Inspection on 07/09/05 for Broken Banks (2)

This inspection was carried out on 7th September 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) 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 Broken Banks Colne Lancs BB8 0JY Lead Inspector Keren Nicholls Unannounced 07 September 2005 12.40 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. Broken Banks F57 F07 S9622 Broken Banks V248030 26.9.05 Stage 4 doc.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Broken Banks Address 2 Broken Banks Colne Lancs 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 Ltd Mr Thomas Hanna Care Home 3 Category(ies) of MD Mental Disorder, excluding learning registration, with number disability or dementia of places 3 Broken Banks F57 F07 S9622 Broken Banks V248030 26.9.05 Stage 4 doc.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Mental disorder, excluding learning disability or dementia at 2 Broken Banks, Colne. BB8 0JY 2. 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 4th May 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. At other times, service users can telephone for staff assistance and 24 hour emergency support is provided by Calder View. 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 with a shed. 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, store, kitchen, dining room and lounge. Broken Banks F57 F07 S9622 Broken Banks V248030 26.9.05 Stage 4 doc.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second of two statutory inspections to be conducted between April 2005 and April 2006. This unannounced inspection took place between 12:40 and 3:30. During this time the inspector spoke to two of the three residents, looked at written information and with the permission of the residents, viewed the premises. The inspector then visited Calder View (the ‘core house’) to speak to the registered manager. What the service does well: What has improved since the last inspection? What they could do better: The manager should ensure that assessments are carried out in respect of risk management, prevention and reduction. For example, design solutions to prevent the risk of hot water scald and to prevent risk from Legionella should Broken Banks F57 F07 S9622 Broken Banks V248030 26.9.05 Stage 4 doc.doc Version 1.40 Page 6 be implemented as necessary. Subsequent water temperature checks should be made to ensure that any thermostatically controlled devices fitted are working. The manager should also risk assess window restrictors as matters of safety and security for service users, and provide restrictors as necessary. The old bedroom door locks should be made inoperable and a lock that respects the privacy and safety of residents should be fitted to the bathroom. Resident’s personal electrical belongings should be checked and fitted safely before use and should not jeopardise the home’s equipment (such as use of the house telephone). Minor works, such as providing a carpet strip to one bedroom and repairing a kitchen cupboard door should be carried out promptly. Although the residents and staff kept the home clean on a daily basis, for thorough hygiene, infection control and food safety it is recommended that the manager conducts a periodic ‘deep’ clean throughout the house, including window frames, curtain poles, inside cupboards etc. 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. Broken Banks F57 F07 S9622 Broken Banks V248030 26.9.05 Stage 4 doc.doc Version 1.40 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 Broken Banks F57 F07 S9622 Broken Banks V248030 26.9.05 Stage 4 doc.doc Version 1.40 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) 1 and 2 The manager and staff followed the admission procedure, to make sure that new people could make an informed decision about whether Broken Banks was the right place for them to live. Proper assessments had been made prior to people moving into the service, to ensure that their needs were known and could be satisfactorily met. EVIDENCE: The three residents had resided at Broken Banks for some time. The two people spoken with said they all got on well together and liked living at the home. Each person had received the ‘service user’s guide’, which explained the aims and objectives of the home and relevant information about complaints, the premises and staff team. The Statement of Purpose was freely available for everyone to read if they so desired. Everyone said they understood the ‘house rules’ and their rights and responsibilities of living at the home. All the residents had written needs assessments as part of the mental health ‘care programme approach’ (CPA), which formed the basis for each person’s care plan. Broken Banks F57 F07 S9622 Broken Banks V248030 26.9.05 Stage 4 doc.doc Version 1.40 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, 9 and 10 There were good arrangements to draw up and regularly review care plans with the residents, based on the Care Programme Approach. The culture of supported independence ensured that residents made decisions about their lives and were enabled to take responsible risks. Confidentiality was understood within a risk assessment framework and was respected by staff. EVIDENCE: Residents knew about the care planning process. They were involved in care plan discussions and regular care plan reviews with the home’s staff and mental health professionals, which ensured their changing needs were known and met appropriately with flexible staff support. The way of life at Broken Banks encouraged and supported independence in a risk-based framework. Residents explained how they made decisions about every aspect of their lives inside and outside the home within agreed limitations (such as with alcohol, drugs or money management). Staff respected confidentiality within the boundaries of the home’s policy. Residents’ files and other confidential information was kept locked away safely and securely, but residents knew they could look at their files if they wanted. Broken Banks F57 F07 S9622 Broken Banks V248030 26.9.05 Stage 4 doc.doc Version 1.40 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) 11, 12, 13, 14, 15, 16 and 17 There was a supportive environment at the home, which enabled residents to lead fulfilling lives, and participate in appropriate leisure and social activities of each person’s choosing. Staff respected everyone’s rights and helped residents with personal development, community and family links and social inclusion. Healthy eating was promoted. EVIDENCE: Residents had a good deal of independent responsibility for their home. Housekeeping tasks and security arrangements were shared, although each person had different routines and made their own arrangements for meals, shopping and keeping provisions, doing their own washing, cleaning bedrooms etc. The house keyworker helped residents to devise and maintain routines and there were regular house meetings. Two residents often had meals at the core house (Calder View) and the keyworker assisted residents with cooking and food-shopping skills, which helped to ensure everyone had an appropriately nutritious diet. Residents said they kept in close contact with family and made their own Broken Banks F57 F07 S9622 Broken Banks V248030 26.9.05 Stage 4 doc.doc Version 1.40 Page 11 choices regarding friendships and personal relationships. The two people spoken to explained that they continued to enjoy a variety of individual interests and leisure activities. These included TV, music and videos, playing guitar, going to the pub, shopping, cinema, church, swimming, walking, cycling, going to football matches, holidays and day trips. One person was looking forward to getting his driving licence back. Activities were positively encouraged and supported by the staff team, who provided transport and company and were viewed as important for confidence building, personal development and improving social skills. The house ‘rules’ (such as those relating to behaviour, alcohol, smoking and drugs) were written down, understood and respected by everyone. Residents said they all got on well together. They and the staff respected each other’s privacy and rights to freedom, although responsibilities and risks were understood and agreed. Broken Banks F57 F07 S9622 Broken Banks V248030 26.9.05 Stage 4 doc.doc Version 1.40 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 and 19 Personal and healthcare support was provided in a flexible and individual manner, which respected each person’s privacy, dignity and independence. EVIDENCE: Residents explained that they made their own choices about personal routines, such as getting up/going to bed times, bathing, clothes choice, going out etc. The house keyworker and manager gave support in respect of personal care as necessary. Healthcare needs were monitored by staff observation and residents’ own assessments of need. GP, outpatient and other medical check visits were recorded in residents’ care plans. Residents explained that appropriate professionals oversaw mental healthcare needs and staff followed agreed care plans in respect of mental health. Residents said that staff accompanied them to hospital and other appointments (such as routine checks by dentist, optician, chiropodist etc.) or they go alone if they prefer. Broken Banks F57 F07 S9622 Broken Banks V248030 26.9.05 Stage 4 doc.doc Version 1.40 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 Staff training and vulnerable adults procedures ensured that the people living in the home were protected from abuse. EVIDENCE: The registered manager and the house keyworker had attended a certificated course in respect of understanding how to protect vulnerable adults. The house keyworker was knowledgeable about protection issues and had discussed these with the residents. Residents said that they had no protection issues at the current time. They felt safe and supported and knew who to speak to if they had a problem. The home had an Adult Protection procedure (including Whistle Blowing), which complied with the Public Disclosure Act 1998 and the Department Of Health Guidance ‘No Secrets’. Policies and procedures that ensured that resident’s financial affairs were handled appropriately and that residents were protected from physical and other harms were followed. There were good recruitment and supervision procedures, which helped to ensure that staff were suitable to work with vulnerable adults and understood how to protect residents. The risks to individuals were known, recorded and minimised. Broken Banks F57 F07 S9622 Broken Banks V248030 26.9.05 Stage 4 doc.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 to 30 The house was non-institutional and suitable for its stated purpose of supporting younger adults who have a mental health problem. The building and grounds were maintained in good order, providing a comfortable and ‘homely’ environment, suited to the needs of the current service users. Some hazards were identified, which for the safety of residents should be rectified. There were no assessed needs for specific aids or adaptations for the current occupants. EVIDENCE: Broken Banks is a good-sized four-bedroom modern house, similar to other houses in the locality and near to Colne town centre shops and amenities. Residents said they liked the quiet location, with rural views and private back garden (with shed). Residents commented they liked their house. The communal rooms are spacious, with domestic style furniture, fittings and decoration, chosen by the residents. Personal belongings and pictures gave the house a ‘homely’ feel. Residents 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. Broken Banks F57 F07 S9622 Broken Banks V248030 26.9.05 Stage 4 doc.doc Version 1.40 Page 15 Private bedrooms were inspected with the permission of the occupant. Residents they were happy with bedroom accommodation, which they had personalised with their own belongings. Safety checks had been carried out and since the last inspection a bedroom door had been repaired, the outside store lock fixed and bedroom door locks replaced. New bedding had been ordered. The broken drier was due to be repaired. The recommendations from the last inspection (regarding window restrictor risk assessment and provision and hot water safety) had not been completed (see also Standard 42). During this inspection it was noted that a cupboard door in the kitchen was hanging off, a curtain was missing from the dining room and one curtain in the lounge was hanging down and needed more hooks. Upstairs, the old bedroom door locks should be made inoperable; for the safety and privacy of residents a bathroom door lock that indicates ‘engaged’ and is accessible in case of emergency should be fitted; and the carpet strip in the doorway of one bedroom needs fitting. As discussed with the resident and the manager, part of this carpet needed cleaning. Of some concern was the amount of electrical goods and appliances owned by a resident that appeared hazardous and had not been PAT-tested. For example, the free standing radiator in the upstairs corridor, the speakers on the wall in the lounge that were not safely attached, and the many telephones that affected the operation of the house telephone. Although the residents were doing a good job of keeping their house generally clean on a day to day basis, for reasons of hygiene and infection control residents need more help for periodic deep ‘spring cleaning’ (especially the inside of cupboards and to remove the nicotine stains on window frames, curtain rails etc.). Ways in which this may be achieved with staff help or employing a specialist-cleaning firm were discussed with the manager. Broken Banks F57 F07 S9622 Broken Banks V248030 26.9.05 Stage 4 doc.doc Version 1.40 Page 16 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 The house keyworker and other support staff provided a reliable, safe, competent and flexible personal and social care service, which met resident’s individual needs and wishes. EVIDENCE: Residents said they thought the keyworker and other staff were knowledgeable, 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. Residents said they liked the staff, thought they had good attitudes and were available when needed. The staff-training and supervision programmes were progressing satisfactorily. Previous inspections identified that the staff had achieved appropriate NVQ level 3 and mental health training. A robust recruitment process helped to protect residents. Broken Banks F57 F07 S9622 Broken Banks V248030 26.9.05 Stage 4 doc.doc Version 1.40 Page 17 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) 38 and 42 The manager provided appropriate leadership and supervised and directed the staff team in a way that promoted the wellbeing of residents. The service had an effective quality assurance system, which encouraged and enabled service users to express their views and opinions. Risks to service users were minimised by generally good health and safety practices, although areas for risk reduction were identified. EVIDENCE: A qualified and experienced manager was in charge of Broken Banks and the residents had confidence in his knowledge and skills. Residents said they could speak to the manager whenever they wished and they felt their views and opinions were listened to and acted upon. The manager used several strategies to further the aims of the home, based on the views of the residents and other stakeholders. These included house meetings; ensuring continuity through a designated house keyworker but also diversity by a mix of staff; encouraging peer support by enabling residents to contact others in the Scheme; ensuring residents and staff had opportunities Broken Banks F57 F07 S9622 Broken Banks V248030 26.9.05 Stage 4 doc.doc Version 1.40 Page 18 for group and private discussion with the registered manager and provider; promoting independence in the running of the house; reviewing individual’s goals through care planning; promoting a friendly atmosphere where visitors were welcomed; obtaining and using feedback from residents and their representatives through ‘customer satisfaction’ surveys. Staff worked with residents to ensure that there were safe working practices in the home, which followed procedure. Staff had received training in health and safety matters and the residents spoken to were knowledgeable about general health, safety and security in their home. Gas and electrical safety checks were carried out regularly. However, recommendations from previous inspections window restrictor risk assessment and provision and hot water safety (risk from scald and risk from Legionella) had not been carried out. Risk to residents in respect of maintaining a safe environment (by removing obstacles in corridors and maintaining resident’s personal electrical equipment etc. - see also Standard 24) should be minimised and the limitations and suitability of bringing electrical appliances into the home agreed with residents. Broken Banks F57 F07 S9622 Broken Banks V248030 26.9.05 Stage 4 doc.doc Version 1.40 Page 19 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 3 3 x x x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 4 x 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 2 2 3 N/A 2 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Broken Banks Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x 3 x x x 2 x F57 F07 S9622 Broken Banks V248030 26.9.05 Stage 4 doc.doc Version 1.40 Page 20 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 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. Refer to Standard 24 Good Practice Recommendations The kitchen cabinet door should be repaired and curtains properly hung (24.1) The carpet strip in one bedroom doorway should be replaced and all electrical appliances tested and fitted safely before use. Corridors must be kept clear of obstructions (24.6) The repair to one bedroom door should be completed by rubbing down the filler and repainting (26.1) 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 two inspections: a)That formal risk assessments in respect of window F57 F07 S9622 Broken Banks V248030 26.9.05 Stage 4 doc.doc Version 1.40 Page 21 2. 26 3. 4. 5. 27 30 42 Broken Banks 6. 42 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) That the manager ensures that all electrical equipment brought into the home is safe before use (42.iii) Broken Banks F57 F07 S9622 Broken Banks V248030 26.9.05 Stage 4 doc.doc Version 1.40 Page 22 Commission for Social Care Inspection Unit 4 Petre Road Clayton-le-Moors Accrington 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. 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