Inspection on 09/05/07 for Sign Health

This inspection was carried out on 9th May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Sign Health 26/08/09

Sign Health 10/01/06

Sign Health 02/08/05

Sign Health 25/02/05

Sign Health 24/08/04

Sign Health 24/03/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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

CARE HOME ADULTS 18-65 Constance Way 2 Constance Way Leicester Place Leeds West Yorkshire LS7 1HX Lead Inspector Stevie Allerton Key Unannounced Inspection 9th May 2007 09:30 Constance Way DS0000001439.V330776.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 Constance Way DS0000001439.V330776.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. Constance Way DS0000001439.V330776.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Constance Way Address 2 Constance Way Leicester Place Leeds West Yorkshire LS7 1HX 0113 2457991 (0113) 2457993 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) www.signcharity.org.uk SIGN Miss Susan Gill Care Home 6 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (6), Mental disorder, excluding of places learning disability or dementia (6), Mental Disorder, excluding learning disability or dementia - over 65 years of age (6), Sensory impairment (6), Sensory Impairment over 65 years of age (6) Constance Way DS0000001439.V330776.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th January 2006 Brief Description of the Service: 2 Constance Way provides care and support in individual purpose-built flats for six profoundly deaf people, who have additional needs due to some mental health problems. The service is managed by SIGN, a national charity specialising in this area of care, whilst the building is owned and maintained by a housing association. The service is situated in a mixed residential/business area close to the universities in Leeds and within walking distance of key facilities, such as the centre for deaf people. The two storey building stands within a development of mixed housing and there is nothing from the exterior that identifies it as anything other than a complex of flats. However, internally the accommodation has been designed around the needs of deaf people and is fully equipped for this purpose. One of the ground floor flats is also equipped to accommodate a wheelchair user, although no-one with this type of disability currently lives there. This is a highly specialised service for culturally deaf people. The language of the house is British Sign Language (BSL). Service users are expected to use this form of communication, as are all of the staff team, the majority of whom are deaf themselves. Current fees are £1,136 per week. Constance Way DS0000001439.V330776.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place without prior announcement and was carried out by one inspector over a 6 hour period. Two British Sign Language (BSL) interpreters assisted the inspector to communicate with deaf staff and the people who use the service, during the course of the day. The Manager and the Team Leader were both on duty and assisted during the inspection visit, as did other staff on duty. Prior to the visit, a review of information about the home was carried out, including information supplied on a regular basis by the home’s Line Manager following her monthly visits. The Manager had supplied statistical information in a questionnaire in October 2006, and also information regarding any accidents or untoward incidents occurring to the people who live there (the tenants). Most of the tenants were out at different activities or projects at the start of the visit, although two arrived home later in the afternoon and spoke with the inspector. Easy-read surveys were left for individuals to complete later; all five were returned. Comments from these surveys are included within the report. What the service does well: The home continues to provide a high standard of communication support for deaf users of the service, 24 hours a day. Tenants are encouraged to improve their own communication skills, which in turn increases their confidence in involving themselves in the hearing community. Tenants have the opportunity to develop social and domestic skills in a supportive setting, so that they may be able to live more independently if they wish. Staff are strong on respecting the privacy of the individual, whilst also encouraging them to take responsibility for their own decisions. The staff are supported by an extensive range of written policies and procedures, providing guidance for best practice in any given situation. Many of these policies have now been re-written to match the National Minimum Standards. Many of the policies in regular use in the home have also been translated into plainer English, for ease of use by people whose first language is BSL rather than English. Constance Way DS0000001439.V330776.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Constance Way DS0000001439.V330776.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Constance Way DS0000001439.V330776.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 4 & 5 People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The level of written and visual information helps prospective tenants to make a decision about whether they would like to live at the home. Assessment of needs is very thorough, which makes sure that places are only offered to people whose support and communication needs can be met. EVIDENCE: There is a current vacancy, one former tenant having moved on to a placement more suitable to her increasing personal care needs. The vacant flat is suitable for a wheelchair user. Some referrals have been made and the written information for a prospective tenant was seen. This showed that the person had been to look round and meet the other tenants. The plan was for them to stay overnight for a few times, to see how the group gets on together. Documentation provided to the home included a comprehensive assessment from the John Denmark Unit in Manchester (a specialist NHS unit for deaf people with mental health problems), an Occupational Therapy assessment, Constance Way DS0000001439.V330776.R01.S.doc Version 5.2 Page 9 Community Programme Approach (CPA) review notes; also SIGN’s own risk indicator document. The Tenant Information Pack was seen; this includes the tenancy agreement, which each person has a copy of in the file in their flat. The home currently uses two versions of the tenancy agreement, one from the Housing Association along with SIGN’s own easy-read summary. Surveys confirmed that tenants felt they had sufficient information about the home before they moved in. One said, “I stayed one night, then three nights, then a week, to help me decide to stay for life”. Constance Way DS0000001439.V330776.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Support plans reflect current and changing needs and individual goals, ensuring that the tenants receive support that will help them to achieve the things they want. Staff provide people with a high level of assistance and communication support, which helps them to become more confident at making their own decisions. Staff achieve a good balance between the promotion of rights and the management of risks, which encourages independent lifestyles. EVIDENCE: Three tenants were selected for case tracking, their support plans looked at in depth, key staff spoken to and discussions with the people themselves when they were available in the afternoon. Constance Way DS0000001439.V330776.R01.S.doc Version 5.2 Page 11 Support plans were detailed and had been drawn up with the involvement and agreement of each individual, signed by them and their key worker. Some people had typed these up themselves on computer with their key worker. One was seen to contain a written statement of permission to share personal information, and who with. There was some good recording that showed how the staff were managing a substance misuse problem, trying to work with the tenant to minimise risky behaviour. Daily progress sheets showed evidence of how key workers engage with people. The Manager said that key workers were assigned to tenants based on their talents, or how well they get on together, and are changed round periodically. Staff were asked about their roles as key workers and described some of the areas they work with their clients on. Tenants who were spoken to said that staff are around to help them with day to day decisions if they need it, or help them manage their money, budgeting for food, holidays, etc. Tenants confirmed that the staff support them in daily life, some saying that they have improved in confidence and in their communication skills since coming to live there. “The staff have given me a lot of help and support. I’m happy here”. “Staff help with practical stuff, like budgeting, but they also give emotional and communication support. I’ve been here 3 years and my confidence and health have improved.” Constance Way DS0000001439.V330776.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16. Standard 17 does not apply. People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Each person is supported to become as independent as they can with regard to their chosen lifestyle, interests and contacts in the wider community. EVIDENCE: Food is not provided and all tenants cater for themselves, with different levels of support. Staff cook with each person initially, to assess their ability, and support plans are then drawn up detailing how the preparing of meals is to be supported. This may involve help with drawing up shopping lists and the buying of appropriate ingredients, to actual instruction in the tenant’s own kitchen. The records show what people are doing on a daily basis around the house or out in the community. This includes college courses, voluntary work, support groups, domestic tasks, visiting relatives, etc. Tenants described the courses Constance Way DS0000001439.V330776.R01.S.doc Version 5.2 Page 13 and groups they are taking part in and what they enjoy doing at home. They confirmed that staff help with budgeting and gave advice about cooking meals; also that they helped them to fill out forms and use the internet. House meeting minutes revealed that peer pressure is a strong motivator - the behaviour of one person whose actions had affected others was discussed with that person in the meeting, with a clear message that a repeat would not be viewed kindly. The Manager said that the current group of tenants were articulate and keen to be involved and were taking it in turns to chair the meetings. One tenant spoken to said that she takes the minutes and has help to type them up. All of the user surveys confirmed that people felt they could make decisions and had some say over what they did each day. Constance Way DS0000001439.V330776.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People receive good support in healthcare matters, ensuring that their physical and emotional health and well-being is promoted. EVIDENCE: Support plans showed the service has strong links with other specialised services for people with mental health problems, both specifically for deaf people and for everyone in the community, including self-help groups and individual counselling. There was evidence of staff working in a positive way with substance misuse, trying to work openly with the person on limiting the frequency of use. Staff also provide advice and support on a wide range of health-related issues and assist the individual in making appointments to see GPs etc, if necessary. Independent interpreters are booked in advance wherever possible for health appointments, promoting privacy and dignity for the individual. Constance Way DS0000001439.V330776.R01.S.doc Version 5.2 Page 15 Personal care is not currently being provided for anyone. Medication is managed in line with assessed risk and each individual’s ability to take responsibility for their own medicines. One person has worked up to holding a week’s supply at a time; support plans showed how goals were agreed & set, giving them increased responsibility, but carefully reviewed to monitor compliance. There is good information available to staff regarding new drugs, stored in the handover file so that it is easily accessible. Constance Way DS0000001439.V330776.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Tenants have confidence that their views and concerns will be listened to and acted upon. Vulnerable people are protected from abuse. EVIDENCE: The complaints procedure and associated records were seen, indicating that tenants know how to put the procedure into action. They have made complaints about the lack of hot water, which led to an official from the housing association coming to a tenants’ meeting to listen to their complaints. The Adult Protection policies & procedures from all of the funding authorities were readily available. Some staff have done Adult Protection training. The inspector discussed with the Team Leader the recommendation that Adult Protection should be included in the service’s induction programme for all new staff. All of the surveys indicated that people who use the service know how to make a complaint and that they know who to speak to if something is wrong. Constance Way DS0000001439.V330776.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The tenants live in a homely, comfortable and safe environment that is specifically equipped for deaf people and promotes their independence. EVIDENCE: The communal areas were seen and one tenant invited the inspector to see her flat. She explained that she had decorated it herself, with staff help. She explained what the flashing lights meant (fire alarm and doorbell) and that she also had a vibrating fire alarm under the pillow. The flat was compact, but well laid out, with sufficient space for living and sleeping areas, a kitchen and a bathroom. It was well furnished and clean, as were the communal areas that were seen. The communal living room had been recently redecorated. There was a rota displayed on the tenants’ noticeboard for cleaning tasks to be done each day. Constance Way DS0000001439.V330776.R01.S.doc Version 5.2 Page 18 These were also referred to within the tenants’ daily notes, which gave a good picture of the household activities, gardening, etc., that people take part in. Risk assessments and evidence that regular safety checks are undertaken were seen, including safety certificates. There was also evidence that the housing association are checking the condition of the premises and internal systems on a regular basis. One of the tenants said that a project manager from the housing association had been to a tenants’ meeting to try to resolve the problems with the hot water. It had been slightly better since, but the tenants still experience unacceptably cold water at times when they want a bath. A skylight has been fitted to the upstairs landing to improve ventilation – this is awaiting painting and finishing off. External footpaths are to be re-laid as they are uneven. User surveys confirmed that the home was always kept clean, some saying that the tenants take turns to clean. Two also made mention of the hot water problems. Constance Way DS0000001439.V330776.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 & 36 People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Tenants are supported and protected by the recruitment practices in place. Staff are well trained and have a good level of support and supervision in their roles, which ensures that tenants’ needs are met. EVIDENCE: No new staff have been employed since the last inspection, which had provided evidence of a high quality recruitment procedure. Criminal Record Bureau disclosures were seen for existing staff. The Manager, Team Leader and two Support Workers were spoken to. The Team Leader is currently doing National Vocational Qualifications (NVQ) at level 4; one Support Worker is doing the Mental Health Certificate and others in the team are doing NVQ level 3, through Park Lane College, two of the team doing the Assessors’ Award in conjunction with this. All mandatory training is up to date. One of the Support Workers confirmed the training she had had, apart from the mandatory topics, including mental Constance Way DS0000001439.V330776.R01.S.doc Version 5.2 Page 20 health, women & violence and British Sign Language (BSL). All hearing staff have to have a minimum of BSL level 2, although most now have achieved level 3. A refresher course in Substance Misuse was being arranged, as the team were currently working with this issue. Support staff said they felt the service was well managed and that they got good support as workers. Communication was said to be excellent and the staff team worked well together. The Manager and the Team Leader provide staff supervision, both for personal development and to look at the support plans of those tenants they key-work. These take place at least 2 monthly, more frequently if needed. Constance Way DS0000001439.V330776.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41 & 42 People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The service is well run, in the interests of the tenants. They are confident that they are listened to and that their views count and they are actively encouraged to take part in running their home. Tenants’ rights and best interests are safeguarded by good record keeping, policies and practices. EVIDENCE: A range of regulatory records were seen, all of which were in order. These included: support plans, daily care notes, accident records, medication records, fire safety records, health and safety records and house meeting minutes. Constance Way DS0000001439.V330776.R01.S.doc Version 5.2 Page 22 Some policies were also seen, most of which have been translated into plainer English, for ease of accessibility by staff and tenants who use BSL. Staff are supported in the keeping of written records through supervision. The Manager spoke of the difficulties she has had in getting an adequate NVQ provider so that she can complete the Registered Managers Award. The home’s Line Manager visits the service and completes a monthly report which is provided by email to CSCI. Tenants are involved with these monitoring visits. The daily notes and minutes of house meetings also show how tenants are involved in making decisions about the place they live in and how it is run. Constance Way DS0000001439.V330776.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 4 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 3 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 4 35 3 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 4 X LIFESTYLES Standard No Score 11 X 12 3 13 4 14 X 15 3 16 4 17 N/A PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X 3 3 X Constance Way DS0000001439.V330776.R01.S.doc Version 5.2 Page 24 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. 1 Refer to Standard YA23 Good Practice Recommendations All new staff should receive some training in adult protection during their induction period; this is so that they are aware of possible abuse that tenants might experience and can safeguard them. 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