Inspection on 20/09/07 for California House

This inspection was carried out on 20th September 2007.

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

California House 31/08/06

California House 24/02/06

California House 20/08/05

California House 13/03/05

California House 17/07/04

Similar services:

Ruskin Lodge

Clover House

Dystlegh Grange

The Good Companions

Cuerden Grange Rest Home

Springfield Cottage

Parkside

Park Lodge

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

CARE HOME ADULTS 18-65 California House 23 California Road Kingstown Carlisle Cumbria CA3 0BT Lead Inspector Liz Kelley Unannounced Inspection 20 September 2007 10:00 California House DS0000022676.V348390.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 California House DS0000022676.V348390.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. California House DS0000022676.V348390.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service California House Address 23 California Road Kingstown Carlisle Cumbria CA3 0BT 01228 596292 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) carlislemencap@aol.com Carlisle Mencap Mrs Sheila Gregory Care Home 4 Category(ies) of Learning disability (4) registration, with number of places California House DS0000022676.V348390.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service may accommodate four people with learning disabilities (LD) four of whom may have physical disabilities (PD) 31st August 2006 Date of last inspection Brief Description of the Service: Carlisle District Society Mencap is the provider of respite care at California House for four people who have a learning disability. The home is situated close to junction 44 off the M6 motorway on the outskirts of the City of Carlisle. The location provides easy access to the city centre by the homes or public transport. The property is a semi-detached house in a quiet residential road. The home has been adapted to accommodate people who have a physical disability. There are garden areas to the front and rear of the home. The Home has a wheelchair accessible mini bus for use by people during their stay. All referrals and bookings are made through social services and the charges for respite care are arranged by Social Services. California House DS0000022676.V348390.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an inspection where all the key areas of the National Minimum Standards were checked. People who use the respite service, and their families, and members of staff had given their opinions regarding the service and care to the inspector. These comments, and the observations made by the inspector, have informed the judgements made in this report. The inspector also: • Received questionnaires from professionals and other people working with the home • Interviewed the manager and staff • Visited the home, which included examining files and paperwork • Received a self-assessment report/questionnaire from the manager. On the day of this visit four people where staying at home, two had gone to their usual day service and another two people were having a look round to see if they would like to stay sometime in the future. The house had a lively and friendly atmosphere with people busy making cups of tea, snacks and chatting with staff in the lounge about plans for the day. There had been a Garden Party the day before with an open invitation to people who regularly stay at the home, family, friends and staff. People were chatting about how well this had gone and clearing up after the event. What the service does well: California House continues to provide a well-used and valued service as borne out by customer satisfaction surveys, relatives and professionals. It offers not only respite holiday style breaks but also provides a service to people who have had a crisis, and need short-term care. The overall picture we gained was that people using the respite home are very happy as they are being offered an individually tailored service that promotes choice and an enjoyable stay. “I do lots of things here, playing games… and help to do things in the kitchen. Everyone (staff) looks after me here, I like it very much, they are nice to talk to.” “Staff and the house are great” “When somethings wrong I can talk to staff here at California House, and they help me out”. A relative of a person with no verbal communication said “They are always happy to go to California House and they continue with their daily routine.” California House DS0000022676.V348390.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. California House DS0000022676.V348390.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 California House DS0000022676.V348390.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has robust procedures and paperwork in place to ensure appropriate referrals and that they accept people whose needs they can meet. EVIDENCE: The home provides new people and their families with an information booklet about the home. Each time Social Services makes a referral to the home a thorough assessment process is implemented. The new person and their family are invited to come and look around the home. The family or carers will be asked to complete an in-depth form that looks at the likes and dislikes of the person, normal daily routines, medical history and any other social or care needs they may have. The introduction to the home is completely flexible and can take from only one visit to months depending on the need and the pace required by each person. The organisation is flexible to supporting and encouraging friendship groups to stay in the home together, and is mindful of ensuring that people are compatible. All referrals are via Social Services, the home does not currently take private fee payers. One of the four beds is classed as an emergency bed and can be utilised by Social Services for emergency admissions, this information is given to everyone in case of last minute cancellations. California House DS0000022676.V348390.R01.S.doc Version 5.2 Page 9 The home is currently in the process of up-dating its literature given out to new people to reflect recent developments, such as a new manager and improvements to the home’s facilities. These will be examined on the next inspection. California House DS0000022676.V348390.R01.S.doc Version 5.2 Page 10 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 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care planning continues to improve resulting in greater choices and more opportunities for people during their stay. EVIDENCE: Care plans are being developed in a style termed “Person Centred ” and staff are being supported to use a variety of skills and ways to engage people in planning their care and setting goals. Maintaining independence and enabling people to make their own decisions about how they wish to spend their time and the support they need is a key objective for the home. People are able to enjoy a full and stimulating life-style with a variety of opportunities to choose from during their stay. This objective is possible through careful and comprehensive risk assessments, which are regularly reviewed. The service has a ‘can do’ attitude and risks are California House DS0000022676.V348390.R01.S.doc Version 5.2 Page 11 managed positively to help people using the service lead the life they want. Any limitations on freedom, choice or facilities are always in the person’s best interests, and are recorded. Working in this way ensures that each person is supported to live a lifestyle of their choosing through the skilled support of the staff team. California House DS0000022676.V348390.R01.S.doc Version 5.2 Page 12 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): 12,13,15,16 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Positive and supportive relationships are formed between staff and people staying at the home leading to a caring, friendly atmosphere. EVIDENCE: The home has sought people’s views and considered their varied interests and abilities when planning the routines of daily living and arranging activities. This is an important consideration that the manager does well when planning who should be booked in together. Routines are very flexible and people can make choices in all areas of their stay. The routines, activities and plans are led by the needs of individuals and can usually be quickly changed to meet changing needs. California House DS0000022676.V348390.R01.S.doc Version 5.2 Page 13 An example of this was witnessed on this visit when one person changed their mind about what they wanted to do, instead of going on a day trip they wanted their hair cut instead and this was very quickly accommodated. The manager and staff are aware of promoting equality and diversity and this is reflected by people having a lifestyle and interests that are individual to them. Some people choose to take part in group activities such as going for bar meals, walks, shopping, while others chose to go out individually with staff support. Staff were observed spending time with individuals helping them to make these choices. The meal arrangements are very flexible and staff are able to respond to individual requests. Menus are planned with people on a weekly basis and a communal evening meal is usually encouraged. The manager is hoping to involve people more in the preparation of meals and in going out to shop for food. This is all part of a drive towards healthy lifestyles and supporting people to make healthy choices. California House DS0000022676.V348390.R01.S.doc Version 5.2 Page 14 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 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People’s physical and emotional health needs are well met during their stay at the home. EVIDENCE: The home does not have overall responsibility for managing healthcare but does monitor their health across their stay. The home has relevant contact details of GPs and details on medical conditions, and medications. A medical consent form is used that gives permission to seek emergency medical advice and treatment in the event of peoples families/legal guardian being unobtainable. Also in place were consent to administer medication on behalf of people who use the service. Staff are aware of the personal support that each person requires from the information gained from families and carers and also from assessment. The personal preferences for each person were seen in the plans of care, these included morning washing/bathing preferences and bedtime routines. California House DS0000022676.V348390.R01.S.doc Version 5.2 Page 15 Records of healthcare needs are well maintained and kept up-to-date, these are linked to care plans to alert staff of any changes, and include monitoring sheets for specific issues. The home has various aids and adaptations to aid in the care of people and to ensure their comfort and safety, these included high/low beds, an assisted bath, and manual handling hoists and moving equipment. Medications in the home are well managed and effective systems have been developed for the recording and safe handling of medicines. Medications are checked by two staff against the original package. Staff receive appropriate training in medications as part of their induction period. The new manager has introduced a further check at staff handover each day to ensure that all medications have been correctly administered. For each stay a new information sheet is completed requesting details on changes in medication or any change in health, and any discrepancy is double checked. These measures all ensure that medication is safely handled and managed across a person stay. California House DS0000022676.V348390.R01.S.doc Version 5.2 Page 16 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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes policies and procedures ensure that people are safeguarded from harm and their views and concerns are listened to, and acted upon. EVIDENCE: The systems for consultation are good with a variety of evidence that indicates that people’s views are valued, sought and acted upon. The home has an adequate complaints procedure with a copy given to each new person and these are written in accessible formats. The home also has regular House meetings for people to express their opinions and have a say on the running of the home. The policies and procedures regarding protection of residents are of a high quality and are regularly reviewed and updated. The service is clear when incidents need external input and who to refer the incident to. Protecting vulnerable adults is integrated into the training and development plan for each member of staff. The manager and staff are familiar with the multi-disciplinary guidance and include arrangements for training to be appropriately renewed. Feedback from relatives and others associated with the home state that they are very satisfied with the service provision, and are confident that people are safe and well supported by the home which has their protection and safety as a priority. One person who stays at the home said “When something’s wrong I can talk to staff here at California House, and they help me out”. California House DS0000022676.V348390.R01.S.doc Version 5.2 Page 17 People using the service have good and varied links with outside organisations and advocate groups, and the management committee of Carlisle Mencap, who run the home, ensure that 50 of members are also users of the service. This ensures open and transparent governance with different channels for people to express views and concerns if necessary. California House DS0000022676.V348390.R01.S.doc Version 5.2 Page 18 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Home is ideal for short stays being a modern adapted semi-detached house that has a good location and is well equipped to meet people’s needs. EVIDENCE: Individual bedrooms are of a good size and the home has a sitting room and conservatory, which provides a good range of shared and individual space. There are aids to assist any people with mobility problems and there are sufficient bathing and toilet facilities to meet their assessed needs. These facilities are in the process of being up-graded by adapting the upstairs bathrooms to make them more modern and easier to use. Whilst the home is clean and hygienic there is a homely lived-in feel which adds to the friendly atmosphere. California House DS0000022676.V348390.R01.S.doc Version 5.2 Page 19 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): 32,34,35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff recruitment, training and supervision practices are well developed which ensures that people are well supported by staff who have the qualities, aptitudes and skills to support people with a variety of needs. EVIDENCE: California House has a core group of staff with a good mix of skills, experience, age, and gender, which reflects the profile of people using the service. All staff are clear regarding their role and what is expected of them. Relative comment cards stated that staff know what they are meant to do, and that they are able to meet their needs. This leads to good levels of confidence and satisfaction from residents, relatives and professionals with the care that is delivered. “I feel the care home is exceptionally good at being home from home” A new member of staff interviewed described their experience of the home “ Very supportive staff team, great atmosphere, and we all pull together”. California House DS0000022676.V348390.R01.S.doc Version 5.2 Page 20 The Home follows the recruitment procedures of Carlisle Mencap. Staff files are held in the home, and contained all the relevant documentation, being clearly sectioned and well-organised. The selection procedure includes obtaining two written references, a formal interview and an informal interview involving residents, wherever possible, and applications are subject to equal opportunities monitoring. All staff have CRB disclosure checks and a check list ensures that all safeguards are put in place prior to an appointment. The home has a framework for supervisions and appraisals, and these have been carried out to good standards; staff reported that these are helpful and they feel well supported by the manager and the organisation. Staff training continues to have a high profile in the home and staff are keen to gain new knowledge and skills that will assist them in supporting residents. Staff receive varied training to equip them with skills and knowledge to support residents. A rolling programme of training includes first aid, abuse and neglect, fire wardens, moving and handling, health and safety and physical intervention training. California House DS0000022676.V348390.R01.S.doc Version 5.2 Page 21 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 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is benefiting from having a designated full-time manager who is bringing about a number of improvements in the running of the service. EVIDENCE: A new manager has been appointed who is dedicated just to the respite home, and consequently she has had time to review the running of the home and has started to improve the paperwork and develop the quality of care delivered. The organisation’s director has given full support and input into these developments. An example of this is the introduction of a new staff handover which covers key areas such as medication, petty cash and service users cash, and along with the introduction of a communication book has led to no discrepancies in these areas. The manager is also reviewing the quality assurance system and is looking at the best ways of seeking the views of people who use the service. California House DS0000022676.V348390.R01.S.doc Version 5.2 Page 22 The home employs a handyman who carries out general repairs as well as having key areas of health and safety responsibilities such as fire checks. The records examined on the day of the inspection were well-ordered, relevant, appropriate and up-to-date to assist in the smooth running of the Home. California House DS0000022676.V348390.R01.S.doc Version 5.2 Page 23 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 2 2 3 3 x 4 x 5 x 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 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x California House DS0000022676.V348390.R01.S.doc Version 5.2 Page 24 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. 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. Refer to Standard Good Practice Recommendations California House DS0000022676.V348390.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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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