Inspection on 18/12/06 for Broken Banks (2)

This inspection was carried out on 18th December 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Broken Banks (2) 07/09/05

Broken Banks (2) 04/05/05

Broken Banks (2) 25/01/05

Broken Banks (2) 07/06/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Broken Banks (2) 2 Broken Banks Colne Lancashire BB8 0JY Lead Inspector Andrew Windsor Unannounced Inspection 18th December 2006 09:00 Broken Banks (2) DS0000009622.V321676.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Broken Banks (2) DS0000009622.V321676.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Broken Banks (2) DS0000009622.V321676.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Broken Banks (2) Address 2 Broken Banks Colne Lancashire BB8 0JY 01204 594550 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) Pendle Residential Care Limited Mr Thomas Hanna Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places Broken Banks (2) DS0000009622.V321676.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Mental disorder, excluding learning disabiltiy or dementia at 2 Broken Banks, Colne. BB8 0JY The service employs at all times, a suitably qualified and experienced person who is registered with the Commission for Social Care Inspection as Manager of Calder View, 2 Broken Banks and 284 Burnley Road, Colne 7th September 2005 Date of last inspection Brief Description of the Service: 2, Broken Banks (accommodating 3 younger adults) is part of Calder View Dispersed Homes Scheme. This is a semi-independent living scheme for younger adults who have mental health problems, with a staffed core house nearby at Calder View in Colne. This dispersed house has staff support as needed by the service users. Broken Banks has a designated keyworker who visits every day. Further support is provided by visits from the registered manager and provider. A care support worker is available to visit in the evening and at week-end, according to the assessed needs of service users. Service users can telephone for staff assistance whenever they need and 24 hour emergency support is provided by Calder View (core house). Broken Banks is located in a quiet residential area, near to Colne town centre shops and other amenities. The house has long-distance views over the surrounding countryside, on-street parking and pleasant private gardens. Transport in staff cars is provided for service users. Upstairs are 3 single bedrooms and a house bathroom. A further small bedroom is available as compensatory space for the smallest single bedroom. Downstairs is a WC cloakroom, kitchen, dining room and lounge. The fees charged for Broken Banks vary between £332 and £351 per week. Information about the home is given to prospective residents on referral. Broken Banks (2) DS0000009622.V321676.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key unannounced inspection, which included a visit to the home, was conducted at Broken Banks on 18 December 2006. The purpose of the inspection was to assess quality of life in the home, and check that the home meets legal requirements. The inspection comprised of looking around the home, and speaking to service users and staff members. It also involved the examination of service users’ records and other documents. What the service does well: What has improved since the last inspection? What they could do better: Controls measures are not in place to prevent Legionella. This means that service users and staff may not be fully protected. Risk assessments have not been completed for the lack of window restrictors. This is potentially placing service users at risk. Broken Banks (2) DS0000009622.V321676.R01.S.doc Version 5.2 Page 6 The old locks on bedroom doors have not been made inoperable, to ensure the health and safety of service users. Similarly, a bathroom door lock that indicates occupancy and has an emergency override has not been fitted. The house would benefit from a ‘spring clean’, so that it is hygienic and comfortable for service users. 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. The summary of this inspection report can be made available in other formats on request. Broken Banks (2) DS0000009622.V321676.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Broken Banks (2) DS0000009622.V321676.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2;3;5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Admission procedures meant that service users could be confident that their needs could be met. EVIDENCE: The inspector spoke with service users, and examined two care files. All three service users currently using the service have resided at Broken Banks for some time. Service users spoken to stated that they had been provided with information about the home prior to admission. Both the Statement of Purpose and Service User Guide were found in the care plans of service users. These provided detailed information about the aims and objectives of the home. Each resident had received an assessment of need, which had been done using the Care Programme Approach. One of the files examined also contained an assessment of need that had been completed by a social worker. This made specific reference to suitability of Broken Banks. Both care files examined contained individual contracts, which had been signed by the service users. This means that service users were aware of any restrictions placed upon them by living at Broken Banks. Broken Banks (2) DS0000009622.V321676.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6;7;8;9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The needs of service users are reflected in their plan of care. Service users are encouraged to retain their independence, and make their own decisions through informed choices. EVIDENCE: The inspector discussed care planning with service users and staff, and examined the care files. Service users knew what was in their care files, and were encouraged to participate in the care planning process. Care planning in home tends to be maintained by one particular staff member, who visits the home at least twice each day. Mental health professionals review the Care Programme Approach every 6 months. Discussions with service users indicated that they were supported to live as independently as possible, within a risk-based framework. The care plans examined contained a number of risk assessments, to ensure that service users were safeguarded. Care files examined contained the home’s policy on Broken Banks (2) DS0000009622.V321676.R01.S.doc Version 5.2 Page 10 confidentiality. Information about service users was securely locked, to protect their privacy. Broken Banks (2) DS0000009622.V321676.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12;13;14;15;16;17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Independence and choice are encouraged, which enables service users to be part of the community. Contact with family members is maintained. EVIDENCE: The inspector examined two care plans, and discussed community and leisure activities with service users and staff. The individual contracts of residents contained a list of ‘house rules’, which had been agreed with service users. Service users spoken to were aware of any limitations placed on their lifestyle by these rules. Service users took responsibility for their own leisure and recreational activities. Staff provided encouragement and occasional support. Activities included visits to the pubs, meals out, watching football, and shopping trips. One service user commented that he had a car, which made accessing Broken Banks (2) DS0000009622.V321676.R01.S.doc Version 5.2 Page 12 community facilities much easier. Another service user did voluntary work, and regularly attended church. Service users took responsibility for their own meals. One service spoken to chose to have his meals at the core house (Calder View). Staff provided support with cooking and shopping as required. There was an expectation that domestic tasks would be shared, which service users had agreed among themselves. Each individual took responsibility for their own bedroom. Staff helped service users to devise and maintain routines. Broken Banks encourages contact with family and friends. One service user commented that his sister visits every fortnight. Another stated that a family member had visited the previous week. Broken Banks (2) DS0000009622.V321676.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18;19;20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Health care needs are recorded, and addressed by accessing healthcare facilities in the community. Procedures for the administration of medication protect service users. EVIDENCE: Service users stated that they make their own decisions about personal routines, such as getting up/going to bed times, bathing, clothes etc. The long-term mental health of service users is monitored through review of the Care Programme Approach. Care records examined demonstrated regular contact with mental health professionals and the social work team. Staff provide support within the mental health framework laid down in the care plan. The ongoing healthcare needs of service users are monitored, by interacting with them on a day-to-day basis. The same staff member usually provides support twice each day, known as the ‘keyworker’. Service users therefore benefit from a consistent approach to care. Support is also available 24 hours a day, by contacting the core house (Calder View). Broken Banks (2) DS0000009622.V321676.R01.S.doc Version 5.2 Page 14 The ‘keyworker’ would typically accompany service users whenever they were accessing community healthcare facilities, such as the GP, optician, dentist etc. Care plans examined contained a policy on the self-medication of medicines. They also contained a tool used to assess competency to self-medicate. Service users are strongly encouraged to take their medication as part of the Care Programme Approach. A Medication Administration Record (MAR) chart was kept by staff for each service user. The receipt of drugs was appropriately recorded on the MAR chart. Service users were supported to take their medication, and the fact that medication had been ‘made available’ to them was recorded on the MAR chart. The home contained appropriate lockable storage for both drugs, and controlled drugs. Lockable storage for medication was also available to service users in their bedrooms. The ‘keyworker’ had received accredited training in the administration of medicines. Broken Banks (2) DS0000009622.V321676.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22;23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users were confident that their concerns would be listened to and acted upon. Service users were protected from abuse and harm. EVIDENCE: The complaint’s procedure is a concise document, which included in the Service User Guide. Service users spoken were aware of the complaint’s procedure. One service user stated that it was on the notice board, should he need it. Another stated that he had made a verbal complaint a while ago, which had been dealt with by the manager. According to the ‘keyworker’, complaints are usually dealt with informally. No formal complaints have been recorded by Broken Banks since the last inspection. Broken Banks had a policy on safeguarding adults, which had recently been reviewed. There was also a ‘whistleblowing policy’ for the protection of staff. Similarly, the ‘keyworker’ had received training in the safeguarding of adults. Risk assessments for self-harm/suicide where found in the two care files examined. Service Users stated that they managed own money, with ‘a bit of support’ when required. Broken Banks (2) DS0000009622.V321676.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24;25;26;27;30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Broken Banks provides a homely environment for service users. Some environmental issues need to be addressed to ensure the health and safety of residents. There is room for improvement in the general tidiness and cleanliness of the house. EVIDENCE: Broken Banks is a good-sized house, which is in keeping with other houses in the area. It is close to local shops and amenities. Service users spoken to were happy with the location. A perimeter fence has now been erected in the back garden, to ensure the privacy of residents. The house was found to be homely and comfortable. For example, there were four Christmas Trees located in different parts of the house to create a festive environment. Broken Banks (2) DS0000009622.V321676.R01.S.doc Version 5.2 Page 17 A number of environmental issues were highlighted at the time of the last inspection. The kitchen cabinet door has now been repaired, and the curtains in the kitchen hung correctly. The carpet strip in one bedroom doorway has now been replaced. Electrical appliances being brought into the home by service users are now being tested before use, to ensure that service users and staff are safeguarded. Corridors are now being kept free from obstructions, for health and safety reasons. Also, one of the bedroom doors in the house has now been repaired. However, the old locks on bedroom doors have not been made inoperable, to ensure the health and safety of service users. A bathroom door lock, which indicates occupancy and has an emergency override, has not yet been fitted. Bedrooms were lockable, and all service users had keys to both their rooms and the front door. The downstairs hallway carpet needed to be cleaned or replaced. The bedrooms of service users required a ‘spring clean’. The last report recommended that arrangements for a periodic ‘deep clean’ of the house be made. This remains outstanding. Broken Banks (2) DS0000009622.V321676.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31;32;34;35;36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Recruitment procedures were robust and meant that service users were safeguarded. Staff have received the training they need to do their jobs in a safe and competent manner. EVIDENCE: The ‘keyworker’ system adopted at Broken Banks ensures that service users receive continuity of care, as they are supported by the same staff member each day. According to the ‘keyworker’, two other members of staff are familiar with the service users at Broken Banks. This is to ensure that people are appropriately supported during periods of sickness and annual leave. Service users spoken to were happy with the ‘keyworker’ approach. The availability of staff from the core house 24 hours a day also made them feel well supported. The inspector examined the staff file for the ‘keyworker’. Appropriate preemployment checks had been made by the service prior to employment. The Broken Banks (2) DS0000009622.V321676.R01.S.doc Version 5.2 Page 19 file also contained a Criminal Records Bureau (CRB) check that had been completed in the last two years. In addition to mandatory training, the ‘keyworker’ had also recently completed a National Vocational Qualification (NVQ) level 4 in management, and the Registered Manager’s Award (RMA). He was therefore well qualified to support service users in a safe and competent manner. Broken Banks (2) DS0000009622.V321676.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37;39;40;41;42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users were consulted about how Broken Banks was run and managed. Policies and procedures were robust. Some health and safety issues needed to be addressed, to ensure that service users were protected. EVIDENCE: The registered manager for Broken Banks has an NVQ4 in Care, and an RMA. They have also completed Advanced Management in Care with City and Guilds, in addition to some specific qualifications in mental health. A ‘customer satisfaction survey’ for the Calder View Dispersed Homes Scheme was completed earlier in the year, so that service users could give their views about how the scheme was running. The results of this survey were made available to the residents of Broken Banks. The views of service users were also sought through the use of house meetings, and day-to-day discussions Broken Banks (2) DS0000009622.V321676.R01.S.doc Version 5.2 Page 21 with the ‘keyworker’. Broken Banks also encourages service users to visit the core house regularly, so they can meet with others on the scheme and speak with the registered manager. Quality assurance systems are Broken Banks would benefit from further development. According to the ‘keyworker’, ongoing issues that require further attention are scheduled into his diary. However, the registered provider does ensure that a representative of the organisation makes an unannounced visit to the home every month. According to the ‘keyworker’, arrangements were in place for appraisal and supervision, to ensure that he and other staff were supported to do their jobs. Health and safety procedures were available, which included the safe storage of hazardous materials. Staff attempted a collaborative approach with residents regarding health and safety issues. Broken Banks did not contain any risk assessments for the environment. However, the care files of service users contained individual risk assessments for most issues. Gas and electrical safety checks were carried out regularly, to protect service users. Portable Appliance Testing is now being carried out on electrical items at the house. Fire procedures were found to be up-to-date. It was identified during a previous inspection that restrictor valves have not been fitted to the hot water system. This means that service users could potentially be placed at risk. The home has produced risk assessments for this issue, which are contained in the care files. However, controls designed to minimise the risk of Legionella were not found to be in place. It has been recommended in previous inspections that formal risk assessments be completed regarding the lack of window restrictors, and that restrictors be provided if necessary. This issue remains outstanding. Broken Banks (2) DS0000009622.V321676.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 3 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 2 27 2 28 X 29 X 30 2 STAFFING Standard No Score 31 3 32 4 33 X 34 3 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 3 3 2 X Broken Banks (2) DS0000009622.V321676.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard YA24 YA26 YA27 YA30 YA42 Good Practice Recommendations The downstairs hallway carpet is cleaned or replaced. (24.6) The old bedroom door locks should be made inoperable (26.4) A bathroom door lock, which indicates occupancy and has an emergency override should be provided (27.6) The manager should arrange for the house to have a periodic deep clean (30.1) This recommendation carried forward from the last three inspections: a)That formal risk assessments in respect of window restrictors are completed, reviewed and restrictors provided where necessary (42.3 v) b)That records of hot water tests and evidence of design solutions to prevent both the risk of scald and to prevent risk of Legionella should be provided (42.3 iv) Broken Banks (2) DS0000009622.V321676.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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