CARE HOME ADULTS 18-65
Callum House 234 Wroxham Road Sprowston Norwich NR7 0BE Lead Inspector
Hilary Shephard Announced 13 July 2005 14.00 hours
th 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. Callum House I55 s55744 callumhouse v227730 290605 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Callum House Address 234 Wroxham Road, Sprowston, Norwich, NR7 8BE 01603 408150 01603 417617 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) Klair House Ltd Mr Robert Ian Arneil Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Callum House I55 s55744 callumhouse v227730 290605 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: Ten (10) Service Users of either sex may be acoomodated who are aged between 18 and 65 years and have a learning difficulty (In the category LD) Date of last inspection 26th October 2004 Brief Description of the Service: Callum House offers personal care for up to ten adults with learning disabilities and is situated in a residential area to the north of the city of Norwich. The building is typically domestic in style and blends in well with the surrounding area. There is car parking space to the front and garden space to the rear of the home. The home is well placed for the use of local amenities which include a supermarket, shops, pub and direct bus access to the city centre. Callum House I55 s55744 callumhouse v227730 290605 stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This announced inspection was carried out over 4 ½ hours, during which time seven of the ten residents and the manager were spoken with. Information was gathered from residents, manager, staff and residents’ files, ten residents comment cards and one relatives comment card. The residents views of the service are reflected in the findings in the report. What the service does well: What has improved since the last inspection?
New garden furniture and two new armchairs have been purchased which residents enjoy using. Residents advised that they had been given an air hockey game recently which they were enjoying. The exterior of the building has been repainted. Callum House I55 s55744 callumhouse v227730 290605 stage 4.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. Callum House I55 s55744 callumhouse v227730 290605 stage 4.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 Callum House I55 s55744 callumhouse v227730 290605 stage 4.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 The home has a good format for assessing the needs of prospective residents before they are admitted. EVIDENCE: Care files contained assessments covering all aspects of the residents care needs. These included specific details regarding the residents’ wishes for gaining employment, maintaining social contact and plans for their future. Callum House I55 s55744 callumhouse v227730 290605 stage 4.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 and 9 The home has developed a good care plan structure but care plans and risk assessments have not been updated or amended to reflect changes and do not reflect residents current needs. Residents receive assistance from staff enabling them to make decisions about their lifestyle. EVIDENCE: Care plans have a good structure, but assessed and changing needs are not always reflected in the planning process. Residents advised that the staff were very supportive, and helped them with areas of their lives they have difficulty managing. Care staff clearly know the residents well, and are well aware of their changing needs, and how to care for them, however, this was not always reflected in the care plans. Risk assessments have been completed, but evidence recorded in the reviews indicated that these were out of date, and needed to be amended to reflect the changing needs of the residents. A recommendation has been made regarding care plans and risk assessments. Callum House I55 s55744 callumhouse v227730 290605 stage 4.doc Version 1.30 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 15, 16 and 17 Residents are given lots of opportunities to develop and learn new skills, they are enabled to maintain appropriate relationships, and enjoy good home cooked food. EVIDENCE: Residents advised that they go out to work and undertake a variety of jobs, which they generally enjoy. Some residents attend local day services, but did not seem to benefit as much from this as those residents who have obtained employment. One resident who has poor sight regularly attends Braille classes, and is well supported by the Norwich Association for the Blind. Another is involved in a local disability group, and most are involved in lots of community activities. Residents are encouraged to maintain contact with their family and friends, and one advised that his mother regularly visits him in the home. Residents also go away on organised holidays and short breaks, and also stay with their families and friends at weekends. Food is bought in fresh and meals are prepared from fresh ingredients. The menu offers choice and variety and a healthy option, which is often chosen by the residents. On the evening of the inspection, residents were in the garden enjoying their meal of roast beef.
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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) Not assessed at this inspection. EVIDENCE: Callum House I55 s55744 callumhouse v227730 290605 stage 4.doc Version 1.30 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) 22 and 23 Residents feel safe, and are confident that concerns raised are listened to and dealt with. Residents’ finances are managed well within the home. EVIDENCE: Residents advised they would always refer any problems or concerns to staff or the manager. The home has a good complaints and adult protection policy which aims to protect residents from harm. Comment cards from residents indicated that they felt safe in the home and were well cared for. The home also has an excellent procedure for managing residents money, encouraging them to be in control of their finances but providing support as required. One resident advised that he had previously been in debt, but the manager had helped him manage his money, so that he was able to save some to buy items he wanted. Callum House I55 s55744 callumhouse v227730 290605 stage 4.doc Version 1.30 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) Not assessed at this inspection. EVIDENCE: Callum House I55 s55744 callumhouse v227730 290605 stage 4.doc Version 1.30 Page 15 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) 33, 34 and 35 Residents are currently well supported by adequate numbers of experienced and trained staff, but by not following proper recruitment practices, residents’ safety is compromised. EVIDENCE: Staffing levels are provided to meet the needs of the residents, and usually one member of staff is duty during the day. The residents are not often all in the home together so staffing levels are increased depending on the number of residents in the home, and their level of support required. Residents said they were satisfied with the amount of staff on duty, and advised that they were good staff. Staff have undergone induction training, and some have obtained NVQ level 2 and have commenced NVQ level 3. Files of two newly appointed staff were checked. Both had commenced prior to the home receiving checks made against the Protection of Vulnerable Adults (POVA) register, one had commenced prior to the home receiving two written references, and one did not contain a reference from the previous employer. A requirement and recommendation have been made regarding proper recruitment checks.
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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) 42 Residents’ benefit from a safe and well-maintained environment. EVIDENCE: The home and gardens are well maintained, and the manager has plans to develop the service further to meet the changing needs of the residents. The manager is good at ensuring equipment is serviced regularly, and weekly checks are made on the fire alarm system. Good hygiene practices are maintained by staff who have access to a range of information regarding infection control. Callum House I55 s55744 callumhouse v227730 290605 stage 4.doc Version 1.30 Page 18 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 x x x Standard No 22 23
ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 2 3 x 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x 3 2 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Callum House Score x x x x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x I55 s55744 callumhouse v227730 290605 stage 4.doc Version 1.30 Page 19 None 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 34 Regulation 19 Requirement The Registered person must ensure that two satisfactory written references and clear POVA checks are obtained prior to staff commencement. Staff must also work under supervision from a named supervisor whilst waiting for the CRB check. Timescale for action Prior to commence ment of new staff. 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 6 Good Practice Recommendations The Registered person is recommended to update all care plans and risk assesssments and to provide clearer guidelines enabling staff to understand the identified care needs of the residents. The Registered person is recommended to obtain written references from staff applicants previous/present employer. 2. 34 Callum House I55 s55744 callumhouse v227730 290605 stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection 3rd Floor, Cavell House St Crispins Road Norwich NR3 1YF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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