Inspection on 27/06/06 for Column Care Ltd

This inspection was carried out on 27th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Column Care Ltd 25/06/07

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Alfred House Residential Care Home

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Fernhaven

Thames House

Creative Support

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

CARE HOME ADULTS 18-65 Column Care Ltd 40 Carlin Gate Blackpool Lancashire FY2 9QT Lead Inspector Ms Janet Spink Unannounced Inspection 27th June 2006 09:00 Column Care Ltd DS0000066398.V298265.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 Column Care Ltd DS0000066398.V298265.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. Column Care Ltd DS0000066398.V298265.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Column Care Ltd Address 40 Carlin Gate Blackpool Lancashire FY2 9QT 01253 596369 01253 596387 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) Column Care Limited Mrs Kathleen Veronica Gorton Care Home 7 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (7) of places Column Care Ltd DS0000066398.V298265.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The home is registered for a maximum of 7 service users in the category of MD (mental disorder, excluding learning disability or dementia). Bedroom numbers 1 and 7 may only accommodate clients who are in short term placements of six months or less. Any clients accommodated in room number 7 must be given exclusive use of the adjacent wc and provided with a key for this. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. N/A Date of last inspection Brief Description of the Service: Carlin Gate has recently become registered with the Commission for Social Care Inspection (CSCI), and this was the first inspection to this service. It is registered to accommodate younger adults of both sexes who have a mental health disorder with the aim of rehabilitating clients in order that they can become as self sufficient as possible and live independently in the community. The home is situated in close proximity of the promenade and local shops and public transport routes. There are seven bedrooms, all of which are single and six have an en-suite facility. The seventh bedroom has a wc adjacent to it, which is for exclusive use of the person accommodated in this bedroom. There are a number of lounge areas including a smoking a room, and a large dining room as well as a therapy room. At the time of the inspection the fees ranged individually based on the Local Authority assessment of clients. The registered manager is aware that the inspection report must be made accessible for clients and visitors, and intends to place it in the hallway for their information. Column Care Ltd DS0000066398.V298265.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and was conducted over five hours. There were two clients accommodated, one who had been staying for approximately eight months and one who had only been admitted the previous day. The inspection involved discussions with the registered provider, service users and staff. Documentation such as pre admission records, care plans and daily notes were looked at and some information had been provided prior to the inspection. One comment card was received from a social care professional who made positive comments about the home. A tour of the building was also undertaken. What the service does well: The home-owner and staff ensure that a full assessment is carried prior to offering a place to a client. This is carried out in conjunction with the client and other professionals so that only clients whose needs can be met are admitted in to the home. Care planning systems are detailed giving staff clear guidance on the support required by individuals. There was evidence from discussions with a client that they are regularly consulted and are encouraged to make decisions about their support. This home is good at encouraging people to become more independent by assisting to develop social and independent living skills. This has led to a client becoming more confident so that they have been successful in obtaining a voluntary job in a local shop. The environment provides a welcoming atmosphere as it has been recently refurbished and is decorated and furnished to a high standard throughout. Staffing levels are high despite the present low occupancy levels, and staff have good understanding of the philosophy of rehabilitation. Staff spoken to understood their role as “enablers” rather than “carers”. The managers are good at providing daily support to staff and on a more formal basis. Staff spoke of “feeling valued” and “kept up to date with everything.” Staff confirmed that a meeting had been held the previous day to discuss the needs of the person being admitted on the day of the inspection. Column Care Ltd DS0000066398.V298265.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Written information about the home needs to be reviewed to reflect the fact that it now admits clients of both sexes. Risk assessments should be more detailed out lining action to be taken when a risk has been identified. The medication policy should be reviewed to reflect practices in the home due to it providing a rehabilitation service. It should state the decision making process in relation to clients taking over responsibility for their medication. It is recommended that all staff are provided with training in Protection of Vulnerable Adults. Induction should be developed to ensure it meets the standards set by the Skills for Care Council. Staff development should also include mandatory training including food hygiene, moving and handling, first aid and health and safety. It is acknowledged that the home owner is currently in discussions with Blackpool Care Learning Partnership to organise training for staff. A recommendation has been made that the owner of the home completes the Registered Manager’s Award, and the inspector was informed that she is very close to achieving this. Please contact the provider for advice of actions taken in response to this Column Care Ltd DS0000066398.V298265.R01.S.doc Version 5.2 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Column Care Ltd DS0000066398.V298265.R01.S.doc Version 5.2 Page 8 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 Column Care Ltd DS0000066398.V298265.R01.S.doc Version 5.2 Page 9 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): 1,2 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home carries out full assessments prior to admission to ensure that clients’ needs are met. EVIDENCE: The home has a Statement of Purpose, but this needs updating to reflect that it now accommodates people of both sexes as initially it intended only to admit females. The pre admission process is detailed with clear admission criteria in place ensuring that staff have a complete assessment of the prospective client. This includes taking details at the initial referral stage such as healthcare needs, medication, cultural needs, mental wellbeing and spiritual needs. Following this an “Initial Assessment Package” is completed in conjunction with hospital staff, the client, family (if appropriate) and other health or social care professionals. This is carried out over a period of time at a pace that is convenient to the client, and ensures that the home only admits people whose needs it can meet. During the inspection a client was admitted. The inspector observed the person being helped in a sensitive manner and was assisted with the unpacking of luggage as well as being introduced to service users and staff. Column Care Ltd DS0000066398.V298265.R01.S.doc Version 5.2 Page 10 Client Agreements and Terms and Conditions were seen to be available for both people accommodated and were clear about length of notice, services provided and circumstances under which someone would be asked to leave. Column Care Ltd DS0000066398.V298265.R01.S.doc Version 5.2 Page 11 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): 6,7,8 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Care planning systems ensure that changing needs and personal goals are reviewed regularly with clients. EVIDENCE: Following the initial assessment the staff work closely with the client to develop “Rehabilitation Pathway” that considers individual support needs such as assistance with budgeting, cooking, employment and social needs etc. This links in to the “Life Plan Package” which addresses more long-term needs with a view to rehabilitating the individual in to the community. There was evidence that these are reviewed on a regular basis, which was confirmed by the service user. The client who had been accommodated long-term informed the inspector that staff always encourage them to make decisions regarding their support requirements. Column Care Ltd DS0000066398.V298265.R01.S.doc Version 5.2 Page 12 Risk assessments are an integral part of the care planning system, however the inspector advised that these be more detailed giving specific details of the risk management strategy when a risk has been identified during assessment. Column Care Ltd DS0000066398.V298265.R01.S.doc Version 5.2 Page 13 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): 11,12,13,15,16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Staff ensure that clients have opportunities to develop their skills and have access to the local community. EVIDENCE: The inspector spoke to the client who had been living in the home for approximately eight months and was told that “This place is a god send.” The inspector was given examples of skills that the person has developed such as managing their own money, social skills, shopping for food and cooking. They have also taken responsibility for their own laundry. Books and videos are also provided by the owners for clients’ enjoyment. The client told the inspector that staff assisted her to find a voluntary job in a local charity shop, which she feels has increased her self-esteem and that she now uses public transport independently. The client told the inspector that they feel more confident with people as “I never used to talk to anybody, but her I am talking to you about this place.” Column Care Ltd DS0000066398.V298265.R01.S.doc Version 5.2 Page 14 There are no restrictions in the home regarding client contact with families and friends. The client spoken to confirmed that they visit their family when they choose, but has not had visitors in the home. The inspector was told that meals are nutritious and varied and that the clients are consulted in the choice of menus. They are also encouraged to be involved in the shopping and preparation of meals as part of the rehabilitation process. The inspector joined staff and clients at lunch-time and it was pleasing to note that staff eat meals with clients promoting general discussion and a homely atmosphere. Column Care Ltd DS0000066398.V298265.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to the service. The home ensures that clients’ mental well-being is continually assessed and reviewed so their needs are met. EVIDENCE: Personal support needs are documented in the “Initial Assessment Package” and the care planning records, however this was minimal in relation to physical and personal support needs at the time of the inspection due to the nature of the client group. Documentation is comprehensive in relation to mental health support needs and psychological well- being, which is reviewed regularly with clients and other professionals. One client spoken to referred to being “more confident and happier” since being supported by the staff team. The home has worked at developing relationships with local General Practitioners to explain the objectives of the service. This has been successful resulting in them being willing to have temporary clients registered with them. Column Care Ltd DS0000066398.V298265.R01.S.doc Version 5.2 Page 16 The policy in relation to the management of medication was looked at, and it was agreed that it should be reviewed to ensure it is relevant to the specific home and to a rehabilitation service. Medication is securely locked in a metal cabinet in a locked room and records were seen to be up to date and accurate. There is an ongoing programme to ensure staff receive training in the safe ordering, storage, administration and recording of medication so that they are aware of good practice. This was confirmed by staff. Column Care Ltd DS0000066398.V298265.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The quality outcome in this area is adequate. This judgement has been made using available evidence including a visit to the service. The home’s policies, procedures make sure that clients are supported and protected, but this could be improved by providing staff with training in safeguarding vulnerable adults. EVIDENCE: The complaints procedure is displayed in the hallway and is also included in the Statement of Purpose. There have been no formal complaints made to the owner or to CSCI since the home opened. An open approach to encouraging comments through client meetings and daily discussions goes some way to ensuring that concerns are addressed prior to them becoming formal complaints. The home has policies and procedures in relation to the protection of vulnerable adults including a missing person’s procedure that has been developed in conjunction with the local police. It is considered good practice for all staff to be provided with training on the Protection of Vulnerable Adult procedures, and a recommendation has been made in respect of this. Column Care Ltd DS0000066398.V298265.R01.S.doc Version 5.2 Page 18 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): 24,25,26,27,28,29 and 30. The quality outcome in this area is excellent. This judgement has been made using available evidence including a visit to the service. The building is well maintained, clean and furnished to a high standard ensuring that clients are accommodated in a homely and welcoming environment. EVIDENCE: This home has recently been purchased by the directors who have carried out considerable refurbishment on the property. The inspection confirmed that five bedrooms meet the National Minimum Standards for long stays while two bedrooms meet standards for short term care (a period of up to six months). While the service aims to rehabilitate clients in to the community it is envisaged that no placements will be permanent, but a condition has been placed to ensure only short-term placements are accommodated in these two rooms. One of the bedrooms does not have an en-suite facility; however there is a WC that is immediately adjacent to the bedroom and the person accommodated in this bedroom will have excusive use of this WC. All bedrooms are furnished to a high standard with bedding, curtains and televisions being provided. Column Care Ltd DS0000066398.V298265.R01.S.doc Version 5.2 Page 19 There is a choice of four lounges for clients, which in total provide in access of the required space. One of these is designated smoking. All rooms have been furnished and decorated to a high standard. In addition the home provides treatment room for counselling and therapies. There are two bathrooms with bath and shower facilities, situated on the ground and first floors. Documentation from the fire and environmental services confirmed that they are satisfied with systems in the home. Other records provided at the site visit confirmed that electrical and gas safety certificates have been obtained. The building was found to be clean, and laundry facilities are situated in an area where dirty linen does not have to be taken through an area where food is being prepared or cooked. Column Care Ltd DS0000066398.V298265.R01.S.doc Version 5.2 Page 20 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): 31,32,33,34,35 and 36 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to the service. Staffing levels are maintained at a level that meets service user needs. There is a need for staff to be provided with training in NVQ level II in care. EVIDENCE: A recently recruited member of staff confirmed that information regarding roles and responsibilities was given to him prior to interview. This was further endorsed by a staff contract and job description following his appointment. The member of staff was clear that his role is to support and enable rather than “do for” in order to promote client independence. Despite low occupancy levels during the last few months the provider has recruited a full staff team. This was evidenced through documentation, discussions with staff and the service user. This has meant that there have been sufficient staff to meet the needs of the service user. The visit was unannounced and there were four members of staff on duty with two people accommodated and one person being admitted. The home provides two waking staff during the night. Recruitment practices were assessed and found to be professional ensuring that clients are assisted by staff who have had all necessary checks carried Column Care Ltd DS0000066398.V298265.R01.S.doc Version 5.2 Page 21 out. This was confirmed through looking at documentation and discussions with a member of staff. Induction is provided to new staff that is adequate in giving new staff information about policies and practices in the home. The inspector referred the owner to the Care for Skills Council that provides information regarding more in depth induction details. A training programme should be developed to ensure all staff receive mandatory training in areas such as moving and handling, food hygiene, fire safety, protection of vulnerable adults and health and safety. The inspector is aware that the owner has initiated discussions with a local training organisation to implement this. Column Care Ltd DS0000066398.V298265.R01.S.doc Version 5.2 Page 22 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): 37,38,39 and 42 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to the service. This is a well run home where staff and service users feel valued. EVIDENCE: It was evident from discussions with staff and clients and observations that there is mutual respect in this home. A client was able to give examples of positive outcomes while living in the home, and told the inspector “ I am very happy here.” The inspector was told that the service user is encouraged to voice their opinions and make decisions around their care. Staff also spoke highly of the support given by the managers and confirmed that regular meetings are held. The home owner has many years experience in the field of mental health, and is a qualified psychotherapist. At present she is working towards achieving the Registered Manager’s Award. Column Care Ltd DS0000066398.V298265.R01.S.doc Version 5.2 Page 23 Discussions took place regarding developing a Quality Assurance system to gain the views and opinions of all interested parties to ensure continual improvement in the home. The owner agreed to give this some consideration. Column Care Ltd DS0000066398.V298265.R01.S.doc Version 5.2 Page 24 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 2 2 3 3 x 4 x 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 4 29 3 30 3 STAFFING Standard No Score 31 2 32 2 33 3 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 2 1 LIFESTYLES Standard No Score 11 3 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 3 3 x x 3 x Column Care Ltd DS0000066398.V298265.R01.S.doc Version 5.2 Page 25 N/A 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 medication policy should be reviewed to ensure there are clear procedures in relation to clients taking responsibility for their own medication as part of the rehabilitation process. All staff must be provided with training in the protection of Vulnerable Adults. Timescale for action 31/08/06 2 YA23 13(6) 31/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 5 6 Refer to Standard YA1 YA9 YA32 YA35 Good Practice Recommendations The Statement of Purpose must be reviewed to reflect that the home admits people of both sexes. Risk assessments should contain more detail regarding action to be taken when a risk has been identified. Induction should be developed to ensure it meets with Skills for Care Council standards. Staff development should address the mandatory training such as moving and handling, food hygiene, health and safety etc. It is recommended that the manager achieve the DS0000066398.V298265.R01.S.doc Version 5.2 Page 26 YA37 Column Care Ltd Registered Managers Award. Column Care Ltd DS0000066398.V298265.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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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