of the care home 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-storey, 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 bedrooms 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 Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 3 Brief description of the care home side of the home with hard standing for parking to the rear. The fees for the home are £1220 per week. The home has a Statement of Purpose that explains the aims, objectives and philosophies of the home and this is available in alternative easy read and picture formats. The most recent inspection report is made available to anyone who wishes to see it. Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people using this service experience good quality outcomes. This is a report of an unannounced inspection, conducted on the 22nd October 2008, and covering all of the key standards of the National Minimum Standards for Care Homes for Adults. Before the site visit the service returned a pre-inspection questionnaire that provided good information about the service. During the inspection a tour of the building was conducted, records and care plans examined and the inspector spoke to the people living in the home, the acting manager Care Homes for Adults (18-65 years) Page 6 of 27 and members of staff. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes statement of purpose and service users guide provide residents and prospective residents with details of the services provided. The homes admission and assessment procedure ensures that only those people whose needs can be met will be admitted. Evidence: The homes statement of purpose and service users guide clearly sets out its aims, objectives and philosophy; it is available in easy read format with pictures and photographs. The statement of purpose contains up-to-date information about all members of staff, their experience and qualifications. There have been no admissions to the home since it opened; however information contained in the AQAA, examination of the admissions policy and conversation with the acting manager revealed that, following receipt of a referral and prior to admission, there would be a transition period. During the transition period the prospective resident would visit the home on several occasions, during which in-depth assessments Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: would be carried out to determine the homes ability to meet the persons needs, compatibility with current residents and to give time for the person to decide if he/she likes number 67 Boroughbridge Road and wishes to live there. Care Homes for Adults (18-65 years) Page 11 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes care planning process ensures the needs of the people living in the home are identified and met. Residents are put at the centre of the care planning process and are supported to make choices and to take control of their lives at a level appropriate to their skills and abilities. Evidence: All care plans were examined; each was well organised and coverered all areas of the persons life: health, mobility, communication, personal and social needs. Assessments had been completed and action plans devised covering all areas of daily living and personal need. Risk assessments had been conducted and risk management strategies developed to support independence and to eliminate or reduce risk. Constant monitoring and regular reviews ensure action is taken to respond to any change of need. Care plans show that each person living in the home owns his own care plan and is put at the centre of the care planning process; there is a strong commitment from staff to involve each resident, as much as possible, in the development of his Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: plan and to support him to exercise choice and make decisions about matters affecting his life. The personal profile includes good background information likes/dislikes etc and areas of special needs such as communication difficulties. Care Homes for Adults (18-65 years) Page 13 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are treated with respect and presented with opportunities to lead fulfilling lives. Staff encourage and support residents to take part in appropriate leisure activities. Evidence: Care plans show how each person living in the home is encouraged and supported to develop his skills, to lead a satisfying life and to achieve as much independence as possible. Care plans, confirmed by members of staff and residents, show that opportunity is provided for each person to take part in a range of appropriate leisure activities including: horse riding; gardening; organised walks; bingo; visits to the cinema, attendance at day centres etc. Each of the three residents has been on holiday Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: this year. Two residents, accompanied by a member of staff regularly attend church. Each resident has been allocated a key worker who ensures social needs are being met. The key worker works closely with the resident, his family and friends and other appropriate persons e.g. social worker to produce a person centred plan that highlights likes/dislikes and preferences and is used as a basis for planning social events and activities. Staff recognise the importance of residents maintaining contact with family and friends, and help them to keep in touch by arranging home visits whenever possible. It was observed during the inspection that residents are treated with respect and that there is a happy and relaxed atmospher in the home. Routines are flexible, promote independence and allow people to exercise choice and maintain control over their lives (subject to their individual plan and risk assessments). Meals are generally served in the dining room at set times, however there is a great deal of flexibility to allow for individual wishes and activities. Peoples preferences and dietary needs are taken into account when menus are prepared. A balanced and varied diet is provided and alternatives are always available should someone not wish to have the dish of the day. Care Homes for Adults (18-65 years) Page 15 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Health and personal needs are met by staff who provide support in a sensitive and flexible manner in accordance with the wishes of the individual Evidence: Care plans contain information about residents general health, dietary requirements and details of any specific illness or medical condition. Constant monitoring of health is undertaken and healthcare needs addressed by the individual residents own doctor and other community-based professionals; in addition specialist support is given by the Learning Disabilities Team. None of the people living in the home is able to control his own medicine and all medicines are administered, according to the homes policy and procedures, by members of staff who have undergone suitable training. Medication records are accurately maintained and all medicines are stored securely in a suitable metal cupboard; however the location of the cupboard is inappropriate and it is recommended the provider re-locates the cupboard to a more suitable position within the home. Care Homes for Adults (18-65 years) Page 16 of 27 Care Homes for Adults (18-65 years) Page 17 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has a suitable complaints procedure and policies and procedures to safeguard people living in the home from abuse. Staff have received training in adult protection. Evidence: There is an appropriate complaints procedure stating how complaints can be made, who will deal with them, the timescale for the process and what to do if not satisfied with the way in which the matter has been handled. The procedure is included in the statement of purpose and service users guide and is available in written and pictorial format. The home has not received any complaints since the last inspection. Policies and procedures are in place to ensure the safety and protection of the people living in the home and to respond to any suspicion or allegation of abuse. Abuse awareness is included as part of staff supervision and all members of staff have received training in the protection of vulnerable adults. Care Homes for Adults (18-65 years) Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides comfortable and safe accommodation and meets the needs of the people who live there. Evidence: Number 67 Boroughbridge Road is a two storey end of terrace house offering the people who live there a warm, comfortable and homely environment. There are wellmaintained gardens to the front and rear of the house; the garden to the back of the house contains garden furniture and provides a safe and pleasant place for people to enjoy. The house is pleasantly decorated and furniture is comfortable and domestic in design. The internal and external fabric of the building is maintained in good condition; records show that regular checks and servicing is undertaken of all equipment. A walk round the building revealed it to be clean, hygienic and free from offensive odours. All areas of the building, including the kitchen and laundry, are accessible to the people who live there; subject to risk assessments. Each bedroom has been furnished to the occupants taste and has been individualised Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: by the inclusion of personal effects such as pictures, photographs, posters, television etc. Since the last inspection parts of the house have been re-decorated and new furniture purchased for the living room and dining area. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are protected by a competent staff team and by the homes policies and procedures on recruitment and training. Evidence: On the day of the inspection there were sufficient members of staff on duty to meet the assessed needs of the people in the home. Conversation with the acting manager and members of staff; and examination of staffing rosters indicated there are always sufficient staff on duty. Examination of personnel files revealed that prior to a newly appointed member of staff commencing employment all necessary checks, including Criminal Records Bureau (CRB), are carried out and two satisfactory references received. Training records and conversation with the acting manager and members of staff indicate the staff team has the skills and experience necessary to meet the needs of the people living in the home. New members of staff receive formal induction training and are required to complete the Learning Disability Induction Award; they also receive all mandatory training. There is ongoing training for all staff to aid professional development and to help meet residents needs, including: NVQ level 3; refresher Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: mandatory training and training specific to the service user group and role of the staff member. There is a supervision programme ensuring all members of staff receive a minimum of six formal supervision sessions a year; in addition members of staff are supported by an external body, Lifeworks, that offers guidance to staff over a range of matters including legal and counselling. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A well-managed home with an enthusiastic and well-trained staff team. The health, safety and welfare of the people living in the home are protected by the homes recordkeeping and policies and procedures. Evidence: The home has been without a registered manager for some considerable time however a new manager has now been appointed and will take up his position as soon as CRB clearance has been received. The acting manager has many years experience in working with people with learning disabilities; he is the holder of the NVQ level 3 and the A1 Assessors Award, he is currently studying for a foundation degree in Business Management. The home has policies and procedures complying with current legislation and recognised professional standards and covering all aspects of the management of the home. Records are kept to safeguard the rights and best interests of residents and to Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: ensure the safe and effective running of the home; these are up-to-date and stored appropriately. The acting manager is aware of his responsibilities under health & safety legislation. Regular checks of the building are undertaken and maintenance and servicing undertaken to ensure a safe and comfortable environment. There are various systems in place, both formal and informal, to measure success in meeting the homes aims, objectives and statement of purpose and to ensure the rights and best interests of the people living in the home are safeguarded: Regulation 26 visits by St Annes area manager, monthly team meetings, key worker meetings and monthly reviews, resident surveys. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 20 The medicine cupboard should be removed to a more suitable location within the home Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - 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!