Inspection on 09/06/05 for Castle-Ford

This inspection was carried out on 9th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Castle-Ford 29/07/08

Castle-Ford 30/01/08

Castle-Ford 07/11/06

Castle-Ford 30/11/05

Castle-Ford 07/12/04

Castle-Ford 06/07/04

Castle-Ford 22/01/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

Pennine Camphill

Muston Road (70)

Grayling

The Cornerstone

John Street Nursing Home

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

CARE HOME ADULTS 18-65 Castle-Ford 46-48 Princes Avenue Withernsea East Yorkshire HU19 2JA Lead Inspector Sarah Sadler Unannounced 9 June 2005 09:40 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Castle-Ford J53_s19657_Castle-Ford_v224370_090605_stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Castle-Ford Address 46-48 Princes Avenue Withernsea East Yorkshire HU19 2JA 01964 613164 01964 612412 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 John Frederick Wright Mr Mark Anthony Wright Care Home 18 Category(ies) of LD Learning disability 18 registration, with number of places Castle-Ford J53_s19657_Castle-Ford_v224370_090605_stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 7 December 2004 Brief Description of the Service: Castleford is a privately owned registered establishment catering for the needs of 18 service users who have learning difficulties. It is located in the seaside town of Withernsea, within easy access to local shops and public transport.The home consists of three terraced properties converted into one building.There are several lounges, an activities area,a small shop run by the home and a sensory room.There are 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.There is a rear garden and adjacent car parking. All personal care needs are met by the staff in the home with access to specialist services accessing other professionals as necessary. Castle-Ford J53_s19657_Castle-Ford_v224370_090605_stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was completed as part of the programme of inspections for the year. It was an unannounced inspection undertaken by two inspectors, Sarah Sadler and Michael Tomlinson. The inspection day lasted from 9.40 am until 3.30 pm with a previous half day preparation also undertaken. During the inspection a tour of the premises was completed, a number of services users were spoken with, time was spent with service users in the communal areas of the home observing their daily lives and further time was spent reading service users’ care plans and files. Discussions were held with service users, one of the proprietors and staff during the day. What the service does well: What has improved since the last inspection? What they could do better: Staff hours and deployment could facilitate more activities for service users. Some service user activities could be less undermining. Staff could be trained in Learning Disability Award Framework training. Castle-Ford J53_s19657_Castle-Ford_v224370_090605_stage 4.doc Version 1.30 Page 6 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. Castle-Ford J53_s19657_Castle-Ford_v224370_090605_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 Castle-Ford J53_s19657_Castle-Ford_v224370_090605_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) 2,5 Service users receive an assessment to ensure their needs can be met. Service users receive a statement of terms and conditions that enables them to be clear about expectations when residing in the home. EVIDENCE: Service user files contained copies of community care assessments undertaken by the Local Authority and copies of the homes’ own assessment of the needs of the service users. Service user files contained copies of their terms and conditions/contracts for residing in the home. These included that service users are offered a seven day annual holiday as part of the basic contract price of residing in the home. The contract did not include all of the recommended areas, for example, a copy of the service user care plan. Castle-Ford J53_s19657_Castle-Ford_v224370_090605_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) 6,8 The internal care management arrangements for the service users are inconsistent, which may result in a poorer standard of service. EVIDENCE: Service user care plans reflected that service users’ needs are assessed and detailed in a care plan. Copies of care management reviews are available and service users when able to have signed to say that they agree to their care plan. There was however little evidence of the service user involvement in the drawing up of the plan. Records were viewed of service user and staff meetings. The last service user meeting was in October 2004. Service user meetings notes reflected that the meetings inform service users of any changes in their home. Service users were asked if they required more activities and their opinions on new members of staff. Suggestions were to be forwarded to the registered provider. Staff meetings did not involve service users and minutes of the meeting included communal notes for service users. No evidence was found that service users participate formally in staff recruitment. The quality assurance system has not been fully implemented and those sections that have been completed involved relatives of the service users. Castle-Ford J53_s19657_Castle-Ford_v224370_090605_stage 4.doc Version 1.30 Page 10 Service users, where able to, informed the staff of their plans for the day, from this the staff determined their plan for the day in supporting those service users who are less independent. One service user was informed that they were able to have their lunch only when they promised to behave. This would not be considered good practice and must be addressed further. Records reflected that service users are supported throughout the night with regular checks from staff to ensure their health and safety. Staff records reflected that staff have undertaken a variety of training, but that there has not been training specific to the service user group. Castle-Ford J53_s19657_Castle-Ford_v224370_090605_stage 4.doc Version 1.30 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) 13,15,16,17 Service users’ social needs are not being fully met. Some activities undermine the dignity of the service user involved. EVIDENCE: Care plans reflected that service users undertake activities in the home. Often these activities are limited to watching television with the other service users. On occasions baking has taken place. There was only limited evidence of how and when the sensory room is used. There is an activities plan for the week, this detailed that there are 3 hours for the social club/videos on a Monday, 1.5 hours for crafts or other activities on a Tuesday, 1.5 hours for games on a Wednesday, 3 hours on a Thursday for the Social club/puzzles and half an hour for games on a Friday. Observations reflected that service users are often sat for periods with little activities undertaken as staff are deployed in the cooking and laundry. One service user was dressed in a comic style boxing outfit that made them the brunt of a joke and was undignified. Castle-Ford J53_s19657_Castle-Ford_v224370_090605_stage 4.doc Version 1.30 Page 12 There is not a policy to support service users should they wish to develop an intimate personal relationship. Menus are planned and service users stated that they enjoyed the food provided. Records are kept of the food provided. The majority of the service users have no assessment undertaken to ascertain if the nutritional needs of service users are met. Only one service user is currently being monitored regarding their dietary intake. As little information regarding this was provided with their individual assessment when they moved into the home. No service user choice regarding food is recorded and service users low in weight are descried as “munchkins” by the staff. This may be seen as poor practice and should be addressed further by the registered provider. Castle-Ford J53_s19657_Castle-Ford_v224370_090605_stage 4.doc Version 1.30 Page 13 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) 19,20 Service users’ health needs are met. Service users’ personal care needs are not always met. EVIDENCE: Service user records reflected that their personal hygiene needs are met. However one service user remained in damp and stained clothing for the majority of the day. There was no toilet roll readily available to service users. The inspector was informed that this was due to the behaviour of some service users. No toilet roll was available for those service users without these behaviours. Files contained details that service users are registered with a dentist and that there is input from other health professionals. The physiotherapist was visiting service users on the day of the inspection. Service users sat outside were assisted with the administering of sun tan lotion. However one member of staff completed this whilst smoking a cigarette. Service user files included behaviour monitoring charts, and details of visits to the GP. Castle-Ford J53_s19657_Castle-Ford_v224370_090605_stage 4.doc Version 1.30 Page 14 Medicines are recorded when received into, administered and leaving the home. Castle-Ford J53_s19657_Castle-Ford_v224370_090605_stage 4.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 Service users are not fully protected by the practices in the home. EVIDENCE: There is a copy of the Local Authorities’ procedure ‘ The Protection of Vulnerable Adults’. One service user had made an allegation against a member of staff, this was being investigated. The staff member had been informed in writing who had made the allegations. Castle-Ford J53_s19657_Castle-Ford_v224370_090605_stage 4.doc Version 1.30 Page 16 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) 26,30 Service users live in a clean home. Service users’ bedrooms do not fully meet the needs of the service users. EVIDENCE: There is an activity room and a shop, which the inspectors were informed is run by one of the registered providers. There are communal lounges and a large dining area. The laundry floor has been repaired and is now impermeable. A number of service users’ beds are placed against radiators that are not guarded, this is a risk to the more vulnerable and frail service users in particular. The hot water in some shared rooms has been disconnected as a result of risk assessment. However the risk assessment related to only one of the two service users. The decoration in some rooms is in need of repair/replacement and the staff member assured the inspector that this is part of the ongoing refurbishment of the home. Lampshades were not always in place, this detracts from the ambience of the home. Castle-Ford J53_s19657_Castle-Ford_v224370_090605_stage 4.doc Version 1.30 Page 17 There is a bathroom with a walk in shower. Castle-Ford J53_s19657_Castle-Ford_v224370_090605_stage 4.doc Version 1.30 Page 18 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) 32,33,34,35,36 Recruitment practices ensure the safety of the service users. Service users are not supported by an effective staff team. EVIDENCE: During the inspection there were two care staff on duty. These staff also completed the cooking. One of the registered providers was available for part of the day; they are employed as the ‘handyman’. Service user notes reflected that key worker time is only two hours per week. Staff were observed to interact readily with service users. However conversation between staff and service users was often directing and instructing to the service users, for example, “Get off “ and “ Go to the toilet”. At times the conversation was not appropriate as service users were told “ You are slobbering” “Go on push off”, “ You can have your lunch when you promise to behave”. Staff files all contained evidence of Criminal Records Bureau checks, written references and training. The training was varied and includes, for example, Dysphagia, Infection control and Adult Protection. Staff supervision notes reflected that staff are receiving regular supervision. These sessions discuss practice issues, service user specific issues, training needs and individual needs/issues. The new staff member had completed her induction test. Castle-Ford J53_s19657_Castle-Ford_v224370_090605_stage 4.doc Version 1.30 Page 19 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) 37,40,41,42 The home is not always run in the best interests of the service users. EVIDENCE: The registered manager was not available on the day of the inspection. Service users were seen being spoken to inappropriately and a service user was dressed comically. This fails to uphold service users dignity and must be addressed. The registered manager is continuing to work to achieve their National Vocational Qualification level 4. Up to date checks have been completed fro Portable Appliance Testing (PAT), electrical checks, gas checks and fire checks, including a monthly fire drill. Castle-Ford J53_s19657_Castle-Ford_v224370_090605_stage 4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x 1 Standard No 22 23 ENVIRONMENT Score x 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x 1 x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x 1 x x x 1 Standard No 11 12 13 14 15 16 17 x x 1 x 2 2 2 Standard No 31 32 33 34 35 36 Score x 2 1 3 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Castle-Ford Score x 1 3 x Standard No 37 38 39 40 41 42 43 Score 2 x x 2 x 3 x J53_s19657_Castle-Ford_v224370_090605_stage 4.doc Version 1.30 Page 21 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 5 Regulation 4,5,17 Requirement Timescale for action 15.8.05 2. 8 3. 13 4. 16 5. 19 The registered provider must ensure that the service users contract/statement of terms and conditions covers all of the required areas. This is an ongoing requirement with a previous compliance date of 7.3.05. 4,5,6,10,1 The registered provider must 2,16,24,2 ensure that service users are 6 supported to take part in all areas; including the day to day running of the home, and development of policies, procedures and services. This is an ongoing requirement with a previous compliance date of 14/2/04 16 The registered provider must ensure the provision of adequate activities for all service users. this is an ongoing requirement with a previous compliance date of 7.1.05. 12(4(a)) The registered provider must ensure that service users are dressed and spoken to appropriately. 13(3) The registered provider must ensure that the personal hygiene needs of service users J53_s19657_Castle-Ford_v224370_090605_stage 4.doc 15.8.05 and ongoing. 15.8.05 and ongoing. 15.8.05 15.8.05. Castle-Ford Version 1.30 Page 22 are met. 6. 26 12,16,23 The registered provider must ensure that the service users’ bedrooms include sufficient equipment. Service users choices for this must be recorded. This is an ongoing requirement with a compliance date of 14/2/04. The registered provider must ensure that the home complies with the Water Supply Water Fittings) Regulations 1999. this is a previous requirment an ongoing compliance date of 7.2.05. The registered provider must ensure that staffing hours support the service users in the meeting of their needs. this is a previous requirement with an ongoing compliance date of 7.1.05. 15.8.05 and ongoing. 7. 30 13 15.8.05 and ongoing. 8. 33 19 15.8.05 and ongoing. 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. 2. 3. 4. 5. 6. 7. Refer to Standard 6 8 15 17 23 26 26 Good Practice Recommendations The registered provider should ensure that service users are involved in the development of thier care plan. The registered provider should ensure that service users are involved in the quality assurance systems in the home. The registered provder should ensure a policy to support service users should they wish to develop an intimate personal relationship. The registerd provider should ensure that service users nutritional needs are assessed and reviewed.Ensuring that a full balance diet is provided at all times. The registered provider should ensure that service users are protected by the procedures undertaken in the home. The registered provider should ensure appropriate access to washing facilities. The registerd provider should ensure appropriate lighting J53_s19657_Castle-Ford_v224370_090605_stage 4.doc Version 1.30 Page 23 Castle-Ford 8. 9. 10. 11. 12. 13. 14. 32 32 37 40 40 and furnishings. The registered provider should ensure that 50 of the staff team hold an NQ level 2 or equivalent by 2005. The registered provider should ensure that staff are trained in Learning Disability Award Framework Training. (LDAF) . The registered manager should be qualified at level 4 National Vocational Qualification, in both management and care. The registered provider should ensure that the procedures in the home ensure the best interests of the service users. The registered provider should ensure that service users have access to policies in appropriate formats and opportunities to format policies Castle-Ford J53_s19657_Castle-Ford_v224370_090605_stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection First Floor Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 Castle-Ford J53_s19657_Castle-Ford_v224370_090605_stage 4.doc Version 1.30 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!