CARE HOME ADULTS 18-65
Conroy Close (1) 1 Conroy Close Easingwold North Yorkshire YO61 3NS Lead Inspector
Mrs Irene Ward Unannounced Inspection 14th February 2006 09:45 Conroy Close (1) DS0000007946.V280350.R01.S.doc Version 5.1 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 Conroy Close (1) DS0000007946.V280350.R01.S.doc Version 5.1 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. Conroy Close (1) DS0000007946.V280350.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Conroy Close (1) Address 1 Conroy Close Easingwold North Yorkshire YO61 3NS 01347 821700 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) h1m001jeffery@mencap.org www.mencap.org.uk Royal Mencap Society Mr Graham Howard Jefferys Care Home 6 Category(ies) of Learning disability (3), Learning disability over registration, with number 65 years of age (3) of places Conroy Close (1) DS0000007946.V280350.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Registration is for 6 persons with a learning disability who may also have a physical disability, three of whom are over 65. 11th October 2005 Date of last inspection Brief Description of the Service: 1 Conroy Close is a care home providing personal care and accommodation for six people with learning and physical disabilities, some of whom are over the age of 65 years. The majority of service users have high dependency needs. The premises are owned by a housing association and the care is provided by Mencap The house is a dormer bungalow with two service users bedrooms on the first floor and the other four bedrooms are all on ground floor. The home is situated in a cul-de-sac close to local amenities. Conroy Close (1) DS0000007946.V280350.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This report relates to an unannounced inspection carried out on the 14 February 2006, which started at 09.45 until 12.30. All service users were in at the time. The registered manager was on duty at the time of inspection. A tour of the home was carried out which included two of the service users private accommodation. A selection of records was looked at and time was spent observing activity in the home. Due to communication difficulties only one service user was spoken to in private. The focus of the inspection was a number of key standards. There were also discussions with the manager and staff member on duty. What the service does well: What has improved since the last inspection?
Risk assessments have been completed. Formal supervision and annual appraisals in line with the organisations policies have taken place and are followed. The registered manager has now completed NVQ Level 4 and is waiting to be verified. This should take place on 20 March 2006. Conroy Close (1) DS0000007946.V280350.R01.S.doc Version 5.1 Page 6 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. Conroy Close (1) DS0000007946.V280350.R01.S.doc Version 5.1 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 Conroy Close (1) DS0000007946.V280350.R01.S.doc Version 5.1 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): 1,4 and 5 Service users have all been given a written contract. EVIDENCE: No new service users have been admitted into the home as all the service users have lived together in the home for many years. No changes have been made to the Statement of Purpose or the Service User Guide. Terms and Conditions of residency or tenancy agreements are given to service users and a copy held on their file. Conroy Close (1) DS0000007946.V280350.R01.S.doc Version 5.1 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): 6,8 and 10 Service users are supported in making decisions about their personal lives. Risk assessments have now been completed which cover all areas of daily living. EVIDENCE: There are comprehensive plans of care in place. Two service users support plans were inspected. These had been regularly reviewed. The plans contained details of the service users daily living routines, personal care needs, interests and dietary needs. Risk assessments have been completed on all areas of daily living and the assessments are held on each service users file. Staff was observed to enable service users to be as independent as possible and also available to assist where necessary. The organisations policy regarding confidentiality is in place. Information regarding both service users and staff are held in the office/sleeping in room in a locked filing cabinet.
Conroy Close (1) DS0000007946.V280350.R01.S.doc Version 5.1 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): 14 Service users social links and opportunities are promoted. EVIDENCE: Service users support plans detailed the types of activities that they may enjoy. Plans included a range of activities that service users access such as going to York shopping, going out to lunch, group trips out, Gateway Club and swimming. One service user has taken up art and baking. Four service users have a car. This is funded through motorbility for those service users who do not have cars public transport or taxi service is used. Conroy Close (1) DS0000007946.V280350.R01.S.doc Version 5.1 Page 11 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 21 Service users health and personal care needs are well met. EVIDENCE: Service users support plans detailed how their health care needs are met and are supported by the staff team. Each person living in the home is registered with a GP through whom specialist health services are accessed if required. Staff support them in having regular health checks and checks with their dentist and optician. Discussions were held regarding the ageing process of service users living at 1 Conroy Close. The staff and the registered manager were able to demonstrate their knowledge and understanding, as to the needs of older people with learning disabilities. Discussions were also held in respect of death and dying and how staff in the home would deal with such a situation. The organisations policy and procedure is in place. Counselling from the organisation is available. Conroy Close (1) DS0000007946.V280350.R01.S.doc Version 5.1 Page 12 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 Service users complaints are listened to. EVIDENCE: The organisations complaints policy and procedures are in place. The complaints policy is clear and user friendly. There had been no complaints received by either the home or the Commission For Social Care Inspection. Conroy Close (1) DS0000007946.V280350.R01.S.doc Version 5.1 Page 13 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): 25,26,27,28 and 30 The environment of the home is maintained to a good standard and provides service users with a clean and homely place in which to live. EVIDENCE: One service user showed me their bedroom. They stated that they were very happy with their accommodation and all aspects of their home. Three bedrooms were inspected all bedrooms had been furnished to a good standard. Service users have personalised their own bedrooms. All communal areas of the home were warm, well lit, ventilated and clean. The home has sufficient bathrooms and toilets that were clean and well maintained. The organisation is considering carrying out major works due to the mobility needs of one service user, which is deteriorating. The service user has temporarily moved to 2 Conroy Close as this building is a bungalow and is able to meet the needs of the service user in promoting her independence. Conroy Close (1) DS0000007946.V280350.R01.S.doc Version 5.1 Page 14 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): 36 Service users benefit from well supervised staff. EVIDENCE: Three staff supervision files were inspected. This showed that staff receive supervision regularly and supervision notes are held for each staff member. Supervision notes identified personal development and how this may be achieved through relevant and appropriate training. Outcomes and goals for staff were also discussed and identified. Conroy Close (1) DS0000007946.V280350.R01.S.doc Version 5.1 Page 15 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 and 42 Service users’ health safety and welfare are promoted and protected. EVIDENCE: Throughout the morning and from discussions held with service users and staff and through observation, 1 Conroy Close continues to be managed well with a committed staff team. The organisations health and safety policies and procedures are in place. A number of health and safety records were inspected all of which were up to date and accurately maintained. Conroy Close (1) DS0000007946.V280350.R01.S.doc Version 5.1 Page 16 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 3 2 X 3 X 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 X ENVIRONMENT Standard No Score 24 X 25 3 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X 3 X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 3 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X X 3 3 X X X X 3 X Conroy Close (1) DS0000007946.V280350.R01.S.doc Version 5.1 Page 17 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement Timescale for action 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 Conroy Close (1) DS0000007946.V280350.R01.S.doc Version 5.1 Page 18 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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