Inspection on 07/09/05 for Church View

This inspection was carried out on 7th September 2005.

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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Church View 01/10/07

Church View 22/05/06

Church View 25/04/05

Church View 13/09/04

Church View 11/05/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 Church View Kirkleatham Village Redcar TS10 5NW Lead Inspector Stephen Smith Unannounced 7 September 2005 09:15 am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Church View B51-B01 SN105 Church View VN248250 070905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Church View Address Kirkleatham Village, Redcar. TS10 5NW Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01642 283320/21 01642 283319 Tees and North East Yorkshire NHS Trust Mrs Marsha Gregson Care Home 8 Category(ies) of LD Learning Disability (8) registration, with number of places Church View B51-B01 SN105 Church View VN248250 070905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: There are no conditions of registration. Date of last inspection 25th April 2005 Brief Description of the Service: Church View is owned and operated by Tees and North East Yorkshire NHS Trust and is registered under the Care Standards Act 2000 to accommodate 8 people under the age of sixty-five with learning disabilities (LD). It is a large detached property in a rural location in its own large garden. The home is divided into two units, upstairs and downstairs each with four single bedrooms, though this division is not rigidly applied. The bedrooms all meet the size requirements of the Care Homes for Adults (18-65) National Minimum Standards and have a hand basin fitted. None are equipped with ensuite bathroom or toilet facilities. Both upstairs and downstairs areas have their own kitchen, bathroom and communal areas. The care needs of the people who live at Church View needs are high and support is provided by the staff team with the support of external professionals and agencies. Church View B51-B01 SN105 Church View VN248250 070905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and started at 9:15 am. The inspection lasted for five and a half hours and concentrated on the Choice of Home, Individual Needs and Choices, Lifestyle and Personal Healthcare and Support groups of standards. Adult protection arrangements were also considered. In addition examination was given to how the home had addressed requirements and recommendations from the last inspection. During the inspection two staff members were interviewed, one of whom was the senior person in charge of the home on the day of the visit and another two staff members were spoken to informally. A tour of the premises was undertaken and various records were examined including residents’ plans of care and other records. Relatives of people living at the home were consulted by questionnaire with responses being received from relatives of five of the home’s eight residents. Some time was spent in the presence of the residents, the majority of whom are unable to communicate verbally, in order to observe interactions between staff and residents. What the service does well: The home is very good at finding out what help the residents need and at planning how their very complex needs are to be met. Staff draw up and follow detailed plans so that people can be cared for in a consistent way that meets their needs and helps them to become more independent. The home is also good at offering residents a range of activities and helping people learn the skills to be able go into the community and take part in things that go on outside the home. This is very difficult for some of the residents and the home is good at making outings an opportunity for residents to develop their abilities and confidence. The complex health and support needs of the residents are well met by the home and the good way it works with other specialist professionals who work with the residents. The home is also good at making sure that residents have a say in how they are cared for; staff do this by being alert to their responses and behaviour to make sure they are working with residents in a way that they are happy with. Good work is done to support residents’ families to be involved in and have a say about the care of their relative. Church View B51-B01 SN105 Church View VN248250 070905 Stage 4.doc Version 1.40 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. Church View B51-B01 SN105 Church View VN248250 070905 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Church View B51-B01 SN105 Church View VN248250 070905 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 The home is good at ensuring that detailed assessments of residents’ needs take place and residents benefit from the comprehensive plans developed to meet their needs. EVIDENCE: The plans of care and care records for two residents were examined. Both these sets of records contained very detailed assessments of the person’s needs including all the specific care needs and assistance required arising from the person’s disability. These assessments contained evidence of very frequent updating as the person’s needs change. People living at the home are subject to the Care Programme Approach (CPA) multi-disciplinary assessment and planning process. It is clear that needs are identified and plans developed from information gained during this process as well as from the day-to-day work of the home. Each person’s file examined contained a detailed care plan setting out in detail the specific actions required from staff to support the residents. This information included, for example, how to approach service users, exactly how to assist them to eat or bathe or how to manage their needs while in the community. Church View B51-B01 SN105 Church View VN248250 070905 Stage 4.doc Version 1.40 Page 9 Care plans seen were regularly reviewed and contained detailed assessment of any risks the resident might face along with detailed actions to be taken by staff to reduce these risks. Evidence was in place in the files examined that residents’ parents had been consulted about the content of the care plans and had signed their agreement to their implementation. All of the five relatives who returned questionnaires stated that they are consulted about their family member’s care and informed of important matters relating to them. Church View B51-B01 SN105 Church View VN248250 070905 Stage 4.doc Version 1.40 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 9 The home is good at finding out what residents want and need and at working out how they need to be helped. Residents’ wellbeing is promoted by their detailed plans of care but the home needs to make sure that its comprehensive recording is all up-to-date. EVIDENCE: The records of the two residents examined were detailed and comprehensive. They contained detailed plans of care covering all areas of the person’s life as well as any particular difficulties faced, or challenges presented, by the person. The plans of care examined clearly linked to the CPA process in respect of the person and were regularly reviewed. Keyworkers review the home’s internal care plans on a monthly basis and the multi-disciplinary team discusses each service user on a monthly basis. Full CPA reviews take place approximately six-monthly with parents being invited to attend. Plans in the home clearly set out who is responsible to carry out its actions and the input of external professionals is sought and recorded as necessary. Key workers at the home act as CPA coordinators so are in a positions to ensure that reviews take place appropriately and that actions are carried out as planned. Church View B51-B01 SN105 Church View VN248250 070905 Stage 4.doc Version 1.40 Page 11 Care plans at the home are retained within two files, the person in charge of the home during the inspection explained that one is the day-to-day file used to record daily observation notes and the most important and recent care plans and risk assessment. The other file, he explained contains more detailed background information. On examination, information was duplicated across the two files and in a number of instances, although care plans hade been amended in the “background” file, these changes had not been reflected in the file used on a day-to-day basis. The home needs to ensure that this file contains the most up-to-date information to ensure that staff are providing the correct care. A great deal of evidence was available from records in care plans information displayed in the home and discussion with staff members to show that the home works hard to reflect the wishes of the residents and to allow them to make decisions and choices about their care, their diet and their activities. The nature of the residents’ disabilities means that seeking their views is difficult but interviews with staff and observation during the inspection demonstrated that staff spend a lot of time observing the reactions and recording where preferences or dislikes are expressed. Detailed assessments of any risks faced by residents are in place on their file and these assessments set out in detail the action required to manage and reduce any risk. Clear plans are in place to ensure that residents can carry out activities inside the home and in the community with enough support to make this as safe as possible for them. Specific arrangements are in place for example about where people should sit in the car, the support they need in when out for a walk or going shopping. It was noted in the file of one resident that a risk assessment and care plan had not been developed in respect of an incident that had taken place a week before and there was no other information in the file other than in the daily communication notes and an incident form. The person in charge said that the keyworker would be in the process of developing such an assessment and that all staff were aware of the situation. The manager confirmed when spoken to that clear instructions were given to staff in the home’s communication book and that a new risk assessment had been devised and was being typed at the time of the inspection. Church View B51-B01 SN105 Church View VN248250 070905 Stage 4.doc Version 1.40 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15, 16 and 17 Residents are well supported to take part in a wide range of leisure and educational activities in the home and in the community and receive very good help with their personal development. House routines and activities are based on residents’ wishes and needs. Residents’ dietary needs and choices are well catered for. EVIDENCE: The pronounced needs of the home’s residents are such that educational and vocational opportunities in the conventional sense are not relevant to them. Resident’s plans of care, however, are very detailed in terms of their aim to assist residents to be able to become more independent and to assist them to function better in the community. A great deal of effort is made to help residents develop their social, communication and independent living skills along with structured support to help them manage their behaviour. Two residents attend local day care services, though at the time of the inspection discussion was taking place with other agencies following the announcement of the closure of a day centre and a resulting change of provision. Church View B51-B01 SN105 Church View VN248250 070905 Stage 4.doc Version 1.40 Page 13 Staff interviewed told the inspector that all residents have a half-day session once per week where they are accompanied on activities based on their needs and wishes by two staff members. They said this special individual time is in addition to other activities and outings undertaken with other residents. Evidence of a wide range of activities taking place was recorded in the residents’ files examined and the detailed care plans demonstrate that outings are used to help promote people’s development in line with their plan of care. All relatives who returned questionnaires said that the home has enough staff on duty and this was confirmed by observation at this unannounced inspection. This staffing level allows activities and outings to take place and, at the time of the inspection, residents were seen going on and returning from outings. All five family members who returned questionnaires said that they are able to visit their relative at the home and spend time with them in private. Staff members spoken to described the range of level of contact that residents have with their families. It is evident that families are consulted over the care of their relatives at the home and that contact is promoted. Care plans contained evidence of work undertaken to help a resident maintain contact with family and friends from where she had live previously. Residents’ care plans set out very specifically the degree of personal care required. For most residents the help needed with their personal care is significant and plans contain information about how to maintain people’s rights and privacy whilst meeting their needs and promoting their independence. A staff member told the inspector how residents are encouraged to help to make their own meals and this was confirmed by one resident’s plan of care and from daily recording notes. Staff members use observation and the residents’ detailed plans of care to seek their views and to promote their ability to undertake activities in the community. The home keeps records of all food served and discussion with staff members showed that diets are individualised based on residents’ choices and needs. Staff said that two residents are on diets aimed to manager their weight whilst another two needed diets to ‘build them up’. Discussion with staff and observation of the menu plan showed the menu tries to accommodate different needs without making the difference too obvious. One staff member explained, for example, that four ladies would be having curry for their tea but that two would have chicken and the other two would have quorn in order to help them watch their weight. All staff spoken to said that choices are offered if people choose not to eat the planned meal. Examination of food stocks showed them to be satisfactory. Church View B51-B01 SN105 Church View VN248250 070905 Stage 4.doc Version 1.40 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 and 20 Residents receive high levels of support that is based on their individual needs. Healthcare in relation to residents learning and associated difficulties is very good but the home needs to get better at arranging and recording the occurrence of annual general health, dental and optical checks. Residents’ wellbeing is promoted by an effective system of controlling and administering medication. EVIDENCE: The home’s detailed care planning system contains very specific information about the residents’ situation, needs and preferences and it is evident that plans are developed taking these into account. Residents’ support needs are very high and it is clear that although plans are in place across many areas of people’s lives, priority is given to areas that individual residents are more interested in, have most need of or in which they have most chance of success. Clear evidence is contained within plans about people’s preferred routines and how to help to promote these. Staff members spoken to were obviously very aware of each individuals needs. Church View B51-B01 SN105 Church View VN248250 070905 Stage 4.doc Version 1.40 Page 15 Care planning records demonstrated that a wide range of health professionals are involved with residents and that their input is coordinated within the CPA process. Recording in files showed that appointments are made as necessary and that people’s conditions are monitored regularly and any changes in medication or care required are implemented. The needs of some residents are such that they are unable to access community health services and these people’s needs are provided for via specialist NHS Trust services. Care plans examined did not, however, contain enough information to demonstrate that residents receive enough preventative health checks unrelated to their disability. Records showed that visits to doctors had taken place for specific conditions but did not show that regular general health, dental and optical checks had taken place. The home must ensure that residents receive these health checks in line with Standard 19.4 of the Care Homes for Adults (18-65) National Minimum Standards and that clear records are kept to monitor that these checks are taking place. Medication in the home is securely stored and administered by suitably trained staff members. Records of medication administered are well maintained and the home has an effective system of recording the receipt and return of medication to the pharmacy. Arrangements are in place to ensue that ay changes in medication are clearly notified to the appropriate people and that medication record sheets are maintained up-to-date. A system for auditing medication stocks held on a monthly basis has recently been implemented and this has further improved the home’s medication handling procedure. Church View B51-B01 SN105 Church View VN248250 070905 Stage 4.doc Version 1.40 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 Staff understand adult protection issues and requirements; this helps protect residents. EVIDENCE: All five relatives who completed and returned questionnaires stated that their family member is well looked after at the home. The home has a clear policy and procedure in place for responding to any adult protection concerns or allegations and a copy of the areas multi-agency vulnerable adults procedure ‘No Secrets’ is available in the home. Both staff members spoken to were clear of the action they would take if they suspected or were told that someone may be being abused. Both staff members had received training in adult protection. Church View B51-B01 SN105 Church View VN248250 070905 Stage 4.doc Version 1.40 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These seven standards were not assessed at this inspection. EVIDENCE: Although these standards were not inspected, progress towards the compliance with requirements made regarding the home’s premises at the last inspection was monitored. Although it was found that issues identified at previous inspections including the need to decorate the upstairs hallway and the need to re-carpet the downstairs office had not been addressed it was clear that arrangements are in place for this work to be carried out. Church View B51-B01 SN105 Church View VN248250 070905 Stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These six standards were not assessed at this inspection. EVIDENCE: Although these standards were not inspected, progress towards the compliance with requirements made regarding the home’s record of its recruitment process at the last inspection was monitored. These requirements have been addressed by the home with the exception of the need to retain the information relating to staff members set out in Schedule 4 of the Care Homes Regulations 2001 in the home. The manager and the home’s line manager informed the inspector that information is being gathered from staff members to make this possible. Church View B51-B01 SN105 Church View VN248250 070905 Stage 4.doc Version 1.40 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These seven standards were not assessed at this inspection. EVIDENCE: Church View B51-B01 SN105 Church View VN248250 070905 Stage 4.doc Version 1.40 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 4 x x x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 4 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Church View Score 4 2 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x x x B51-B01 SN105 Church View VN248250 070905 Stage 4.doc Version 1.40 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 19 Regulation 12, 13 Requirement The home must ensure that residents receive minimum annual health checks in line with Standard 19.4 of the Care Homes for Adults (18-65) National Minimum Standards and that clear records are kept to monitor that these checks are taking place. Full redecoration of the homes upstairs hallway is still required. (Previous timescale of 04/10/04 not met.) The missing light shade in the dining room must be replaced. (Previous timescale of 27/05/05 not met.) The carpet in the downstairs office must be replaced. Previous timescale of 20/07/05 not met.) Records of fire alarm system, emergency lighting system, gas installation and fixed wire servicing, maintenance and testing must be retained in the home. (Previous timescale of 27/05/05 not met.) Full information and documentation with regard to Timescale for action 14/10/05 2. 24, 26 23 28/10/05 3. 28 23 14/10/05 4. 28 23 28/10/05 5. 42 13 14/10/05 6. 34 17, 19 14/10/05 Page 22 Church View B51-B01 SN105 Church View VN248250 070905 Stage 4.doc Version 1.40 each staff member, as set out in Schedule 4 of the Care Homes Regulations 2001, must be available in the home. (Previous timescale of 21/06/04 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. Refer to Standard 6 Good Practice Recommendations The manager should ensure that care plans residents dayto-day file are kept up-to-date when changes are made in the persons main file. Church View B51-B01 SN105 Church View VN248250 070905 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Unit B - Advance St Marks Court Teesdale Stockton-on-Tees. TS17 6QX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Church View B51-B01 SN105 Church View VN248250 070905 Stage 4.doc Version 1.40 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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