Inspection on 10/04/07 for Cragmere

This inspection was carried out on 10th April 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cragmere 14/02/06

Cragmere 25/05/05

Cragmere 11/01/05

Cragmere 05/08/04

Cragmere 17/03/04

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 Cragmere Colne Road Glusburn North Yorkshire BD20 8RB Lead Inspector Chris Taylor Key Unannounced Inspection 10th April 2007 09:30 Cragmere DS0000007881.V336161.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 Cragmere DS0000007881.V336161.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. Cragmere DS0000007881.V336161.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cragmere Address Colne Road Glusburn North Yorkshire BD20 8RB 01535 635678 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) Northern Life Care Limited T/A U.B.U. Post vacant Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Cragmere DS0000007881.V336161.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered for 4 residents with Learning Disabilities 2 of whom may also have Physical Disabilities 14th February 2006 Date of last inspection Brief Description of the Service: Cragmere is registered to provide accommodation and personal care for 4 adults with disabilities. The home is a detached dormer bungalow situated on the main road in the village of Glusburn. There are local amenities and leisure facilities in nearby towns. The Statement of Purpose and Service User Guide are provided upon enquiry. The Cost of a placement at the home is dependent on individuals needs. Currently charges range from £1224.39 to £1547.39. The cost to the service user is dependent on the level of Local Authority funding and benefit entitlement. Cragmere DS0000007881.V336161.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is what was used to write this report. • • • Information about the home kept by the Commission for Social Care Inspection. Information asked for before the inspection, this is called a Pre Inspection Questionnaire. Information from surveys that were sent to service users’ care managers, and advocates. Three surveys were sent out and three were sent back. An unannounced visit to the home. This lasted four hours and included talking to support staff and manager’s about their jobs and the training they have completed. And checking some of the records polices and procedures the agency has to keep. Some time was spent with two service users. • • What the service does well: What has improved since the last inspection? More staff have completed NVQ training, this means staff have better knowledge and understanding to support people with learning disabilities. Cragmere DS0000007881.V336161.R01.S.doc Version 5.2 Page 6 UBU is improving the information that is written down for service users, it will be easy to read or has pictures to help service users understand what it means. 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. Cragmere DS0000007881.V336161.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 Cragmere DS0000007881.V336161.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. Quality in this outcome area is excellent. Service users’ needs are properly assessed prior to admission. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All service users are admitted following a local authority care management assessment and the home’s pre admission assessment “getting to know you”. The getting to know you assessment includes all aspects of the service users lives and how they hope support is provided for them. Completion of the document includes information from the service user, family and other professionals and is particularly useful for those service users who have complex needs and/or difficulties with communication. This document supports staff in making the admission for the service users as smooth and as comfortable as possible. If at this stage the home believes they could offer a service then introductory visits commence and these are taken at a pace set by the service user. Compatibility between service users is given considerable thought and existing service user views are included in this. New placements are under review and further assessments are completed. Usually after a six week settling in period a review is held to confirm that the service user and other service users in the house are happy with the Cragmere DS0000007881.V336161.R01.S.doc Version 5.2 Page 9 arrangements. Admissions to the home are infrequent, the last being 12 months ago. Records and discussion with staff confirm that the process described had been followed. Service users are provided with and assisted in understanding the service user guide, which is produced pictorially. Cragmere DS0000007881.V336161.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 and 9. Quality in this outcome area is excellent. Service users’ needs are assessed and are met promoting independence, choice and respect for individuals. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Whilst staff were supporting service users during the morning it was clear that they understood individuals needs. They supported people sensitively and supported people to make choices. There were clearly elements of risk for service users during the morning particularly in the kitchen area and staff handled these discreetly and safely. Staff were seen using makaton and physical prompts to support service users. Staff discussed individual needs and demonstrated imaginative ways to make sure service users have as much choice and control over their lives. Cragmere DS0000007881.V336161.R01.S.doc Version 5.2 Page 11 Records about service users are kept on computer with some supporting hard copies. Individual Support Specifications identify personal routines and are documented step by step to make sure support is provide exactly how the service user wants and needs. Person centred plans contain information about every aspect of the service users’ lives including areas for developing new skills. These plans are reviewed every six months or as necessary and these reviews focus on achievement and improving opportunities for individuals. Also present were risk assessments with the purpose of supporting service users to live as independently as possible with safeguards in place, these were reviewed regularly. Service users are included in developing the plan, however, the format and language used for this and review documents are not easy to read plain English or supported by pictorial prompts. For instance headings such as targeted ambitions, having a meaningful network of communication and personal control and greater opportunities are difficult concepts to grasp. UBU are actively reviewing and making amendments to this document in order that information is more accessible to service users. Service users are beginning to put all the “getting to know me” information into photograph albums which include photos and leaflets about important people and places; routines and interests. These can then be used in conjunction with service specifications to provide support in the way service want and can be involved in. UBU provide a good induction and ongoing training for staff which makes sure service users are treated with respect, dignity and are supported to make choices in their lives. This was reflected in the observations of staff with service users throughout the visit. For instance in choosing what service users wanted to do during the morning and in choosing what time to have lunch. Staff discussed individual needs and demonstrated ways to make sure service users have as much choice and control over their lives. Cragmere DS0000007881.V336161.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 and 17. Quality in this outcome area is excellent. Service users are supported to lead full and active lives. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During this visit two of the service users were out and two were at home. Service users have the opportunity to attend specialist day centres or college and have days at home to participate in personal shopping, laundry and household tasks. Despite Cragmere’s rural location there are opportunities go to the pub, library, and church, into town to shop or have a meal or coffee. One service user talked about planning a forth coming holiday. Additional staffing is provided to ensure service user have the opportunity to participate in activities of their choice on a one to one. Cragmere DS0000007881.V336161.R01.S.doc Version 5.2 Page 13 One of the surveys received said that Cragmere were particularly good at “ taking time to get to know the service user’s individual needs, abilities and preferences. Working to develop skills and give new opportunity for experiences”. Another said “when you see service users and staff out in the community, people are always supported appropriately and with dignity”. There was written information in service user plans about how service users spend their days and these arrangements are discussed with service user representatives and staff. Details about family, friends and significant events are recorded in service user plans. Examples of how service users are supported to maintain relationships with family and friends were given and service users talked about the contact they have with family and friends. One service users said that they discuss menus in house meetings and take it in turns to help with the supermarket shopping. There is a weekly menu but service users choose what they want to eat particularly at breakfast and lunch. Staff support these meal choices discreetly to make sure service users are choosing a healthy diet. Cragmere DS0000007881.V336161.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 and 20. Quality in this outcome area is good. Service users personal and healthcare is provided appropriately and sensitively according to individual needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users health needs were recorded in service user plans and step by step instruction in individual service specifications. Sometimes service users choice is restricted because of safety and evidence of this was seen in individual service specifications. Service users can access psychology, physiotherapy, and art therapy, speech therapy and specialist community nursing from the local learning disability team. Staff said they have a good working relationship with this team. Medication is locked away and a monitored dosage system is used. Staff have received accredited training. Medication administration sheets were checked. Where medication is not administered by staff at the home, at a day centre or the service user’s family home for instance, a letter is written with a key for Cragmere DS0000007881.V336161.R01.S.doc Version 5.2 Page 15 that letter at the bottom of the page. The letter F is used for the home to write its own description. The letter F was used quite frequently but a description of what this meant was not recorded. The manager said this is usually when a service user takes their medication to college. Failure to complete the key would effect the auditing of medication, as there can be no assurances that medication had been given and by whom. Cragmere DS0000007881.V336161.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 and 23. Quality in this outcome area is excellent. Service users have access to an effective complaints procedure. There are sufficient effective systems in place to safe guard service users from harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users are provided with a complaints procedure which is produced pictorially. Advocates are available to provide an independent voice for service users. There had been one complaint made to the home and this had been investigated properly and the complainant satisfied with the outcome. The details of this complaint were recorded in a book which contained other records. For the purposes of confidentiality and data protection the manager was advised to keep separate records for each complaint with a log to track where the details are held. No formal complaints have been made directly to the Commission for Social care Inspection. There is a comprehensive policy and procedure with regard to safe guarding adults and the procedure to take if there is a suspicion of abuse and staff demonstrated a good awareness of this. Staff receive training in adult protection and safeguarding issues during induction and foundation training and as part of NVQ level 2 and 3. Cragmere DS0000007881.V336161.R01.S.doc Version 5.2 Page 17 Some service users take care of their own spending money and others need staff to do this on their behalf. Money is locked away and there is a recording sheet to record when money is spent and this is receipted. These records are sent to head office to be audited and are checked as part of shift change routine. Cragmere DS0000007881.V336161.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is excellent. Service users live in a clean, comfortable and safe home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home provides spacious accommodation for service users. This includes a lounge and dining room, shared bathroom and office/sleep in room on the ground floor and a further two bedrooms and bathroom on the first floor. The home is decorated and furnished to a very good standard. Each bedroom is individually decorated to reflect the service users age and personality. Service users said that they were included in deciding how their rooms were decorated and furnished and they discussed communal decoration as a group. There is a large garden which is fully accessible. A range of checks is completed on a regular basis to make sure that the house is safe and secure. Cragmere DS0000007881.V336161.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 and 35. Quality in this outcome area is excellent. Staff are properly vetted and trained to ensure service receive the care and support they need. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Prospective staff complete an application form and attend formal interview where any gaps in employment are explored. UBU generally include service users in their interview process and service users are assisted with a pictorial prompt to score on the interviewee’s answers. Prospective staff are also asked to spend two or three hours at the home meeting and spending time with service users and observed by staff. Observations are used and form part of the interview scoring. Written references and POVA (Protection of Vulnerable adults) first checks are made and staff are not permitted to work in the home until they have a CRB (Criminal Records Bureau) check. Staff training records examined showed a comprehensive training programme. All staff complete a home specific induction programme followed by Learning Cragmere DS0000007881.V336161.R01.S.doc Version 5.2 Page 20 Disability Award Framework accredited induction within the first 6 weeks. Nine members of staff out of thirteen have achieved NVQ level 2 or 3. A range of other training including health and safety training is provided. This provides staff with the knowledge and skills to perform their duties in a competent manner. Staff spoken to thought that the training provided is good and staff have recently attended specific training in order to understand and support a service user with a particular condition. Staff said the staff team was very supportive. The home is currently fully staffed. There are usually two or three members of staff on duty with additionally funded hours for specific service users to attend specific activities. There are two members of staff on duty at night one awake and one asleep. There is also an on call system for emergencies. The manager carries out individual staff supervision every four to six weeks, each session has an agenda and is recorded and signed by both parties. Staff confirmed this. Staff meetings are held regularly. One survey said, “Managers and staff will always go the extra mile” another said, “Clear communication and consultation. Good line management support to staff team”. Cragmere DS0000007881.V336161.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 and 42. Quality in this outcome area is excellent. The home is managed in such a way that promotes the best interests of service users. Staff take proper precautions to ensure the health and safety of service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a new manager in post she has yet to apply for registration with the Commission for Social Care Inspection. The new manager has extensive experience in the field of learning disabilities and has worked for UBU for a number of years at Cragmere and other UBU services. Cragmere DS0000007881.V336161.R01.S.doc Version 5.2 Page 22 The home has a formal quality assurance system which relates directly to national minimum standards and is measured against the home’s improvement plan. Service users are surveyed once a year with a questionnaire which is easy read, supported with pictures and responses given using smiley faces, (happy and unhappy). The percentage of returns for this questionnaire is good and information provides a good cross section of service users opinions. The home is audited every month and a report of this audit is forwarded to the CSCI. Records were seen which confirmed that equipment is maintained and serviced appropriately. Fire detection and fire fighting equipment is tested and maintained regularly. Staff receive training with regard to all health and safety matters and there is an effective system to ensure updates are completed. Cragmere DS0000007881.V336161.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 X 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 4 33 X 34 4 35 4 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 x LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 x 3 X 4 X X 4 x Cragmere DS0000007881.V336161.R01.S.doc Version 5.2 Page 24 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 Where a code, denoted by a letter, is used on the medication administration sheet explanation of this code must be recorded. Timescale for action 10/04/07 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 YA41 Good Practice Recommendations Separate records for each complaint should be kept with a log to track where the details are held. Cragmere DS0000007881.V336161.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Cragmere DS0000007881.V336161.R01.S.doc Version 5.2 Page 26 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!