Inspection on 04/05/05 for Broken Banks (2)

This inspection was carried out on 4th May 2005.

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) 18/12/06

Broken Banks (2) 07/09/05

Broken Banks (2) 25/01/05

Broken Banks (2) 07/06/04

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Sunny Bank (P.R.S.) Ltd

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Alfred House Residential Care Home

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Creative Support

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

CARE HOME ADULTS 18-65 2 Broken Banks 2 Broken Banks Colne Lancashire BB8 0JY Lead Inspector Keren Nicholls Unannounced 04 May 2005 12:45 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. 2 Broken Banks Broken Banks Unan.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 2 Broken Banks Address 2 Broken Banks Colne Lancashire BB8 0JY 01282 868077 01282 868077 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) Pendle Residential Care Limited Mr Stephen Dewsbury Mr Thomas Hanna Care Home (CRH) 3 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - MD - 3 of places 2 Broken Banks Broken Banks Unan.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Mental disorder, excluding learning disability 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. Date of last inspection 25 January 2005 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. 2 Broken Banks Broken Banks Unan.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place between 12:45 and 3:00pm (2.15 hours). This was a statutory unannounced inspection. Service users allowed an inspection of the ground floor communal areas (kitchen, dining room and lounge). Private bedrooms were not inspected. All three service users and the house keyworker were spoken to during the inspection. Subsequently, the registered manager was contacted. What the service does well: What has improved since the last inspection? The house keyworker had completed a level 3 NVQ course and attended inservice training. Regular staff supervision and appraisal sessions with the registered manager had been taking place. These developments have resulted in a staff team that understands the needs of service users well. Staff were providing a professional service, which protected service users and represented their best interests to other professionals. Service users explained that the support they received had enabled them to grow in confidence and meet their individual goals. At the request of service users, a shed had been provided in the back garden. The registered provider and manager had met or were working towards the recommendations from the last inspection. 2 Broken Banks Broken Banks Unan.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. 2 Broken Banks Broken Banks Unan.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 2 Broken Banks Broken Banks Unan.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) 2, 3 and 5 Service users needs were fully assessed by trained people. The staff team knew what service users needs and wishes were and how the staff could best meet needs. The contracts made with service users provided sufficient and adequate information and agreements about the terms and conditions of residence for each service user. EVIDENCE: The three service users had resided at Broken Banks for some time. Service users had received sufficient information about the home (a Service User’s Guide). The Statement of Purpose was freely available for everyone to read if they so desired. Service users said that they had sufficient information about the home and liked living at Broken Banks. Everyone had individual written needs assessments as part of the mental health ‘care programme approach’ (CPA). These were linked to the home’s care plan. One service user explained that a recommendation from the last inspection (regarding specifying insurance arrangements and the costs of services not covered by fees in contracts) had been achieved. He had made an individual arrangement regarding insuring extra possessions with the registered provider. All the service users said that they had individual contracts and were satisfied with and understood the terms and conditions. 2 Broken Banks Broken Banks Unan.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 There were satisfactory arrangements to regularly review care plans with service users as part of the Care Programme Approach. Independence was encouraged. Staff support ensured that service users were properly consulted about and participated in all aspects of life at the home and were enabled to take responsible risks. EVIDENCE: The keyworker explained that care plans were reviewed regularly. One service user allowed his recent review record to be inspected. Reviews were conducted with service user’s mental health team and the house keyworker. The keyworker and one service user explained that it had been difficult to contact his professional mental health worker, but staff continued to make every effort to make review appointments. Service users described to the inspector how they made their own decisions about their lives and how they chose to occupy their time. They said they managed their own personal finances, with support from the house keyworker as necessary. Limitations on rights to prevent harm and ways to minimise risk were recorded. Discussion with service users showed that they understood and agreed the need for restrictions (such as with alcohol, drugs or money 2 Broken Banks Broken Banks Unan.doc Version 1.30 Page 10 management). The house keyworker helped service users with skills training in areas such as personal care, cooking and domestic tasks, money management, leisure-time and medication management. Service users said that they decided between them how to run their home and had help in decision making from each other, from family and friends and from staff and other residents at the core house. 2 Broken Banks Broken Banks Unan.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15 and 17 The home had created a supportive environment for service users to lead fulfilling lives and participate fully in appropriate leisure and social activities of individual’s choosing. Staff respected service user’s rights and responsibilities and helped service users to keep in contact with their families and take part in community life. EVIDENCE: Every service user had house and bedroom door keys. There was an expectation that everyone would have a good deal of independent responsibility for housekeeping tasks. Service users said that they usually agreed areas of housework etc. among themselves, with some tasks being shared. Most people had their own different routines and made their own arrangements for meals, shopping and keeping provisions, doing their own washing and cleaning their own bedrooms etc. The house keyworker helped to devise and maintain routines and there were regular house meetings to discuss any difference of opinion. Two service users said that they often had meals at the core house (Calder View) and this helped to ensure that they had an appropriately nutritious diet. 2 Broken Banks Broken Banks Unan.doc Version 1.30 Page 12 Family and friends were welcome at the house. Family links were maintained by visiting family or telephoning and received staff support to keep in contact. Service users said they chose who to see and when. Family and friends were included in aspects of service users lives, as far as each service user wished, and their involvement was noted in individual’s care plan. Service users explained that they made their own choices regarding friendships and personal relationships with others and accepted each other’s personal friends. Local shops, pubs, parks, library, cinema, places of worship and other community facilities were used. Staff cars were available for lifts and trips further afield, but people walked to nearby places or used public transport. Service users explained that they enjoyed a variety of individual hobbies and leisure activities such as music and videos, playing guitar, watching TV, going to the pub, shopping, going to car boot sales, walking, cycling and going to football matches etc. One person said he had recently been on a week’s holiday with a friend and intended to have a second week later in the year. Everyone viewed leisure activities as important for confidence and social skills building. The forthcoming election was discussed and service users said they had the opportunity to vote if they so desired. 2 Broken Banks Broken Banks Unan.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 and 20 Personal and healthcare support is provided in a flexible and individual manner, which respects service user’s dignity and independence. There are good systems for safe administration and service user self-administration of medicines. EVIDENCE: Service users said they made their own decisions and choices about personal routines, such as getting up/going to bed times, bathing, clothes choice, where to shop, when and where to go out etc. The house keyworker and manager gave support in respect of personal care when necessary. Hospital consultants and other mental health professionals oversaw mental health care. Staff followed agreed care plans in respect of mental health. The keyworker system, with designated house staff ensured consistency and continuity of support. Service users said that they were very happy with their keyworker and found him helpful. Service users said they were happy with the emergency and out of hours support from the ‘core’ house. Consent to medication was recorded as part of the Care Programme Approach. A record of drugs administered by staff (MAR) was kept and the home had satisfactory medication policies and procedures. A record was maintained of current medication for all the service users. The keyworker had attended 2 Broken Banks Broken Banks Unan.doc Version 1.30 Page 14 accredited medicines management training. One person self-administered his medication and had locked storage. This was overseen by the keyworker who supported service users in self-medication and in compliance issues. There were no service users taking controlled drugs. There was locked, secure storage for medicines to which only staff had keys. A blister pack, monitored dose system was used. Others used daily compliance aids. Service users demonstrated a good understanding of the drugs they were taking, of their effects and side effects and generally had a responsible attitude towards medicine safety. There were regular medication reviews with consultant psychiatrists, Community Mental Health Team and where appropriate, GPs. One service user explained that he did not agree with his prescribed medication but was working towards a reduction within his CPA. 2 Broken Banks Broken Banks Unan.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 There are good systems for ensuring that service user’s views are listened to and acted upon, with evidence that service user’s suggestions, requests, comments and complaints are satisfactorily addressed in a timely fashion. EVIDENCE: Service users said they knew who to speak to if they had any problems either of a personal nature or about the home in general. The house keyworker listened to what they had to say. They commented that the registered manager visited and talked to them and the registered provider made frequent “secret” visits and talked to them about the premises and other matters. If they so desired they could contact the registered manager at any time. Service users described several instances when the staff team had acted on their suggestions and requests and felt they could freely voice their views and opinions. There was a simple formal complaints procedure available both in the service user’s guide (of which each service user had a copy) and in the policies and procedures file in the lounge. Contacts outside the home (for example, the Commission for Social Care Inspection) were known and there was a list of addresses and telephone numbers by the telephone. 2 Broken Banks Broken Banks Unan.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 28 and 30 The home had a good standard of cleanliness in the communal areas inspected. There were no obvious hazards to safety and the building and grounds were maintained in good order, providing a safe, comfortable and ‘homely’ environment, suited to the needs of the current service users. EVIDENCE: Broken Banks is a good-sized house, similar to other houses in the locality and near to local shops and amenities. Service users said they liked the location, with rural views and the private garden and recent addition of a shed. One person commented that the hill leading to the house was steep, but overall the location pleased the service users. Service users said they liked their house, which was spacious enough for their needs. They kept the house clean themselves, with help from their keyworker. Maintenance was the responsibility of the registered provider, and the home looked to be well maintained. The furniture, furnishings and fittings were satisfactory. 2 Broken Banks Broken Banks Unan.doc Version 1.30 Page 17 Private bedrooms were not inspected, but service users said that they were happy with bedroom accommodation. They also said that they were satisfied with the equipment in the house (such as kitchen and laundry equipment) and everything worked properly and had been safety checked by qualified persons. There was a house telephone and people had their own phones and TVs in their rooms. Personal effects and presents from family and friends made the house look ‘homely’. One person said that the lock on the outside store was not working properly. It was also noted that one bedroom door required repair and the recommendation from the last inspection (regarding replacing bedroom door locks with a type approved by the fire authority) had not been carried out. 2 Broken Banks Broken Banks Unan.doc Version 1.30 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 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, 35 and 36 A trained and qualified keyworker satisfactorily and safely met service user’s needs. Staff had good relationships with service users. The registered manager properly supervised the staff team’s work and performance. EVIDENCE: The house keyworker had recently completed a level 3 NVQ course. Support staff from the core house also has NVQ qualification. All the staff had attended in-service courses and certificated training (such as basic food hygiene, health and safety, medicines management etc.). The keyworker said that he was keen to continue with training opportunities. The service had an annual training budget. Staff development and training formed part of the 3 monthly and twice-annual supervision and appraisal sessions conducted by the registered manager. Service users commented that they thought the keyworker and other staff were competent and helpful. They had good relationships with the staff and said that staff supported them with activities inside and outside the home and with personal development issues as identified in care plans. The keyworker and staff from the core house provided a reliable, competent and flexible 2 Broken Banks Broken Banks Unan.doc Version 1.30 Page 19 personal and social care service, which met the service user’s individual needs and wishes. 2 Broken Banks Broken Banks Unan.doc Version 1.30 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 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, 39 and 40 The manager provided appropriate leadership. The service promoted an effective quality assurance system, which encouraged and enabled service users to express their views and opinions. Sound and comprehensive policies and procedures underpinned care and health and safety practices. EVIDENCE: Service users were satisfied that the registered persons and the staff team listened to their views and opinions. Service users said that a ‘customer satisfaction’ survey had been conducted to find out their views about the service. However, there was no evidence of the published outcomes of the survey at the home and a recommendation regarding this from the last inspection was carried forward. The service’s quality system included an ‘Investors in People’ award in respect of valuing staff training and development. 2 Broken Banks Broken Banks Unan.doc Version 1.30 Page 21 ‘House meetings’ were held to decide how well the house was being run and ways in which to make changes. Service users commented that family and friends were involved in their care support as far as they wished and they felt they were kept informed of developments that affected them individually and the home in general. They were also very well informed of care plan arrangements, content of records and the strengths and weaknesses of local mental health support services. The registered manager was experienced and qualified and the service users had confidence in his knowledge and skills. The policies and procedures were kept openly on the coffee table shelf in the lounge and service users were encouraged to read and comment on them. Service users said they knew where to look for information. Important information about contacting persons outside the home was displayed near the house telephone. Service users said that they thought the home was safe. They were knowledgeable about work carried out in their home. They recollected that the gas fire and cooker had been checked and that electrical equipment and wiring had been checked. Stickers on appliances noted that an annual portable appliance check was carried out. Safety information on products used and risk assessments were available to all in a file in the lounge. Evidence was not seen at the home in respect of recommendation from the last inspection regarding window restrictor risk assessment and water design solutions to prevent risk of scald. These have been carried forward in this report. 2 Broken Banks Broken Banks Unan.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 3 x 3 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 2 x x x 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 x 3 Standard No 31 32 33 34 35 36 Score x 3 3 x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 2 Broken Banks Score 3 x 3 x Broken Banks Unan.doc Standard No 37 38 39 40 41 42 43 Score 3 x 2 3 x x x Version 1.30 Page 23 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 There were no requirements arising from this inspection 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. Refer to Standard 24 26 26 39 Good Practice Recommendations That the outside store door lock is repaired This recommendation carried forward from the last inspection: That the bedroom door locks are changed to a type specified by the fire authority(26.4) That the door to one service users bedroom is repaired (26.1) This recommendation carried forward from the last inspection: That the results of the service user survey are published and made available to service users, their representatives and other interested parties (39.4) and is incorporated into the service user’s guide. This recommendation carried forward from the last inspection: a a)That formal risk assessments in respect of window restrictors are completed and reviewed. 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. Broken Banks Unan.doc Version 1.30 Page 24 5. 42 2 Broken Banks Commission for Social Care Inspection Unit 4 Petre Road Clayton Business Park Accrington Lancashire. BB5 5JB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 2 Broken Banks Broken Banks Unan.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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