Inspection on 10/05/07 for CHAD Limited

This inspection was carried out on 10th May 2007.

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

CHAD Limited 29/04/09

CHAD Limited 05/06/06

CHAD Limited 01/12/05

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

CARE HOME ADULTS 18-65 CHAD Limited Cordingley House 22 Linden Terrace Whitley Bay Tyne & Wear NE26 2AA Lead Inspector Allan Helmrich Unannounced Inspection 10th May 2007 10:00 CHAD Limited DS0000064818.V333618.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 CHAD Limited DS0000064818.V333618.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. CHAD Limited DS0000064818.V333618.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service CHAD Limited Address Cordingley House 22 Linden Terrace Whitley Bay Tyne & Wear NE26 2AA 0191 289 3621 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) Care Homes for Adults with Disabilities Limited Mrs Julie Ann Henry Care Home 4 Category(ies) of Learning disability (4) registration, with number of places CHAD Limited DS0000064818.V333618.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th June 2006 Brief Description of the Service: CHAD Limited is located at Cordingley House in Whitley Bay close to the town centre and seafront. The home is an Edwardian terraced house close to local amenities such as a library, swimming pool, shops and local transport. The home has 2 large rooms for lounging and activities and a large kitchenette used for dining and activities. There are 4 bedrooms, 2 bathrooms with showers and toilets and a separate toilet. The home can provide accommodation for 4 people with a learning disability. CHAD Limited cannot provide nursing care. The range of fees charged is agreed with the local authority and are dependent on individual needs. The current fees are in the range £3378 - £1296 per week. Information about the home is readily available to interested people. CHAD Limited DS0000064818.V333618.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the home’s periodic unannounced key inspection. It took place on 10th May 2007 from 10.00 am until 6.00 pm. One of the owners was on duty throughout the visit. All four residents were at home at various times during the day. Some of the home’s care records were reviewed and the systems that maintain residents safety. Also as part of the inspection the care plans for two residents were inspected against the actual care provided. This is called ‘case tracking. Residents where able, shared their views about the home. Staff were spoken with and time was also spent observing the contact between residents and staff. The communal areas of the home were inspected and residents bedrooms. Questionnaires were provided for residents and visitors to the home. Two responses were received, one from a resident and the other from a relative. Both of the responses were positive about the home and no issues were raised. At the time of the inspection there were no visitors. What the service does well: The management and staff support residents to live an active life in the community. Each resident is supported and encouraged to choose what to do and where to go. All residents in the home enjoy living there and are well supported by the staff team. The home is comfortable and homely. The management team are very able and support residents through their emotional challenges. Staff are well-trained and all have either achieved a NVQ in care or are working towards this qualification. The home is safe and clean for residents. CHAD Limited DS0000064818.V333618.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. CHAD Limited DS0000064818.V333618.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 CHAD Limited DS0000064818.V333618.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 this service. No one is admitted into the home until management have assessed they can meet their needs. EVIDENCE: Management spoke about the admission process that can take several weeks. The process involves professional people involved in the placement and takes account of others living in the home. Two files reviewed contained information that management used in assessing the suitability of the referral. Specific staff training associated with the needs of the referral is obtained. The returned questionnaires confirmed the process of moving in was good and sufficient information was provided to be able to make an informed choice. CHAD Limited DS0000064818.V333618.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, 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have good plans in place for daily living but not to encourage life skills. Residents are involved in making lifestyle decisions. Residents are encouraged to be independent. EVIDENCE: Each resident has a plan of care identifying needs and choices. Communication plans are in place. A picture format is being developed to enable residents to be more involved in their care. These plans have been discussed with the individual resident and this is recorded in the plans. The plans identify to staff the amount of support the resident needs so as not to take learnt skills away. CHAD Limited DS0000064818.V333618.R01.S.doc Version 5.2 Page 10 The information in the plans has been developed with assistance from the local authority’s specialist teams. Regular care reviews are organised with the care managers. Any problems are discussed and appropriate actions are taken. Risks in daily living have been identified, appropriate strategies have been developed for each resident and any staff training necessary has been identified and obtained. Staff have not identified any areas for development. None of the life plans reviewed contained goals to be achieved. Throughout the day staff were involving residents in decision making and respecting their choices. The majority of residents chose to go out with staff but one resident who declined was supported with an activity of his choice at home. CHAD Limited DS0000064818.V333618.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. 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 this service. Residents are supported to live a normal life within the community. Staff support residents to maintain links with families and friends. A range of meals is provided that encourage healthy eating. EVIDENCE: Residents use community services every day. During the inspection residents were seen coming and going with staff support. Each resident has a plan for daily living that is flexible. The plans are individual and contain access to colleges for the development of learning and leisure CHAD Limited DS0000064818.V333618.R01.S.doc Version 5.2 Page 12 pursuits that include; swimming, horse riding, archery and trampoline work. The residents enjoy outings and these are arranged around the coast and in the countryside. One resident from an ethnic minority group is supported by staff that are instructed by his family. The family inform staff of cultural ways. The home have not identified any specific staff training in this respect. Links are maintained with families and regular contact is encouraged. The relative who responded to the questionnaire confirmed the home assisted her relative to keep in touch. Although there is a structure to each residents day, this is flexible to meet the emotional needs of the residents. Staff respect residents choices and where this is not possible risk management plans are produced to support the resident. Residents are treat as individuals, they are referred to by their chosen name and their style of dress is personal. Menus provided before the inspection show that residents are given the choice of wholesome substantial meals. The main meal served during the inspection contained appropriate vegetables to maintain good health. Not everyone had the same meal as one resident requires a specific diet to meet his cultural needs. The larder did not contain appropriate quantities of food. The proprietor stated that the next day would be the normal weekly shopping day. CHAD Limited DS0000064818.V333618.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. 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 this service. Residents are supported to live their chosen lifestyle. An experienced staff team addresses their physical and emotional needs. The systems for dealing with medication are satisfactory for the size of the home and ensure residents health is maintained. EVIDENCE: Throughout the day residents and staff were seen talking to each other. Staff always took the time to talk through any issue mentioned by a resident. Residents emotional needs were regularly addressed by a good and supportive staff team. Care plans describe the needs of each resident and how they should be addressed. All healthcare appointments are recorded and the case records that CHAD Limited DS0000064818.V333618.R01.S.doc Version 5.2 Page 14 were reviewed showed that regular healthcare is obtained to maintain the good health of the residents. Currently some residents are receiving regular support from outside professionals and the records recorded the information provided to assist in the health and wellbeing of each resident. During the inspection residents were observed getting up at various times depending on their preferences. One resident stated he goes shopping with staff for new clothes. He also stated he chooses what to do and when. A system is in place to assist residents with their personal allowances. A book is used to record these matters where two signatures were in place for each transaction and a receipt is obtained for purchases. Management did not audit the records and not all transactions were well described. The homes system for recording and administering medicines is appropriate to the size and style of the home. Staff are trained in handling medicines. All medications are locked away for safety and a record of administration is maintained. Staff have access to a medical reference book and policies and procedures. CHAD Limited DS0000064818.V333618.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. 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 this service. The home has a complaints process that protects residents. Residents are protected from potential abuse, neglect and harm. EVIDENCE: The home has a complaints process that residents/relatives are aware of. Each resident was provided with a copy when they entered the home. No complaints have been received by the home since the last inspection. Staff spoken to are aware of their duty regarding protecting vulnerable people. Training in abuse awareness and dealing with challenging behaviour has been provided and good records of any incidents are provided to the local authority. Local authority representatives spoken to about the care provided are satisfied with the way management handle any concerns. CHAD Limited DS0000064818.V333618.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents live in a homely environment that is clean and reasonably safe. Some decoration and redecoration after repair is needed. EVIDENCE: One resident spoken to is very happy with his private space. The home was found to be clean and safe. Some decoration is required to improve the home for residents. The proprietor stated that a decorator is visiting the home to undertake some work over the next few weeks. CHAD Limited DS0000064818.V333618.R01.S.doc Version 5.2 Page 17 Some repairs have been done in the home and these areas also require decoration. A large crack in the wall near a doorframe needs to be attended to. New windows have been installed in some areas and other work is to follow. All windows should have restrictors to limit the opening for the safety of the residents. The kitchen and laundry areas are appropriate for the size of home. They are domestic in character should residents want to be involved in household chores but also the laundry meets with disinfection standards. CHAD Limited DS0000064818.V333618.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. 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 this service. A well-trained and competent staff group employed in sufficient numbers supports residents. The homes recruitment process ensures residents are safe. EVIDENCE: The home maintains a level of staffing sufficient to meet the needs of the resident group. Information provided before the inspection showed that generally, staffing levels can be 2:1 or 1:1 depending on the risk assessment. During the inspection there were between 2 and 4 staff on duty to meet the assessed needs and planned activities for the day. At night there is one waking and one sleep in staff. The management keep staffing levels under review. CHAD Limited DS0000064818.V333618.R01.S.doc Version 5.2 Page 19 The home has a training programme in place. 60 of staff have completed NVQ Level 2 or above. The Learning Disability Award Framework (LDAF) is provided for all staff. Currently all but 2 staff have level 1 LDAF and some staff have level 2. The local authority have provided specific training related to this resident group. Staff spoken to stated that all training requests are considered. One staff member is being sponsored and encouraged to complete a NVQ level 4 in care. Other training undertaken by the staff team to enable a better standard of care to be provided includes; accredited medication training, British Institute of Learning Disability (BILD) accredited training in restraint techniques, protection of vulnerable adult training and training related to care for people with autism. Training related to equality and diversity issues are not recorded although the proprietor stated that these issues are identified and information is provided by the family of one resident. Two staff files were reviewed. Staff recruitment records are in place, references are obtained and checks are made by the Criminal records Bureau. Staff confirmed that they have regularly 1:1 supervision with the manager and that this is a positive experience. CHAD Limited DS0000064818.V333618.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. 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 this service. A registered manager and the two proprietors are involved in managing the home. The residents are also well supported by a well-trained staff team. The quality of care provided is supported by a formal quality monitoring system involving residents and their families. A good standard of health and safety is maintained for the benefit of residents. CHAD Limited DS0000064818.V333618.R01.S.doc Version 5.2 Page 21 EVIDENCE: The manager was not available during the inspection. A proprietor stated she has recently obtained the Registered Managers Award and is about to start training related to person centred planning. Staff spoken to said they a well supported by management. The two proprietors have worked with people with a learning disability for several years. The home is well run and systems are continually being improved. The staff team are involved in regular meetings where team goals are identified to improve the care provided to residents. Residents are invited into these meetings. Residents made positive comments about the service provided throughout the inspection and those that spoke to the inspector felt the home met their needs. The home has achieved the Investors in People Award and also has a system of monitoring the quality of care provided. Action plans are prepared for issues identified for improvement. The home is reasonably safe. Some windows require a restrictor to be fitted to reduce the opening. Some small repairs and decorations are needed to improve the home for residents. Fire Authority requirements to ensure doors close onto the rebate need to be completed. Action is being taken to address these issues. All staff receive health and safety training. Fire training is provided and the fire log showed that regular checks are done. CHAD Limited DS0000064818.V333618.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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 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 2 3 3 X 3 X 3 X X 2 X CHAD Limited DS0000064818.V333618.R01.S.doc Version 5.2 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 YA24 Regulation 23(2)(b and d) Requirement Timescale for action 31/07/07 2. YA42 23 The manager must ensure the home is kept in good order; Repair cracks in walls, redecorate after repairs and decorate those areas identified during the inspection. The manager must attend to the 31/05/07 following matters associated with health and safety; All windows should have restricted openings to ensure residents are safe. The fire door identified at the last fire inspection should close onto its rebate. 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 YA6 Good Practice Recommendations If the home is to encourage life skills, a goal plan should be developed to ensure there is consistency of effort within the staff team. DS0000064818.V333618.R01.S.doc Version 5.2 Page 24 CHAD Limited 2. 3. YA18 YA35 Financial records should be well described to ensure that a full audit can be done by management. The manager should review the staff training needs relating to equality and diversity. The manager should involve appropriate people to ensure staff are aware of religious and cultural needs within the resident group. CHAD Limited DS0000064818.V333618.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 © 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 CHAD Limited DS0000064818.V333618.R01.S.doc Version 5.2 Page 26 - 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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