CARE HOME ADULTS 18-65 Brackenley 33 Forest Lane Head Harrogate North Yorkshire HG2 7TE
Lead Inspector Chris Taylor Unannounced 19 April 2005 09.30 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. Brackenley Version 1.10 Page 3 SERVICE INFORMATION
Name of service Brackenley Address 33 Forest Lane Head, Harrogate, North Yorkshire, HG2 7TE 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) 01423 862230 01423 861541 Applewalk Homes Ltd Mrs Julie Ann Lunn Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Brackenley Version 1.10 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 9th November 2004 Brief Description of the Service: Brackenley is registered to provide personal care for 12 adults with learning disabilites under the age of 65 years. Brackenley is situated between Harrogate and Knaresbrough which provides good access to the towns amenites. The home is owned by Apple Walk Homes Ltd Brackenley Version 1.10 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place at short notice to make sure that the people who live at the home were there to speak to the inspector. The inspector spent time observing staff help service users have breakfast and get ready to go out to day services. Service users and staff spoke with the inspector and some records about service users and staff were looked at. What the service does well: What has improved since the last inspection?
The house has a large garden and since the last inspection staff and service users have worked hard to improve it. The garden now has a big fence around it and the boarders and lawn tidy. This means that it is safer for service users to spend time in it. Brackenley Version 1.10 Page 6 Staff and the manager have changed the way that complaints are dealt with, particularly complaints from service users. Service users said that they now know what to do if they had a complaint and thought it would be looked into properly. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Brackenley Version 1.10 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 Brackenley Version 1.10 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: Brackenley Version 1.10 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 Proper arrangements are made to ensure service users needs are assessed and met. EVIDENCE: Two service users talked about the planning for their care. They said that they had a care plan and they had the opportunity to talk about their needs with the manager and their key worker. Service users said that they had regular meetings together to talk about the running of the home. Whilst staff were helping service users with breakfast and getting ready for the day ahead it was clear that staff knew individuals’ needs and they were able to reassure and assist service users in a kind and supportive manner Service user plans contained information about every aspect of the service users life and included areas for developing new skills. There was clear instruction to staff about how care should be delivered and service users had signed in agreement. Also present were risk assessments that supported service users to live as independently as possible with safeguards in place, these were reviewed regularly. Brackenley Version 1.10 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 and 16 Service users have full and active lives. EVIDENCE: Service users talked about the day service they attend and how they spend their leisure time. All service users said that they were consulted about what they did through the day and how they spent their leisure time. They described a variety of day services some of which have a work ethos. Service users talked about being involved in the running of the home and specific service user groups outside of the home that help raise the profile of people with learning disabilities having their rights respected. They talked about going to the local pub, church and using local amenities, they said that they knew people who worked at local shops and they were always very friendly. Service user plans contained sections relating to service users leisure and daytime occupation preferences. Respecting service users is included in staff induction, training and supervision.
Brackenley Version 1.10 Page 11 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) none EVIDENCE: Brackenley Version 1.10 Page 12 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 and 23 Service users are safeguarded from abuse. Complaints are dealt with in a proper manner. EVIDENCE: Service users said that they met regularly as a group to talk about the running of the home and they are included in formulating their individual care plans. Services users said that they knew about the complaints procedure and felt able to discuss any concerns with the manager. Staff and service users have recently reviewed the effectiveness of the residents meetings and complaints. Residents meetings tended to be the only forum to air complaints. A new complaints leaflet has recently been implemented and the focus of the residents group is now about improving life for service users at Brackenley. There have been no formal complaints since the last inspection. There is a comprehensive policy and procedure with regard to adult protection and staff have a good awareness of this. Staff receive training in adult protection and whistle blowing during induction and foundation training and as part of NVQ level 2 and 3. Recruitment procedures included carrying out appropriate checks. Brackenley Version 1.10 Page 13 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) 28 Service users have shared space to spend time together. EVIDENCE: There is large dining sitting room which has two dining tables and three settees. There is a large kitchen and further sitting/kitchen room on the first floor. There is a large garden that has been tidied up and a new perimeter fence erected. This makes the space more accessible and safe for service users. Brackenley Version 1.10 Page 14 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) 35 and 36 Service users receive care from well-trained staff. There are good systems in place to supervise and monitor staff competence. EVIDENCE: Staff complete induction and foundation training specific to Brackenley and working with people with learning disabilities. Staff have the opportunity to complete NVQ level 2 and 3. Each member of staff has a training and development plan which is discussed in staff supervision. Staff competence is assessed via direct observation, staff meetings and formal supervision. The manager and deputy have recently attended training in appraising staff and they are due to implement this next month. Brackenley Version 1.10 Page 15 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) 39 Service user views are obtained in a variety of ways and there was evidence that indicates that these are acted upon. EVIDENCE: Service users said that they met regularly as a group to talk about the running of the home. They said that these meetings are the opportunity to raise any concerns. Service users did say that they were included in planning their own lives and had a say in activities they participate in, holidays and the décor of their own rooms. Care plan review notes and daily records provided evidence that service user views are acted upon. In developing the home’s business plan the manager said they would like to further develop ways in which they obtain service users views. Brackenley Version 1.10 Page 16 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 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 x x x x 3 x x Standard No 11 12 13 14 15 16 17 x 3 3 x x 3 x Standard No 31 32 33 34 35 36 Score x x x x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x x x Standard No 37 38 39 40 41 42 43 Score x x 3 x x x x Brackenley Version 1.10 Page 17 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 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. Refer to Standard Good Practice Recommendations Brackenley Version 1.10 Page 18 Commission for Social Care Inspection 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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