Inspection on 15/08/06 for Castle Hall

This inspection was carried out on 15th August 2006.

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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Castle Hall 07/09/09

Castle Hall 15/08/07

Castle Hall 06/12/05

Castle Hall 10/08/05

Castle Hall 07/03/05

Castle Hall 18/08/04

Castle Hall 24/03/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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

CARE HOME ADULTS 18-65 Castle Hall 33 Lee Road Ravensthorpe Dewbury West Yorkshire WF13 3BE Lead Inspector Bronwynn Bennett Unannounced Inspection 15th August 2006 08:25 Castle Hall DS0000026340.V296052.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 Hall DS0000026340.V296052.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 Hall DS0000026340.V296052.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Castle Hall Address 33 Lee Road Ravensthorpe Dewbury West Yorkshire WF13 3BE 01924 520270 NONE None 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) Huddersfield Mencap Mrs Marlene Kenny Care Home 16 Category(ies) of Learning disability (16), Learning disability over registration, with number 65 years of age (16) of places Castle Hall DS0000026340.V296052.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named person category LD/PD Date of last inspection 6th December 2005 Brief Description of the Service: Castle Hall is set in a residential area, in Ravensthorpe, Dewsbury, close to local amenities. The home is managed by Huddersfield Mencap, and is registered to provide personal care and accommodation for up to fifteen adults with a learning disability. Nursing care is not provided at this home. Accommodation is provided on two levels. The home is staffed twenty-four hours a day. There are two waking night staff and an additional member of staff sleeping in on the premises. The provider informed the Commission for Social Care Inspection on 12.6.06 that the fees range from £518.65 to 669.80. There are additional charges for hairdressing, newspapers and magazines, toiletries, trips and holidays. Information about the home and the services provided are available from the home in the statement of purpose and the service user guide. Castle Hall DS0000026340.V296052.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection included an unannounced visit carried out by the inspector. The inspector arrived at the home at 8.25am and left at 5.20pm. During this visit the inspector spoke to some service users, some of the staff and the home’s manager Mrs Marlene Kenny. The inspector read care records, audited a sample of medications, reviewed staff recruitment and training records, and carried out a tour of the home. Prior to this visit the Commission for Social Care Inspection sent ten questionnaires to service users living at Castle Hall. Ten completed questionnaires were returned. There were fifteen service users living at the home on the day of this visit. Surveys were sent to six service users relatives, two GP’s and two other professionals. The inspector received responses from all the surveys. Other information used as part of this inspection process includes notifications from the home to the Commission for Social Care Inspection about deaths, illnesses, accidents and incidents at the home, copies of the monthly management visit reports produced by the care provider, and a pre inspection questionnaire completed by the manager. The inspector would like to thank everyone for their assistance during this inspection process. What the service does well: Nine of the ten service user surveys received by the Commission for Social Care Inspection said that they had received enough information about the home prior to admission, so they could decide if Castle Hall was the right home for them The staff continue to work hard to meet the needs of the service users. There were many positive comments made about the staff at the home from both the service user survey and during the visit to the home. The surveys received by the Commission for Social Care Inspection indicated that the service users are always given sufficient information, supported to make decisions and listened to by the staff. All the service users spoken with during this visit said that they knew who to speak with should they have any concerns or wish to make a complaint. Castle Hall DS0000026340.V296052.R01.S.doc Version 5.2 Page 6 There were positive comments from service users regarding the standard of meals served in the home. During this visit the inspector noted that the food served was well presented, looked appetising, and the service users said they had enjoyed their meal. 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. Castle Hall DS0000026340.V296052.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 Hall DS0000026340.V296052.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Service users’ individual needs and aspirations are assessed prior to admission. Quality in the outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: There have been no new admissions to the home since the last visit by the Commission for Social Care Inspection. Nine respondents from the service user surveys said that they did receive enough information about the home prior to their admission. The admission process was discussed with the manager who said that potential service users would only be admitted to the home following a full assessment. Castle Hall DS0000026340.V296052.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9. The service users know that their assessed and personal needs and goals are recorded in their care plan. Service users are supported to make decisions in their lives. Generally service users are supported to take risks as part of an independent lifestyle. Quality in the outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: As part of this site visit three service users’ care records were audited. All the care records showed that individual service users had been involved in the formulation of their care plan and in their review. The service users spoken with said that they had a chosen key worker. The information from the service user surveys confirms that service uses make decisions about what they wish to do each day. The choices made by individual service users were recorded in their plan of care. The service users are supported to manage their own finances should they wish to do so. Castle Hall DS0000026340.V296052.R01.S.doc Version 5.2 Page 10 The care records audited held up to date risk assessments relating to any identified risks as part of an individual’s lifestyle. However, the inspector was advised that the front door is kept locked. As this is not a secure unit the organisation should demonstrate the reason for this restriction. A requirement regarding this is made in this report. The staff have worked hard to meet the needs of the service users and there is work is ongoing to ensure the individual care records are person centred, and this work should continue. There were many positive comments made about the home during this visit. One service user commented, “It’s a great place, the staff are wonderful”. There were other comments, such as “the staff are nice” and “the staff are helpful”. Castle Hall DS0000026340.V296052.R01.S.doc Version 5.2 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 the following standard(s): 12,13,15,16 and 17. The service users are supported to be part of the local community and take part in appropriate activities. Service users are supported to maintain relationships with family and friends. The service users’ rights are respected and individuals’ choice and independence is promoted. Quality in the outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: There was a care plan in the service users’ records looked at relating to work and employment. No service users at this time are in employment or educational training. The service users are supported to take part in community activity. The service users said that they enjoy going out with the staff. Castle Hall DS0000026340.V296052.R01.S.doc Version 5.2 Page 12 The service users are supported to be part of the local community. The manager advised that the local councillor has been invited to the home to meet service users. Service users also access local facilities such as shops, chemist, pubs, places of interest, and some service users attend the community day care. On the day of this visit the service users were planning to go out on trips with the staff to places of interest. Service users are supported to maintain relationships, and contact with family and friends is recorded in the individual’s care records. The service users spoken with said that their relatives and friends are welcomed into the home when they visit. During this visit the inspector observed good interaction between the service users and the staff. The need for privacy is recorded in the individual care plan. Service users hold a key to their own room and a locked drawer facility if they wish to do so. The service users rights are respected and recorded. Service users’ responsibility for any housekeeping tasks such as cleaning their own room is recorded in the individual care plan. All the service users spoken with said that the food served at the home is good and there is plenty to eat and drink. The service users said they are supported to help plan menus, and some service users enjoy taking part in the preparation of meals. There is a choice of menu each day for service users and on the day of this visit the food presented looked nice and appetising and the service users said they had enjoyed their meal. The nutritional needs and support required by the service user is recorded in their plan of care. Castle Hall DS0000026340.V296052.R01.S.doc Version 5.2 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 the following standard(s): 18,19, and 20. The service users receive personal support in their preferred way. Generally the health care needs of the service users are being met. The home’s medication policy and procedure does not sufficiently protect the service users. Quality in the outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: During this key inspection the service users were observed being treated with dignity and respect. The service users preferred choice such as how to dress, their appearance, and times for rising and going to bed, bathing and meals are recorded in their plan of care. Service users do have some choice of the staff who work with them, and the preferred gender of staff providing personal care was recorded in the care records looked at. The service users spoken with said that the staff are helpful and supportive. Castle Hall DS0000026340.V296052.R01.S.doc Version 5.2 Page 14 All the care records audited contained a health care plan. The service users are supported to choose their own GP and supported in managing health conditions. There was evidence in the care records that the service users are supported to access NHS healthcare facilities. There is additional support for the service users from a visiting physiotherapist. All the service users now have a risk assessment to measure the risk of developing pressure sores (Waterlow risk assessment) and all service users are weighed on a monthly basis. The home has a medication policy and procedure in place however this is in need of updating. The manager said that all staff who dispense medication in the home has received the required medication training. Three service users’ medications were audited, and two of the three medications checked could be reconciled with the records kept. There were errors noted in one service user’s medication and these issues were discussed immediately with the home’s manager. Castle Hall DS0000026340.V296052.R01.S.doc Version 5.2 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 the following standard(s): 22 and 23. The service users feel that their views are listened to and acted upon, and they are protected from abuse. Quality in the outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The home has a complaints policy and procedure in place and there have been no complaints made to the home in the last twelve months. The service users spoken with said that they knew who to speak to should they wish to raise a concern or make a complaint. Ten service users responded to the service user survey and all confirmed that they knew who to speak with if they were unhappy, and knew how to make a complaint. The home has a policy and procedure for whistle blowing. Fourteen staff have undertaken adult protection training and this training is covered as part of the organisation’s induction programme. The staff spoken with during this visit had a good understanding of adult protection issues and the relevant actions that should be taken following any allegations of abuse. Castle Hall DS0000026340.V296052.R01.S.doc Version 5.2 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 the following standard(s): 24 and 30. Generally the home is clean and hygienic. However, action needs to be taken by the organisation to improve the overall environment to ensure the service users live in a homely and comfortable environment. Quality in the outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The service users who responded to the survey said that the home is always fresh and clean. Some service users’ rooms were looked at and these were personalised by the individual. As part of this visit the inspector completed a tour of the home. Generally the home is clean and free from odour. However, the corridors and communal areas were notably dark and the home is generally in need of redecoration. Some work has been undertaken to the identified bathroom, but this area does require new floor covering. Other areas as discussed with the manager are in need of redecoration and routine maintenance. However, the home has no planned maintenance and renewal programme, and this needs to be addressed by the organisation. Castle Hall DS0000026340.V296052.R01.S.doc Version 5.2 Page 17 The relocation of the laundry facilities is now complete and there are now suitable hand washing facilities for the staff. This area now requires redecoration and repair to the floor covering. Castle Hall DS0000026340.V296052.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35. Generally, a competent staff team supports service users. The service users are not sufficiently protected by the home’s recruitment policy and procedure. Quality in the outcome area is poor. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The respondents to the service user survey said that the staff always treated them well and listened to what they had to say. On the day of this visit the service users spoken with made positive comments about the staff team. Two GPs responded to the surveys and both made positive comments regarding their professional relationship with the home. In addition, comments from a district nurse were very complimentary stating that the service users at Castle Hall receive first class care. Ten staff have now achieved NVQ level 2 qualification. The manager continues to support the staff in providing the appropriate responses to the needs of the service users. Two members of staff confirmed that they had undergone induction training provided by the organisation. The organisation should recommence LDAF Castle Hall DS0000026340.V296052.R01.S.doc Version 5.2 Page 19 (Learning Disability Award Framework) accredited training. The organisation should develop a staff training and development plan. The manager is working hard to ensure the staff receives suitable training. All staff are undertaking some training at this present time, such as infection control, dementia training and medication training. The records for three staff working in the home were audited. Generally the required information was kept within these records. A discussion took place with the manager regarding the safe keeping of satisfactory police checks, Criminal Record Bureau (CRB) checks and a satisfactory check of the Protection of Vulnerable Adults list. The inspector was advised that a member of staff had been appointed without the relevant satisfactory police CRB and vulnerable adults checks. This is not good practice. Castle Hall DS0000026340.V296052.R01.S.doc Version 5.2 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42. The service users benefit from a home a well run home. The home is run in the best interests of the service users. The health, safety and welfare of the service users, and the staff, is generally promoted and protected. Quality in the outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. EVIDENCE: The home has a registered manager, Mrs Marlene Kenny was registered by the Commission for Social Care Inspection on 13th April 2006. Generally the home is run in the best interests of the service users. The service users and staff made positive comments about the manager. One member of staff said the manager is very supportive and there were similar comments from other staff and service users. Mrs Kenny should be commended for her work at the home. Castle Hall DS0000026340.V296052.R01.S.doc Version 5.2 Page 21 There is a quality monitoring system in place. Monthly management review reports are completed and quality audits are completed by the home. Questionnaires in suitable formats are sent to service users. The results of consumer surveys are made available in the home. The service users spoken with said that they hold meetings in the home and are encouraged to express their views. The respondents to the service user survey said that the staff always listen and act on what they say. The staff have received fire safety training and many staff have received fire training updates. All staff should receive fire training, and take part in fire drills every six months. Eleven of the care staff have undertaken movement and handling training. All staff should receive annual up dates for safe movement and handling techniques. Through distance learning many of the staff are currently undertaking infection control training. The fire records were checked and were up to date. The fire safety officer has recently visited the home to check the fire safety system. A sample of health and safety records was checked and was found to be up to date. Castle Hall DS0000026340.V296052.R01.S.doc Version 5.2 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 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 1 25 X 26 X 27 1 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 1 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 1 X 3 X 3 X X 2 X Castle Hall DS0000026340.V296052.R01.S.doc Version 5.2 Page 23 Yes 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 YA9 Regulation 17 (1)(a) Schedule 3 (3) (Q) Requirement Timescale for action 15/09/06 2. YA20 13 (2) 3. YA27 YA24 23 (2) (b) (d) 4. YA34 19(1)a,b, (I) The registered person shall keep a record of any limitations agreed with the service user as to the service user’s freedom of choice, liberty of movement and power to make decisions. Therefore, as this is not a secure unit the organisation should demonstrate the reason for the restriction to the front door. The registered person shall make 15/08/06 arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. The registered person shall 15/02/07 having regard for the care home and the needs of the residents ensure that the care home is kept in a good state of repair internally and externally. That all parts of the care home are kept clean and reasonably decorated. Previous timescale 06/03/06 not met. (Regs 19(1)a,b, (I)para 1-9 of 15/08/06 sch 2, c.) The registered person shall not employ a person to work at the DS0000026340.V296052.R01.S.doc Version 5.2 Castle Hall Page 24 care home unless, the person is fit to work in the care home and, they have obtained in respect of that person the information as specified in the requirements opposite. Previous timescale 06/01/06 not met. 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. Refer to Standard YA30 YA35 Good Practice Recommendations The laundry area should be redecorated and the floor covering replaced or repaired. The organisation should develop a staff training and development programme to ensure the staff are appropriately trained to meet the needs of the service users. To ensure safe working practice: All staff should be trained for infection control. To ensure safe working practice: All staff should undertake six monthly updates in fire training. To ensure safe working practice: All staff should receive annual movement and handling training. 3. 4. 5. YA42 YA42 YA42 Castle Hall DS0000026340.V296052.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB 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. 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