CARE HOME ADULTS 18-65
Charles Court Northfields Strensall York YO32 5XP Lead Inspector
Mrs Wendy Dixon Unannounced Inspection 15th November 2005 11:30 Charles Court DS0000015792.V262930.R01.S.doc Version 5.0 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 Charles Court DS0000015792.V262930.R01.S.doc Version 5.0 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. Charles Court DS0000015792.V262930.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Charles Court Address Northfields Strensall York YO32 5XP 01904 491589 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) Joseph Rowntree Housing Trust Anthony Egan Care Home 15 Category(ies) of Learning disability (15), Learning disability over registration, with number 65 years of age (3) of places Charles Court DS0000015792.V262930.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The number of service users over the age of 65 should not exceed 3 at any one time. The category LD (E) is only for use by current service users who have reached 65 and above whose needs can still be met by the home. 14/12/05 Date of last inspection Brief Description of the Service: Charles Court is a purpose built single storey care home jointly managed by the Joseph Rowntree Housing Trust and the York Mencap Hostels Association, which provides long- term residential care to up to fifteen people with learning disabilities three of which may be over 65.The home has one respite place The home is situated in the village of Strensall and is within easy walking distance of all of its facilities, which include shops, pubs and other local amenities. A regular bus service operates between the village and the city centre of York. Charles Court DS0000015792.V262930.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This report relates to an unannounced inspection that took place on Tuesday 15th November 2005. The inspection lasted 3.0 hours (11.30 to 2.30pm) and involved 2 inspectors. There were 15 service users resident in the home, all requiring permanent care. The inspection focused on the key standards and on the areas of concern identified at the last inspection. An inspection of the premises took place, including a number of bedrooms, and lounges. The care records of three service users were examined in detail and a three of service users were spoken with during the inspection. There were also discussions with members of staff and management of the home. What the service does well:
The home had a relaxed friendly and informal atmosphere, service users and staff were chatting and deciding together what to have for lunch in a very natural and informal way. Service users at the home have a wide range of personal care and support needs, some managing to lead an independent lifestyle, being very involved in the local community and attending work placements and daycentres most days of the week. Others require full support with health and personal care needs. The manager and staff support all the service users in a very individual way, according to their needs abilities and wishes. Daily /weekly are well kept and reflect the needs and support given to service users in a straightforward way ensuring good communication within the staff team. Service users rooms are spacious to allow good access and very much service users own decorated to their personal taste one service user was keen to show us her newly decorated room where she had chosen colour schemes etc. Charles Court DS0000015792.V262930.R01.S.doc Version 5.0 Page 6 Access is good throughout the home meaning service users can be as independent as possible when moving about the home not needing to ask staff for help. Equipment to promote service users independence and assist staff in carrying out their work safely and protecting service users dignity such as special mattresses, assisted baths; hoists and mobility aids are in good supply. Staff are well trained, the training records of new staff were inspected. They had received comprehensive induction training before starting to work with service users and were supervised by an experienced carer to ensure they were fit to do the job. All staff had up to date fire, moving and handling and abuse awareness training and a number had attended challenging behaviour and dementia training sessions. Dementia training is particularly relevant to service users at Charles Court as a number are between 50 and 70. 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.
Charles Court DS0000015792.V262930.R01.S.doc Version 5.0 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 Charles Court DS0000015792.V262930.R01.S.doc Version 5.0 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 The service user’s needs are well assessed before they are admitted to the home. EVIDENCE: One new service users has been admitted since the last inspection. The pre admission assessment contained detailed information about service users care and support needs and had been carried out by the allocated key worker and management at the home. Information had also been sought from service users relatives and other professionals such as the care manager and doctors to ensure the service user received the support they wanted and needed. Charles Court DS0000015792.V262930.R01.S.doc Version 5.0 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 and 9 Service users are supported to live their lives are they choose in a safe way though some care plans need to be up dated. EVIDENCE: Three service users care plans were inspected. One was not up to date and was in need of being reviewed, as it did not reflect the current care and support needs of the service user. Care plans did show that service users and their families were involved in the planning and reviewing of the care helping to ensure these plans reflected the wishes of service users. A number of risk assessments outlining the management of issues such as moving service users safely administering medication and service users going out alone were included in care plans, these had involved and been agreed with service users and struck a sensible balance between protecting service users and enabling them to lead a full life. However a one-service user who suffers from seizures needed a detailed risk assessment, which described any seizure, what action staff must take, and at what point medical assistance is to be called.
Charles Court DS0000015792.V262930.R01.S.doc Version 5.0 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 Service users are supported to lead fulfilled lives and be as independent as possible. EVIDENCE: The home has a relaxed friendly and lively atmosphere, staff and service users had an excellent rapport and were deciding together what to have for lunch. Service users at the home ages range from service users being in their twenties and up to their sixties, staff have worked with service users and their families to ensure that service users lead full and active lives taking part in activities they enjoy. Some service users attend colleges’ and local day centres depending on their capabilities, while other who are older and frailer spend their days at home with staff to support them. Charles Court DS0000015792.V262930.R01.S.doc Version 5.0 Page 11 One service users at home at the time of the inspection were keen to talk about her newly decorated room and another had been swimming with his one to one worker. Meals are informal and menus planned with service users. These have to be flexible to suit the needs of all the service users; some trying to reduce weight others struggling to maintain a healthy one-service user needs full assistance with feeding. Staff supports service users to make the correct choices for them. Charles Court DS0000015792.V262930.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 and 19 Service users health and personal care needs are well met. Though some documentation needs to be more detailed and consistent. EVIDENCE: One service users at the home is very dependant and needs total support with her care needs. This service user was at home at the time of the inspection and looked very well cared for; daily progress notes showed that staff were very well aware of all her care needs and worked very hard to make sure all her needs were met. Other service users personal care needs vary a great deal, staff were well aware and records reflected their individual needs and how these were to be met. Charles Court DS0000015792.V262930.R01.S.doc Version 5.0 Page 13 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 Service users and their families are aware of how to make a complaint. EVIDENCE: No complaints have been received since the last inspection. The home has a clear complaints procedure, which is included in the service user guide and staff handbook to inform service users and their families how to complain if they are unhappy with the care they receive. The Joseph Rowntree Housing Trust has produced robust policies regarding abuse copies of which were kept in the home and made available to staff members. As part of the staff induction programme, abuse training is given to all new staff to ensure service users are protected from harm. A copy of No Secrets is also available in the home. Charles Court DS0000015792.V262930.R01.S.doc Version 5.0 Page 14 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): 24,28 and 30 The home offers good quality accommodation to all its service users and is overall a clean comfortable and safe place for service users to live. EVIDENCE: The home is purpose built with good access into and throughout the building. Decoration and maintenance is to a good standard and service users rooms are very much their own. The home has secure well-maintained gardens for service users to enjoy. The home was clean and fresh smelling throughout. However the chairs in the main lounge are in need of recovering/replacing as covers are very torn. Charles Court DS0000015792.V262930.R01.S.doc Version 5.0 Page 15 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 The home provides enough suitably qualified and trained staff to meet service users needs. EVIDENCE: Over 50 of all staff have achieved NVQ level 2 or above in care and all new staff receive a full induction where they are informed as to how to meet service users care and support needs in a safe way. All staff had up to date fire, moving and handling and abuse awareness training and a number had attended challenging behaviour and dementia training sessions. Dementia training is particularly relevant to service users at Charles Court as a number are between 50 and 70. The rota inspected week commencing 14/11/05 showed enough staff are deployed to meet the needs of service users. Charles Court DS0000015792.V262930.R01.S.doc Version 5.0 Page 16 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 home is well managed and provides a safe place for service users to live and staff to work. EVIDENCE: The registered manager has been in post for a number of year’s and has a great deal of experience working with and managing this service user group. The home is well managed care staff receive regular supervision and he meetings with service users their relatives and staff are arranged on a regular basis so they can have a say in how it is run. The manager and his deputy are available in the home on a daily basis to deal with issues as they arise. Charles Court DS0000015792.V262930.R01.S.doc Version 5.0 Page 17 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 X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 1 3 X 3 X Standard No 24 25 26 27 28 29 30
STAFFING Score 3 X X X 1 X 3 LIFESTYLES Standard No Score 11 3 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Charles Court Score 3 3 X X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 3 X DS0000015792.V262930.R01.S.doc Version 5.0 Page 18 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 YA7 Regulation 15 2 b Requirement All service users care plans must • Be kept up to date and reflect the service users current care needs. • Be reviewed on a regular basis. • Document district nurse and GP visits in a consistent format • Contain a clear management plan where service users suffer from seizures. The chairs in the lounge need to be recovered or replaced Timescale for action 06/01/06 2 YA28 23 2 01/02/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Charles Court DS0000015792.V262930.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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