Inspection on 17/11/05 for Calvert Trust Kielder

This inspection was carried out on 17th November 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Calvert Trust Kielder 16/10/08

Calvert Trust Kielder 17/10/07

Calvert Trust Kielder 12/09/06

Calvert Trust Kielder 08/02/06

Calvert Trust Kielder 15/02/05

Calvert Trust Kielder 24/08/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Blenheim House

Prince Bishop Court

Park View (15)

Craigmore House

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

CARE HOME ADULTS 18-65 Calvert Trust Kielder Kielder Water Hexham Northumberland NE48 1BS Lead Inspector Alan Baxter Unannounced 17 November 2005 11.30 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. Calvert Trust Kielder B53-B03 S602 Calvert Trust V241357 171105 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Calvert Trust Kielder Address Kielder Water Hexham Northumberland NE48 1BS 01434 250232 01434 250015 enquiries@calvert-kielder.com The Calvert Trust 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) Mr K G Appleby CRH 20 Category(ies) of LD Learning Disability (20) registration, with number of places Calvert Trust Kielder B53-B03 S602 Calvert Trust V241357 171105 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: All residents may also have a physical disability Waking night staff will be provided in the event of the admission of any service user assessed by yourselves as likely to be unable to independantly summon help or whose care needs may indicate that assistace will be needed. Residents may also be over the age of 65 Date of last inspection Brief Description of the Service: Calvert Trust provides holiday accommodation and activities specifically for people with disabilities. Service users usually stay for one week though occasionally two or three.The site is remote and rural on the edge of Kielder reservoir and as such is ideally placed for sports and activities.As well as the residential accommodation there are a number of chalets providing holiday accommodation for families and groups of children. This enables the service users to socialise with people of similar and different abilities. Some of the site areas are communal such as dining areas and social rooms. Calvert Trust Kielder B53-B03 S602 Calvert Trust V241357 171105 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place in November 2005. Time was spent touring the facilities. The inspector talked to eight guests (service users). All those able to express an opinion said that they were happy with the service being provided, and several said that they have visited the trust many times. A number of staff were also talked with. A meal was taken in the dining room. Time was spent looking at care records and other relevant records, and discussing policies and practices with senior staff and the Director of Operations. The inspection took five hours. What the service does well: The Trust gets a full assessment of a guest’s needs before offering a service to them. There are some good, detailed care plans for some guests. Guests are given choices as to how they spend their day, and are encouraged to make their own decisions. The Trust provides an excellent range of both outdoor and indoor activities. Staff treat guests with respect at all times. The food is enjoyable and nutritious. The facilities are comfortable, safe and clean. Staff are given very good training to meet the needs of guests. Personal care is given with sensitivity, and in line with guests’ wishes. Guests’ physical and emotional health needs are met. No complaints have been received about the service. Calvert Trust Kielder B53-B03 S602 Calvert Trust V241357 171105 Stage 4.doc Version 1.40 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. Calvert Trust Kielder B53-B03 S602 Calvert Trust V241357 171105 Stage 4.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 Calvert Trust Kielder B53-B03 S602 Calvert Trust V241357 171105 Stage 4.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) 2. 2) The Trust makes every effort to obtain a full assessment of each guest’s needs before agreeing to provide a service. EVIDENCE: 2) Care records showed that the Trust will only take a guest when an application form has been received, listing the person’s needs regarding medical conditions; diet; allergies; mobility; communication; nursing inputs; additional care inputs; support with personal care; medications; and behavioural problems. Very occasionally, a guest may be accepted without this information, in an emergency situation. The same information is requested each time a guest applies for a stay. Sometimes there is reluctance by the person or family carer to repeat this exercise, and there is a verbal instruction that there is “no change”. Staff should record this event, with date and signature, on the previous application form. The application form also asks the referrer to provide any other relevant information or existing care plans. Calvert Trust Kielder B53-B03 S602 Calvert Trust V241357 171105 Stage 4.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, and 9. 6) Guests’ assessed needs are reflected in their individual plan, but not always quickly enough. 7) Guests are supported to make decisions about their lives. 9) Guests are supported to take responsible risks by the trust’s general environmental and activities risk assessments, but individual risk assessments need to be improved. EVIDENCE: 6) The issue of how detailed a guest’s individual plan of care needs to be, given the nature of the service being provided and its ‘short stay/holiday’ nature, has been previously discussed at length in previous inspections, and a basic level of care planning has been accepted. About three-quarters of the guests are ‘repeat bookings’ and are well known to the staff. In this situation, it is acceptable for the Trust to use care plans from previous stays, so long as the content is reviewed, and a senior carer signs and dates that it is still relevant (or updates it, as necessary, was as seen in some examples). Calvert Trust Kielder B53-B03 S602 Calvert Trust V241357 171105 Stage 4.doc Version 1.40 Page 10 In other instances, the Trust’s pre-admission request for all relevant information from referrers has yielded some good quality care plans from referring homes/agencies; and/or some very detailed descriptions of the care the guest needs, from family carers. However, in a small number of referrals where none of the above applies (and especially with new referrals), the Trust is sometimes slow in drawing up care plans, with examples seen of taking almost a week to write a plan. The Trust should aim to have care plans in place when a guest is admitted, and should never take more than 48 hours to complete a plan of care for a new guest. Where nursing inputs are required, the trust receives an excellent service from local Nurse Specialists, who draw up detailed care plans that include the required inputs form the Trust’s staff. These care plans are kept in guest’s bedroom, and are accessible by care staff. 7) Guests confirmed that they are encouraged to make their own decisions about their stay at the Trust. Examples given were guests’ decisions about when they want to rise and retire (including having a ‘lie-in’ in the morning, if they so wished); and what activities (if any) they wish to join in. Staff were seen to respect guests’ choices, and to listen carefully to their wishes. Guests’ rights to make their own decisions are limited only through the assessment process, which includes consultation with the guest, and any restrictions are recorded in the guest’s care plan. An example seen was the limitation of a guest’s alcohol intake, for agreed medical reasons. 9) The Trust’s risk assessments were examined. General and environmental risks assessments were in place, and were appropriately detailed. The senior activities leader has drawn up extensive risk assessments regarding activities and equipment, and also gives a safety talk to the guests before each activity. It was noted, however, that there were virtually no risk assessments of the individual guests. Given the relatively high risk of the client group, due to their various disabilities, and the relatively high risk of the physical activities available to the guests, this should be addressed. Calvert Trust Kielder B53-B03 S602 Calvert Trust V241357 171105 Stage 4.doc Version 1.40 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) 12,13,14,15,16,17. !2),13),15) These standards are not considered to be applicable, given the short-stay nature of the service provided. 14) Guests are offered an excellent range of activities during their stay. 16) Guests’ rights are respected at all times. 17) Guests have a healthy and nutritious diet, with choice, and they said they enjoyed their meals. EVIDENCE: 14) The Trust specialises in providing activities for people with physical, learning or sensory disabilities. There is a focus on providing outdoor activities, with fully trained staff to assist and support guests. Activities offered include climbing, abseiling, zip wire, orienteering, archery and golf buggies. Located close to Keilder Water, the Trust can also offer a wide range of water sports, such as sailing, canoeing, motor cruising and kayaking. Calvert Trust Kielder B53-B03 S602 Calvert Trust V241357 171105 Stage 4.doc Version 1.40 Page 12 However, there are also good indoor facilities, with a hydrotherapy swimming pool, sports hall, and a wide range of imaginative activities available to guests. There is a team of experienced, skilled activities staff who work with the support of the care staff. Specialist equipment is in place to allow guests the fullest possible access to the activity facilities. Overall, the provision of activities well exceeds the requirements of this standard, and is to be commended (as is the fact that guests are not obliged to do any activity, should they so choose. 16) Staff were seen to demonstrate their respect of the guests and their rights in their interactions with them. Staff knocked on doors and asked guests’ permission before entering bedrooms; spoke quietly and respectfully to guests; and listened carefully to their views. Guests spoken with confirmed that this was the normal staff approach. Care plans also demonstrated that staff value their guests and take their rights seriously. Where there were restrictions placed on any behaviour such as smoking or drinking, such restrictions were agreed with the guest in advance, recorded in the care plan, and were clearly based on good practice (for example, one guest was on medication that would react badly to more than a small amount of alcohol, so the guest agreed to have a limit on daily intake of alcohol). 17) Dietary needs are assessed as part of the pre-admission assessment. A copy of any special dietary needs/wishes is kept in the kitchen. The menu was examined. There is a wide range of choice available, and the menu seemed well balanced and nutritious. A meal (lunch) was taken in the dining area. Soup was available, as was a cold meat bar and a salad bar, with a light hot course. Staff were seen to interact well with guests, giving sensitive assistance with feeding, where required. The main meal is the evening meal, with choice of two contrasting hot dishes, plus a daily vegetarian option. There is a good range of vegetables served, and fruit is always available. Calvert Trust Kielder B53-B03 S602 Calvert Trust V241357 171105 Stage 4.doc Version 1.40 Page 13 Calvert Trust Kielder B53-B03 S602 Calvert Trust V241357 171105 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19. 18) Guests are given personal care and support in the ways that they would wish. 19) Guests’ physical and emotional health needs are met. EVIDENCE: 18) Guests confirmed that they are able to direct the way their care is given. This was shown, also, in the sample of care plans viewed. Staff demonstrated that they respect guests’ privacy throughout the inspection. Discussion with the registered manager and with staff showed that they are sensitive to the dynamics between individual guests and staff, and respond appropriately to the expressed and implied preferences of guests to particular carers. There is a comprehensive range of equipment in place to ensure the best practices in moving and handling of guests (including ceiling tracking); technical aids, such as alarm calls, deaf fire alarms; and automatic doors, ramps, etc., for ease of access. Calvert Trust Kielder B53-B03 S602 Calvert Trust V241357 171105 Stage 4.doc Version 1.40 Page 15 19) Health and emotional needs are also part of the initial, pre-service assessment, and the Trust is very well supported by its local nurse specialists, and other health therapists, ensuring that guests’ nursing needs are fully met. Staff receive specialist training, where appropriate. An example in the last year was when the Trust provided a week specifically for guests with Prada– Willi syndrome, and staff received appropriate training to meet the needs of this group. This is good practice. Calvert Trust Kielder B53-B03 S602 Calvert Trust V241357 171105 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23. 22) Guests confirmed that their views are listened to, and are acted upon. 23) Guests are protected from abuse, neglect and self-harm. EVIDENCE: 22) It was apparent, throughout the inspection, that staff listen carefully to the guests’ views and opinions; give choices; and respond to the guests’ decisions. This was confirmed in conversations with the guests. A ‘feedback book’ is available to guests, to record their experiences and degree of satisfaction with the service being offered. Quality assurance systems will be focus of the next inspection. 23) It was a requirement of the last inspection report that the Trust makes sure that its ‘Adult Protection’ procedures are up to date and reflect current best practice. This has been implemented. There is now a simple, clear flow chart for staff to follow, in conjunction with Northumberland County Council ‘Practice Guidance for the Protection and Empowerment of Vulnerable Adults’. Calvert Trust Kielder B53-B03 S602 Calvert Trust V241357 171105 Stage 4.doc Version 1.40 Page 17 It was also a recommendation that all staff receive ‘Protection of Vulnerable Adults’ (POVA) training. This has been implemented. All care staff ( and some activity staff, who do not provide personal care to guests) have attended a suitable training course. In addition, senior staff either have, or will be, attending a more advanced course on how to respond to allegations of abuse. The Trust is aware of its obligations to report any allegations of abuse. Calvert Trust Kielder B53-B03 S602 Calvert Trust V241357 171105 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,30. 24) Guests are provided with a pleasant, comfortable, well-equipped and safe environment. 30) All facilities seen were clean and hygienic. EVIDENCE: 24) The buildings and indoor facilities were toured. Bedrooms are well furnished and pleasantly decorated. Communal areas are similarly well appointed, with comfortable seating and a bar that opens in the evenings. Environmental risk assessments were seen and found to be thorough and up to date. 30) All facilities seen were clean and hygienic. It was noted that the quality of the water in the hydrotherapy swimming pool is checked several times each day. Calvert Trust Kielder B53-B03 S602 Calvert Trust V241357 171105 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34,35,36. 34) The Trust’s recruitment and selection policy and practices protect the safety of its guests. 35) The staff have received very good levels of training that allow them to meet both individual and general needs of guests. 36) Guests benefit from a well supported and properly supervised staff. EVIDENCE: 34) It was a requirement of the last inspection that the Trust ensures that its recruitment procedures are followed; that two written references are always obtained for new staff; that proof of identity and a recent photograph is kept on each staff member’s personnel file; and that both criminal record checks and POVA list checks are available for inspection. A study of a sample of staff records showed that all of these issues have now been addressed by the Trust. 35) Care staff training records were seen. Mandatory training has been received by, or has been planned for, virtually all care staff, covering all the required areas. Mandatory training is repeated annually, using the ‘closed’ week in January. This good practice, and exceeds this standard. Calvert Trust Kielder B53-B03 S602 Calvert Trust V241357 171105 Stage 4.doc Version 1.40 Page 20 Guest-specific training takes place. Examples include training regarding epilepsy, Peg feeding, Prada-Willi syndrome, diabetes, catheter and stoma care, and deaf awareness. It was seen that, where a guest’s specific medical condition requires nursing inputs, the Trust’s attached nurse specialist provides the necessary training, and issues a training certificate. This is good practice. 36) It was a requirement of the last inspection report that staff supervision should take place at least every two months. It was also recommended that the supervision records should show that staff are actively participated in the process. Both of these issues have now been addressed. The registered manager supervises senior staff, who supervise the other staff in turn. The documentation shows a two-monthly pattern of supervision is in place. The agenda covers work in general; training needs; and objectives. Outcomes are positive. A training and development plan is in place. Individual staff training needs are identified in supervision, and appropriately addressed. Calvert Trust Kielder B53-B03 S602 Calvert Trust V241357 171105 Stage 4.doc Version 1.40 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 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) None of these standards were examined on this inspection. However, the key standards 39 and 42 were looked at in the last inspection, and both were found to have been met. EVIDENCE: Calvert Trust Kielder B53-B03 S602 Calvert Trust V241357 171105 Stage 4.doc Version 1.40 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 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 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x x x 4 x 3 3 Standard No 31 32 33 34 35 36 Score x x x 3 4 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Calvert Trust Kielder Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x x x x x x B53-B03 S602 Calvert Trust V241357 171105 Stage 4.doc Version 1.40 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 YA6 Regulation 15(1) Requirement Timescale for action 31/12/05 2. YA9 13(4) Each assessed need of a guest must be addressed in a care plan within 48 hours of the person arriving. Individual risk assessments must 31/12/05 be carried out for each guest. 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 Good Practice Recommendations Calvert Trust Kielder B53-B03 S602 Calvert Trust V241357 171105 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Northumbria House Manor Walks Cramlington, Northumberland NE23 6UR 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 Calvert Trust Kielder B53-B03 S602 Calvert Trust V241357 171105 Stage 4.doc Version 1.40 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. 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