Inspection on 05/06/06 for CHAD Limited

This inspection was carried out on 5th June 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 6 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 10/05/07

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 Deborah Haugh Key Unannounced Inspection 5th June 2006 09:30 CHAD Limited DS0000064818.V290531.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.V290531.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.V290531.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.V290531.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st December 2005 Brief Description of the Service: CHAD is located at Cordingley House in Whitley Bay close to the sea. The home is an Edwardian terraced house close to local amenities such as a library, swimming pool, shops and local transport. The home has 4 bedrooms, 3 toilets, 2 bathrooms and 3 showers. The home can provide accommodation for 4 people with a learning disability. CHAD cannot provide nursing care. The range of fees charged between £3,378 - £1,347. CHAD Limited DS0000064818.V290531.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The un-announced key inspection took place on 05/06/06 from 9.30 am until 3.00 pm. The Registered Provider, Elizabeth Whiteman was on duty during the visit. There are currently 3 service users at the home. An examination of health and safety, activities, staffing, recruitment and training of staff, medication and 3 care plans were undertaken. The communal areas, bathroom and toilet were checked. Service users where able, shared their views about the home. Staff were spoken with and time was also spent observing the contact between service users and staff. Prior to the inspection questionnaires were provided to service users/relatives and professionals. Relatives completed two questionnaires and a professional visitor completed one. At the time of the visit there were no visitors. What the service does well: CHAD Ltd is a new home, which provides residential care for people with autism. The setting is homely and relaxed and routines are arranged around the needs of the people who live there. Staff are well trained and there is an on-going training plan to update their practice. The management team is open and encourages comments about CHAD. Comments from service users/relatives were positive and they were satisfied with the overall care provided. Comments included; ‘The staff actively seek X opinions in all aspects of his day to day care.’ ‘Sometimes likes to come home and visit family.’ ‘Enjoys horse riding and swimming.’ ‘I love horse riding.’ ‘I’m going to college.’ Good communication exists between professionals. Records, which the home must keep are clear and helpful where concerns are raised. CHAD Limited DS0000064818.V290531.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. CHAD Limited DS0000064818.V290531.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.V290531.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): 2-5 Service users are only admitted when they are comfortable and the home knows that they can care for them. EVIDENCE: 2-5) Three service user records were examined. Service users who move into the home have the opportunity to visit the home, move in gradually and all have a contract with the home. Assessments are completed by the home and care manager. Assessments by care managers, other professionals as well as the home are in place. Questionnaires from relatives said that they had been provided with enough information and the service users had had trial visits in order to make up their mind that CHAD could meet the needs of their relative. CHAD Limited DS0000064818.V290531.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 6) Care plans ensure that service users are provided with the care and support which they require but some updates are needed. 7) Service users have the opportunity to participate in all aspects of decisionmaking in their lives. However where this is not possible reasons are recorded. 9) Service users are able to take managed risks and any restrictions are recorded and agreed. EVIDENCE: 6) Three service user care plans were sampled and they identify a range of needs and activities. Interventions are detailed and guide the practice of staff. However a communication plan must be in place. A plan for medication which is administered when required and any continence needs must also be in place. The involvement of other professionals is evident to guide the actions of staff. CHAD Limited DS0000064818.V290531.R01.S.doc Version 5.2 Page 10 Multi-disciplinary team work is in place from psychologists, care managers and other professionals where necessary such as Speech & Language Therapy Team (SALT). Daily and nighttime records are maintained and these also record the views of service users. Cultural/religious needs are also identified and this is also reflected in dietary care plans. 7) Questionnaires and observations confirmed that staff actively seek the views of service users on all aspects of care. Household tasks such as tidying, watering plants, food preparation and shopping involve service users if they wish. Some of the needs of the service users are complex and where decisionmaking is not possible relatives/professionals are consulted. 9) Risk assessments are in place and cover a wide range of areas such as safety in the community and lifestyle choices, which incur risk. CHAD Limited DS0000064818.V290531.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 & 17 12-16) Service users are given the opportunity to try new experiences, social settings and maintain friendships and relationships in the home and the community. 17) Service users enjoy a wholesome, well- balanced and nutritious diet. EVIDENCE: 12 - 16) Service users are given the opportunity to go to college, go swimming, horse riding, bowling, ceramics, literacy and numeracy, walking and other activities. The service users have not lived at CHAD for very long and have continued with activities they enjoyed prior to admission and are developing new interests. Staff provide opportunities to service users to try new activities. A trip to Wallington is being organised in June. CHAD Limited DS0000064818.V290531.R01.S.doc Version 5.2 Page 12 Service users are able to maintain relationships they had prior to coming to live at CHAD. Relative’s questionnaires indicated that they are made welcome and can visit in private. Records in the home say when people have visited and where service users have gone out visiting which may include weekend breaks. Daily routines are centred on the needs of the service users. These can be flexible or more structured depending on the assessed need of the person. On the day of the inspection one service user went to college, another person went shopping and bought ingredients to make soup with staff support. Another service user likes to get up later and has his own routine to get ready in the mornings. He later helped staff with some household tasks. Staff were supportive and encouraged service users involvement in the home. 17) Service users dietary needs are catered for which includes cultural/religious requirements. A sample of menus were examined prior to the visit and each service user has their own menu sheet and preferences recorded in the care plan. CHAD Limited DS0000064818.V290531.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 & 20 18) Service users are able to get support with personal care if they require it. 19) Service users are well because there are systems in place to ensure that their physical and emotional health is met. 20) The medication at this home is being managed but some areas continue to need improvement so that service users are protected. EVIDENCE: 18 & 19) Care records were sampled and service users are supported with personal care if they require this. Staff said that they provide prompts, support and encouragement. Questionnaires said that staff were helpful and treated service users well. There are a number of health and social care professionals involved with the home. Staff support service users to go to appointments and follow professional guidance such as food and behavioural care. 20) A sample audit of the medication arrangements was completed with the registered provider, Liz Whiteman. A number of requirements have been made. Staff have received accredited training to administer medication. CHAD Limited DS0000064818.V290531.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 22) The home has a complaints process which protects service users. 23) Service users may not be protected from potential abuse, neglect and harm if staff recruitment checks are not followed. EVIDENCE: 22) The home has a complaints process which service users/relatives professionals and staff are aware of. 23) The home has a POVA procedure and good records have been maintained regarding one incident. Staff interviewed have had training in POVA and are aware of the whistle blowing policy. Staff spoken with are clear about their duty to report poor practice. Staff recruitment records are not robust to protect service users. POVA First checks were not in place for one member of staff currently working at the home. Staff had been working unsupervised when CRB checks had not been obtained. CHAD has a Management of Service Users Money and Financial Affairs procedure. Two signatures are still required for each financial transaction regarding service users money looked after by the home. CHAD Limited DS0000064818.V290531.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30) Service users live in a well maintained, clean and decorated home. EVIDENCE: 24 & 30) The communal areas were inspected and the accommodation is homely and spacious. The home has a ground, first and second floor. On the ground floor there are two comfortable lounges (24.35 sq m and 25 sq m). A breakfast/dining room (18.5 sq m) is located next to the domestic style kitchen. On the first floor there is a bathroom with toilet and separate toilet. Bedroom 1 is 13 sq m, bedroom 2 is 18.65 sq m and bedroom 3 is 23 sq m. The staff room is located on the first floor and has an en suite shower. The second floor has a utility room, office and bathroom. Bedroom 4 is 13.06 sq m. Service users are able to bring their own possessions and personal keepsakes when they move in. The home is clean and good hygiene practice is evident. CHAD Limited DS0000064818.V290531.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 - 36 33) Staffing numbers are appropriate to the assessed needs of the service users, size, layout and purpose of the home, at all times. 32 & 35) Service users are cared for by experienced and appropriately trained staff but staff must have periodic fire instruction. 34) Recruitment is not robust enough to completely protect service users. 36) Service users benefit from well-supported and supervised staff EVIDENCE: 33) The home maintains the level of staffing, which reflects the size and layout of the building and the needs of the service users currently living in the home. The current levels of staffing are calculated per service user and can be 2:1, 1:1 depending on the risk assessment. On the day of the inspection there were 3 staff on duty from 10am until 10pm. At night there is one waking and one sleep in staff. The management keep staffing levels under review. Any reduction would need to be discussed and agreed with CSCI. 32 & 35) The home has a training programme. 86 of staff have completed NVQ Level 2 or above and the Learning Disability Award Framework (LDAF). Seven staff hold first aid certificates. All current staff have completed CHAD Limited DS0000064818.V290531.R01.S.doc Version 5.2 Page 17 accredited medication training. In July staff will complete British Institute of Learning Disability (BILD) accredited training in restraint techniques. Staff must receive fire instruction at the appropriate timescale (3 monthly). 34) Staff recruitment records are not robust to protect service users. POVA First checks were not in place for one member of staff currently working at the home. Staff had been working unsupervised when CRB checks had not been obtained. Staff photographs are not consistently on staff files. 36) Staff confirmed that they have regularly 1:1 supervision with the manager and that this is positive and looks at support, which they require as well as training and recognising good work. CHAD Limited DS0000064818.V290531.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 37) The registered provider has a good understanding of the areas, which the home needs to improve. 39) Formal Quality Assurance systems are not in place but systems are in place to ensure good outcomes for service users. 42) Systems are in place to protect service users from health and safety hazards but staff must receive fire instruction. EVIDENCE: 37) The registered manager is currently completing the Registered Managers Award and NVQ Level 4. The management of the home continuing to provide staff with guidance on good practice and meeting the needs of residents. 39) Formal quality assurance systems are not in place but the Company Secretary has been researching an appropriate model. Other informal systems are in place to monitor the outcomes for service users. The registered provider completes monthly visits and reports, which are in depth and have CHAD Limited DS0000064818.V290531.R01.S.doc Version 5.2 Page 19 good detail regarding life in the home. Staff meetings occur regularly and people feel able to raise any issues should they arise. Relatives and service users are asked for their views and questionnaires are completed. Questionnaires from relatives said that they felt the home was well run and that they are consulted. 42) Maintenance and service checks are in place. Service certificates and contracts are in place. Fire instruction to staff (at least 3 monthly as all staff potentially work nights) was not up to date and is required. CHAD Limited DS0000064818.V290531.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 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 1 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 3 34 1 35 3 36 3 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 3 3 2 X 2 X 2 X X 2 X CHAD Limited DS0000064818.V290531.R01.S.doc Version 5.2 Page 21 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 YA20 Regulation 13(2) Requirement The following medication issues must be addressed. 1. A controlled drugs register must be purchased and used. 2. Medication received records must record total amounts and ‘brought forward’ qualities for auditing purposes. 3. Provide suitable storage for controlled drugs. 4. The security of medication keys must be improved. 5. Creams must be dated when opened. 6. Separate entries on the MAR sheet must be made for variable doses. 7. When required medication must state the circumstances under which they are to be administered. Care plans must provide guidance regarding 1. Communication plans 2. The circumstances and arrangements for ‘When DS0000064818.V290531.R01.S.doc Timescale for action 12/06/06 2. YA6 15 26/06/06 CHAD Limited Version 5.2 Page 22 3. YA34 17 Schedule 2 19 required medication’ is administered 3. Continence where required. Two written references must be obtained prior to employment of staff to protect service users. OUTSTANDING Staff photographs must be on staff records. POVA First checks must be obtained prior to staff commencing employment in the home. Staff must not work unsupervised until CRB checks are obtained. 05/06/06 4. YA42 23(4) Staff must receive fire instruction at the appropriate intervals (3 monthly for staff who work at night and 6 months for day staff) To protect service users all service users monies received and looked after by CHAD two signatures must be obtained at the time of each transaction. OUTSTANDING 12/06/06 5. YA23 17 Schedule 4 05/06/06 6. YA39 24 A Formal quality assurance must be in place. 31/08/06 CHAD Limited DS0000064818.V290531.R01.S.doc Version 5.2 Page 23 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 manager should complete the Registered Managers Award CHAD Limited DS0000064818.V290531.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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