CARE HOME ADULTS 18-65
Castle-Ford 46-48 Princes Avenue Withernsea East Riding Of Yorks HU19 2JA Lead Inspector
Ms Wilma Crawford Unannounced Inspection 11th December 2006 14.30 Castle-Ford DS0000019657.V317678.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 Castle-Ford DS0000019657.V317678.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. Castle-Ford DS0000019657.V317678.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Castle-Ford Address 46-48 Princes Avenue Withernsea East Riding Of Yorks HU19 2JA 01964 613164 01964 612412 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) Mr John Frederick Wright Christine Wright, Mr Mark Anthony Wright, Duncan Joseph Wright Mr Mark Anthony Wright Care Home 18 Category(ies) of Learning disability (18) registration, with number of places Castle-Ford DS0000019657.V317678.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 30th November 2005 Brief Description of the Service: Castle-Ford is a privately owned registered establishment catering for the needs of 18 residents who have learning difficulties. It is located in the seaside town of Withernsea and is within walking distance of the local shops and public transport. The home consists of three terraced properties converted into one building. There is a reasonably private garden and adjacent car parking. Accommodation consists of several lounges, an activities area, a small shop run by the home, a sensory room are available for residents’ use, 4 double rooms and 10 single rooms none of which have en-suite facilities. There is not a stair lift or hoist in the home, residents with mobility problems are situated on the ground floor and have access to bathroom and toilet facilities on the ground floor also. Personal and social care needs are met by the staff, with support from specialist nurses, for example, the Community Team (Learning Disabilities). The home does not provide nursing care. Castle-Ford DS0000019657.V317678.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over eight hours including preparation time. Five residents, two staff and the manager were spoken with during the inspection. The manager was available throughout. The main method of inspection used was called case tracking which involved selecting three residents and tracking the care they receive through the checking of their records, discussion with them, the care staff and observation of care practices. The premises were looked at and the records of three residents and one staff member were inspected. A Pre Inspection Questionnaire asking for information about home was sent out before this visit and information from this was included as part of the inspection process of this service. Comments from replies to questionnaires that were sent out to residents, relatives and professionals are also included in the report. The fee charged is £338.50 per week. An additional charge is made for chiropody treatment. What the service does well:
The home is managed in such a way that residents are involved in making decisions about their lives, the daily activity in the home and looking at ways to ensure risk is minimised to keep them safe from harm. Good relationships have been developed with external agencies that are involved with the residents. Comments from residents included “I like it here I feel safe. I can come and go as I please and I am encouraged to learn new things,”” I have friends here and the staff are good.” Clear comprehensive care plans are in place, containing guidance for staff about all aspects of residents’ personal and development needs. Regular reviews are held and care plans updated. The needs of residents are met through individual care plans that enable them to play an active part in, and meet others within, their local community. Residents are able to access a range of activities in both the home and local community including visits to clubs, pubs, golf, church, college, adult education and work placements. Staff are kept up to date with regular staff meetings. They are also provided with the necessary training, supervision and support to enable them to deliver the required care and support to residents.
Castle-Ford DS0000019657.V317678.R01.S.doc Version 5.2 Page 6 Records within the home are well maintained and residents have access to their own records. Recruitment and selection procedures are robust, ensuring that residents are protected. 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. Castle-Ford DS0000019657.V317678.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 Castle-Ford DS0000019657.V317678.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 the home.” Prospective residents can be assured that their needs will be met. EVIDENCE: Each resident has an individual care plan, which contains a full assessment and gives a detailed description of likes, dislikes and particular care needs. Risk assessments for all areas of daily living are included where necessary. The manager explained that all Residents are visited and assessed prior to moving into the home. They also are given the opportunity to visit, have a meal and an overnight stay before moving into the home. Residents and staff were also able to confirm that this happened. Castle-Ford DS0000019657.V317678.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9,10 “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home.” Residents are able to exercise choice and risk in their lives through their involvement and participation in the care planning process. EVIDENCE: All care plans were completed in detail with involvement from the resident and/or their families. Everybody involved with the residents ‘ care are detailed in the care plan and their contact details recorded so the resident is aware how to contact them if they wish. Reviews are carried out six-monthly (or sooner if required) and residents and their representatives are invited to these to ensure their continued participation in the care planning. Residents’ wishes regarding what activities they want to participate in are documented and appropriate risk assessments are carried out in relation to these if required, ensuring individual choice is exercised. All the residents have a timetable of activities and hobbies that they have chosen to take part in. The home operates a key worker system and residents are aware of who their key worker is. Castle-Ford DS0000019657.V317678.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home.” Residents live fulfilling lives both in the home and in the community. EVIDENCE: The care plans showed that the residents are involved in a wide variety of their chosen activities. On the day of inspection the residents in the home were helping with domestic tasks, drawing and colouring, listening to music, watching T.V. and another was being supported to complete domestic tasks. Other residents were out in the community shopping, at college, attending daycentres and work placements. Residents were particularly looking forward to the Christmas events that they had been involved in, including a party and an outing to a local club. They were also keen to talk about the leisure centre activities that they have recently become involved in. Castle-Ford DS0000019657.V317678.R01.S.doc Version 5.2 Page 11 The activity plan has recently been further developed with an additional staff member being recruited for an extra thirty five hours. Residents indicated that staff assisted and enabled them in making decisions about their personal and family relationships. The home had an open visiting policy and discussion with the manager confirmed that families were actively encouraged to visit and become involved in the life of the home. One resident commented that “There is plenty to do, I can come and go as I please, I really enjoy going out and joining in with things.” The atmosphere in the home was friendly and supportive with residents’ wishes for privacy being respected appropriately. Residents were treated with warmth, dignity and respect. Residents said that the food was good and that they enjoyed their meals. Residents’ meetings minutes confirmed that residents were consulted about the planning of the home’s menu and that different choices were offered to them. Residents files documented individual likes and dislikes. Comments made about the food included “The food is good and there is plenty and we can chose what we have and when.” Residents are also involved in shopping and preparing meals. Castle-Ford DS0000019657.V317678.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home.” Residents receive appropriate health care and personal support. EVIDENCE: Residents’ health care needs are met by accessing health professionals when required. Evidence of regular health care access is documented in individual files. Residents indicated that they received any personal support they needed from staff in a manner that was appropriate for them and to their wishes. The home operates a “ key worker” system, so that staff can develop a thorough understanding of the individual resident’s strengths and needs. Individual files identified objectives that had been set with regards to personal care issues and recorded any progress made. The building does not have any specialist equipment currently as there are no residents requiring this. Case files documented that residents’ health needs were being monitored and discussion with staff and residents confirmed this. The manager indicated that the home had good links with the local community health teams. Castle-Ford DS0000019657.V317678.R01.S.doc Version 5.2 Page 13 A Nomad system of medication is used in the home and only staff that have received appropriate training are able to administer this. Medication is suitably stored and administered. The home had a medication policy and procedure for staff to follow in order to protect residents. An independent pharmacist visits the home to ensure that medication procedures, administration and storage is appropriate. The most recent report indicated that this was considered to be satisfactory and no recommendations had been made. Castle-Ford DS0000019657.V317678.R01.S.doc Version 5.2 Page 14 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): 22,23 “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home.” Residents are protected from abuse and their views are listened to. EVIDENCE: There are policies and procedures that are in place to inform residents and staff of how complaints and allegations of abuse will be dealt with. The manager has an open door policy and residents and staff are free to see him when they please. This was observed at the inspection when residents present freely approached him. Staff complete an induction training when they are first employed and during this time have training on policies relating to recognising and reporting incidents. Recruitment policies ensure that the staff employed are suitable to care for the people who use this service. Residents were confident that any concerns they had would be dealt with and would have no hesitation in raising anything with staff. “If I had a problem my Keyworker or any of the staff would help me sort it out”. Staff spoken with had a good understanding of their role in supporting residents to raise concerns and to protect them from abuse. Castle-Ford DS0000019657.V317678.R01.S.doc Version 5.2 Page 15 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): 24,25,29,30 “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home.” The residents live in a comfortable, pleasant and safe environment, with both private and communal space being suitable for their needs. EVIDENCE: The home is warm, comfortable and clean. It is well maintained and the décor is of a good standard. Residents’ bedrooms were personalised with photographs, pictures, personal belongings and the individual is involved in choosing how the room should be decorated. There are five lounges, ten single bedrooms and four double bedrooms in the home. The eight toilets and three bathrooms provide adequate facilities for residents’ use, as well as the hand basins in each bedroom. During a tour of the building one bedroom was found to have what appeared to be a small damp area above the wash hand basin, a requirement was made in respect of this.
Castle-Ford DS0000019657.V317678.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home.” Staff are well trained and supported ensuring that residents’ personal and safety needs are met at all times. EVIDENCE: All staff are subject to an induction and statutory training, which includes, fire safety, food handling, infection control, manual handling and first aid. Other training provided includes medication, protection of vulnerable adults, challenging behaviour, health and safety, infection control, basic food hygiene, epilepsy, health and nutrition and diabetes awareness. Staff meetings are held on a regular basis and records are kept of the outcomes and the actions agreed. All staff receive regular supervision from the manager. The home currently has 54 of staff with an NVQ qualification and the Learning Disability Award Framework. The home has sufficient staff on duty at all times to meet the needs of the residents. There are now three members of staff on duty during the day and two staff at night. The home also employs a cook and a domestic. The home has a recruitment policy and procedure in order to safeguard and support residents. Only one new staff member had joined the staff team since
Castle-Ford DS0000019657.V317678.R01.S.doc Version 5.2 Page 17 the last inspection and a sample of records inspected confirmed that the procedures were being appropriately followed. Castle-Ford DS0000019657.V317678.R01.S.doc Version 5.2 Page 18 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): 37,39,42 “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home.” The home is managed in an open and inclusive manner with residents being consulted on their care and their health and safety needs being met. EVIDENCE: The registered manager has experience of managing a home and working with people with a learning disability. He does not have an Non .Vocational Qualification at level 4, or the Registered Managers award, but is registered to commence these awards. Staff spoken with felt confident to approach the manager and that he was very approachable and listened to them. Discussion with staff and inspection of the home’s training records indicated that the health, safety and welfare of residents and staff were being promoted and protected. The home’s maintenance records for the home were seen and Castle-Ford DS0000019657.V317678.R01.S.doc Version 5.2 Page 19 found to be satisfactory. Certificates were seen for the maintenance of fire equipments, gas safety and electrical safety. To ensure that the home is run to the best interests of the people who use the service, quality assurance systems are in place. The manager seeks the views of all people involved in the home through regular user questionnaires. The results of this are presented back to staff and an action plan is developed from this. The people who use the service are informed of the results. These procedures ensure that the home continues to meet the needs of the people who use the service and that their opinions matter and are taken into account. Castle-Ford DS0000019657.V317678.R01.S.doc Version 5.2 Page 20 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 X 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 3 26 X 27 X 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 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 Castle-Ford DS0000019657.V317678.R01.S.doc Version 5.2 Page 21 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 YA24 Regulation 23(2 )b Requirement The manager must ensure that the cause of the “damp” area above the wash handbasin to bedroom No 1 downstairs double room is investigated and repaired. Timescale for action 28/02/07 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 YA37 Good Practice Recommendations The registered manager should take action to achieve a National Vocational Qualification at level 4 in both management and care. Castle-Ford DS0000019657.V317678.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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
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