Inspection on 17/10/06 for Creykes Lodge

This inspection was carried out on 17th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found 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

Creykes Lodge 01/11/05

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 Creykes Lodge Rawcliffe Road Rawcliffe East Yorkshire DN14 8SE Lead Inspector David White Key Unannounced Inspection 17th October 2006 09:00 Creykes Lodge DS0000062522.V312970.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 Creykes Lodge DS0000062522.V312970.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. Creykes Lodge DS0000062522.V312970.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Creykes Lodge Address Rawcliffe Road Rawcliffe East Yorkshire DN14 8SE 01405 839198 01405 839012 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) St Anne`s Community Services Mrs Andrea Catherine Sanderson Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Creykes Lodge DS0000062522.V312970.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st November 2005 Brief Description of the Service: Creykes Lodge provides personal care and accommodation for up to six adults with a learning disability. The premises consist of a detached bungalow on the main road in the village of Rawcliffe, on a bus route, close to local amenities, and the towns of Goole and Selby. The home offers single room accommodation, and well-maintained communal areas. There are well maintained gardens to the front, side and rear of the property; level access to all doors and car parking to the front of the property. The grounds are fully enclosed and accessed by a secure gate, providing a safe environment for the residents. Creykes Lodge DS0000062522.V312970.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report follows an unannounced site visit undertaken on the 17th October 2006. This visit was carried out by one Regulation Inspector and took 7 hours with 5 hours preparation time. The home was able to return the requested information before this site visit. Surveys were sent out to relatives and health and social care professionals and six surveys had been returned, three from relatives and three from health and social care professionals. Information was used from the Regulation Inspector’s inspection record, which detailed the history of the home and relevant information about what had been happening in the home since the previous inspection visit. The site visit comprised of an inspection of the premises. The care records of three service users were looked at which included service users assessments, care plans and medication records. Staff rotas and health and safety documentation were inspected. Time was spent talking to a service user, a relative by telephone, three members of care staff and the manager of the home. The activity in the home and the interaction between service users and staff was observed. The focus of the inspection was on a number of key standards and inspecting the case records of a number of service users to establish whether they corresponded with their experiences of life in the home. The manager of the home was available throughout the inspection and the findings were discussed at the end of the inspection. What the service does well: The staff team work very hard to promote the independence of service users whose needs were very complex. Service users received a good standard of care from a caring, committed and well-equipped staff team. Service users were given opportunities to enjoy a range of activities both in and outside of the home. The service users bedrooms were very homely, individual and personalised to meet their personal preferences and choices. Staff turnover was low and this meant that the complexity of the service users needs were well understood and met by a consistent staff team. Creykes Lodge DS0000062522.V312970.R01.S.doc Version 5.2 Page 6 Staff received a range of training, which increased their awareness of service users rights, and how these should be adhered to. The home was well managed and this ensured that concerns would be properly addressed, the interests of the service users were safeguarded and good standards of care were maintained. 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. Creykes Lodge DS0000062522.V312970.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 Creykes Lodge DS0000062522.V312970.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area was good. This judgement was made using all the available evidence including a visit to this service. Although the home had not had any recent admissions, proper pre-admission procedures had been followed in the past to ensure that people moving into the home would have their needs met. EVIDENCE: Although no service users had been admitted into the home since the previous inspection visit it was noted within the care records of three existing service users that the home did have proper pre-admission procedures in place. All the care records contained information that had been obtained from other sources such as placing authorities before any decision had been made about whether the home would be able to meet the person’s needs. Documentation within the care records showed that the home had also carried out an assessment of each service user’s needs and from this information a care plan was put in place describing how identified needs would be met. Prospective service users and their families would be invited to visit the home prior to any decisions being made about moving into the home. Creykes Lodge DS0000062522.V312970.R01.S.doc Version 5.2 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, 7 and 9 Quality in this outcome area was good. This judgement was made using available evidence including a visit to this service. Service users were enabled to live as independently as possible taking into account any risks that needed to be considered. EVIDENCE: The care records of three residents were looked at and these contained a range of information about each person including a needs assessment, a pen picture of each service user which provided information about their personal history and presenting behaviours and detailed and informative care plans which focused on the strengths and likes and dislikes of each service user. The care plans were reviewed on a regular basis and the service user where possible and their relatives were encouraged to be involved in these. The service users had a range of complex needs that were managed sensitively. Most of the service users had difficulty in verbally communicating their needs and so staff used other methods of communication such as Makaton to make sure that service users needs could be understood and acted Creykes Lodge DS0000062522.V312970.R01.S.doc Version 5.2 Page 10 upon and staff had received some communication training from a speech therapist to support them in doing this. A number of risk assessments were in place to promote the service users independence and safety both in and outside of the home and where service users presented with challenging behaviours there was a focus on understanding the reasons for the behaviour and supporting the service users with this. Risk management plans had clear strategies in place to safely minimise risks from different types of behaviour and through observation and information within the care records it was evident that the strategies used were generally effective in reducing distress to service users. Staff felt that care plans and risk management plans were “easy to follow”. Members of staff had a very good understanding of each service users needs and their responsibilities in meeting these and felt that care plans were “easy to follow” and this supported them in knowing what to do in different situations. Daily records were well maintained and reflected the care being provided. There were occasions when staff needed to use individual breakaway techniques and physical intervention to minimise risks from challenging behaviours. It was clearly documented within the care records when this had occurred, the type of interventions used and by whom and the outcomes from the interventions. All staff had received training in promoting non-challenging behaviour and the home had a policy to guide staff on the use of physical intervention and restraint. Creykes Lodge DS0000062522.V312970.R01.S.doc Version 5.2 Page 11 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): 12, 13, 14, 15, 16 and 17 Quality in this outcome area was excellent. This judgement has been made using available evidence including a visit to this service. Service users enjoyed a fulfilling lifestyle and had opportunities to take part in social and occupational activities in the local community. EVIDENCE: Each service user had an individual activity programme that encouraged their involvement with the local community. Some service users attended a nearby resource centre where they enjoyed activities such as cooking classes, computers and music groups. The home had two vehicles of their own so that there were opportunities for people to go on trips out and the service users had recently enjoyed a holiday in Whitby. One service user said she enjoyed music and had recently been to the theatre to see some musical shows and there were visits to the local shops and pubs. Within the home itself there were pampering sessions for service users such as manicures and pedicures and there was a sensory room which one service user particularly enjoyed. At the time of the site visit a sensory session was being held and this provided relaxation and stimulation for the service users and the home had organised a Creykes Lodge DS0000062522.V312970.R01.S.doc Version 5.2 Page 12 number of themed evenings. Activities were carried out with service users on an individual basis and an example of a service user’s craftwork could be seen within their bedroom. Visiting arrangements were flexible and service users were encouraged to maintain regular contact with their families if they wished to do so. Service users could use the home’s portable mobile phones if they wished to contact family and on the day of the site visit one service user was being assisted by staff in going to see their relative at home. A relative commented that they were always made to feel “welcome” when visiting the home and that staff were “always friendly”. Menu planning was carried out to suit the service users individual tastes and alternative meals were available if a service user changed their mind or did not like the food on offer. A mealtime was observed and staff could be seen eating with the service users and offering support where needed. The care records showed that nutritional assessments were carried out on each service user and weight was monitored on a regular basis. Creykes Lodge DS0000062522.V312970.R01.S.doc Version 5.2 Page 13 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 Quality in this outcome area was good. This judgement has been made using available evidence including a visit to this service. Service users physical, health, and emotional needs were met with good access available to specialist services when needed. EVIDENCE: Staff aimed to promote the independence of the service users and staff were seen to be providing support in a sensitive and dignified manner. Each service user had a GP and access to dental, chiropody and optical services when required. Referrals to specialist services were made as appropriate and service users and staff received support from psychology services and the local Community Team for Learning Disabilities. A survey received from a health professional commented that the home worked well with other agencies in meeting service users needs and a relative said that the home was good at keeping them informed of any changes to their relative’s care. The medication records were accurate and up to date and medication was stored safely. There were systems in place for the recording of medications received by the home and a procedure for the wastage and disposal of medications. All the staff had received some medication training. Creykes Lodge DS0000062522.V312970.R01.S.doc Version 5.2 Page 14 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 Quality in this outcome area was good. This judgement was made using available evidence including a visit to this service. Clear complaints and adult protection policies and procedures were in place and well understood by the staff to safeguard the interests of service users. EVIDENCE: The home had a complaints procedure that clearly detailed how complaints would be dealt and this was available in different formats to promote people’s understanding of it. Because of the complexity of the service users needs it was highly unlikely that they would be able to use the procedure, however staff had a good understanding of each service users’ behaviour and felt confident that they would be able to recognise if a service user was unhappy or dissatisfied about something and would take actions to address this. Surveys received from relatives indicated that they were aware of the home’s complaints procedure. The home had a policy and procedure in place for the protection of vulnerable adults and staff had all attended abuse awareness training. Staff had a good understanding of what would constitute abuse and the actions that would need to be taken if abuse was suspected or had occurred. Staff supported service users in managing their monies and service users could have access to their monies at any time. Systems were in place for the storage and recording of incoming and outgoing monies for each service user and bank statements were sent to the home for each service user. Creykes Lodge DS0000062522.V312970.R01.S.doc Version 5.2 Page 15 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 and 30 Quality in this outcome area was good. This judgement has been made using available evidence including a visit to this service. Service users lived in a homely and comfortable environment that was clean and well maintained. EVIDENCE: All the bedrooms were designed for single occupancy and were decorated to a high standard to suit service users personal preferences. One service user who particularly enjoyed sensory stimulation had sensory lighting on their bedroom ceiling and the home had a designated sensory room which provided a calming and stimulating environment. There was ramped access to and from the home to accommodate people with mobility problems and personal and communal accommodation was spacious and well maintained and there was a conservatory that led to a patio area at the back of the home where service users could sit out if they wanted to. The environment was adapted to minimise risks to service users such as the locking of certain rooms, securing of fixtures, fitting and furniture and the use of perspex instead of glass for pictures. The home was clean and bright on the day of the site visit. There was a laundry room which housed a washing machine and tumble dryer and this was Creykes Lodge DS0000062522.V312970.R01.S.doc Version 5.2 Page 16 where staff attended to service users personal clothing, bed linen and other laundry. The kitchen area was clean and tidy and proper arrangements were in place to make sure that safe hygiene and food practices were being followed. The home had a fire risk assessment in place and all the necessary fire safety checks had been carried out to promote a safe environment. Creykes Lodge DS0000062522.V312970.R01.S.doc Version 5.2 Page 17 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): 32, 34, 35 and 36 Quality in this outcome area was good. This judgement has been made using available evidence including a visit to this service. Service users received a very good standard of care from an enthusiastic, well-equipped and motivated staff team. EVIDENCE: There was a good atmosphere in the home and staff said that morale was “high”. Members of the staff team felt that the home was a “good place to work” and it was clearly evident that staff and service users got on together and interacted well between each other through various means. Comments received from relative surveys said that the staff team were “good and always listened to what you had to say”. Staff turnover was low and some staff had been working at the home for a number of years. The levels of staffing ensured that service users needs were being met. In a morning there was four staff on duty and on an afternoon the staffing numbers varied from two to four staff depending on the needs of the service users. At night there was two staff on duty which included one who slept on the premises. The duty rotas showed that agency staff tended to be used for the night shifts due to a slight staffing shortfall that was being addressed by the manager. This was not causing any problems as the same Creykes Lodge DS0000062522.V312970.R01.S.doc Version 5.2 Page 18 agency staff tended to be used and had worked at the home on a number of occasions so were familiar with the specific individual needs of the service users. Staff could be observed spending time with service users on an individual basis and service users had regular opportunities to have trips out. Staffing levels were planned around the needs of the service users and extra staffing was arranged to carry out planned activities and to support service users in attending appointments. The care staff were responsible for attending to cleaning, laundry and cooking duties and staff did say they could be very busy especially if service users were unsettled and when there were only two staff on duty on some occasions in an afternoon or at weekends. It was recommended that the manager reviewed the staffing levels to ensure that the numbers of staff were sufficient in meeting the needs of the service users at all times. The home provided staff with a good range of training to equip them in meeting the needs of the service users. The training was specific to the needs of the service user group such as promoting equality and diversity for people with a learning disability. A number of staff had either completed or were doing the NVQ programme and induction training was in place for all new staff and this was detailed and covered a number of aspects of working at the home. The home was intending to introduce some training called “Pro Act Skip” which had been approved by the British Institute of Learning Disabilities (BILD). The aim of this would be to provide the care team with more intensive training in looking at alternative ways of supporting people with difficult and challenging behaviours. Staff files were looked at and proper recruitment procedures were being followed to safeguard service users from harm. Staff supervision systems were in place and staff files contained evidence that these were taking place on a regular basis to support staff in their roles and to ensure that management were aware of any staffing issues. Creykes Lodge DS0000062522.V312970.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 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, 39 and 42 Quality in this outcome area was good. This judgement has been made including available evidence including a visit to this service. The service users benefitted from a well managed home in which their needs and wishes were put first. EVIDENCE: The registered manager was experienced in running the home and had undertaken further training to enhance her management skills further. Staff felt well supported by the manager and relative and health professional surveys indicated that the home was well run and a health professional had commented that the manager had good leadership skills. Staff morale was good and the atmosphere in the home was warm and friendly. Due to the complexity of the service users needs and their communication difficulties it was difficult to seek feedback from them about the care and services they received. The home had tried giving questionnaires to service users in varying formats in order to try to seek their views but this had proved Creykes Lodge DS0000062522.V312970.R01.S.doc Version 5.2 Page 20 extremely difficult and had very limited success. This was acknowledged by the manager who was working with other members of the St Anne’s organisation to look at alternative ways of how service users views may be sought. Other questionnaires had been sent out to people who visited the home and to relatives about their views of the care and services provided. The manager had developed a “team plan” which set out the aims of the home for the coming year and a senior person within the organisation carried out monthly visits to the home to monitor the quality of the care and services. Proper regard was given to the promotion of a safe environment for service users, visitors and staff. A number of satisfactory reports and certificates were seen relating to the premises although the electrical wiring certificate was not available at the time of the site visit. Staff had undertaken a range of health and safety training to promote safe working practices and a number of general risk assessments had been carried out in relation to different aspects of the home in order to promote a safe environment. Creykes Lodge DS0000062522.V312970.R01.S.doc Version 5.2 Page 21 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 3 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 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Creykes Lodge DS0000062522.V312970.R01.S.doc Version 5.2 Page 22 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. 1 Standard YA42 Regulation 23 Requirement An up to date electrical wiring certificate must be obtained to confirm that the electrical systems in the home are safe and any work required has been completed. Timescale for action 30/11/06 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 Refer to Standard YA33 Good Practice Recommendations The registered person should carry out an ongoing review of the staffing levels in the home. Creykes Lodge DS0000062522.V312970.R01.S.doc Version 5.2 Page 23 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 © 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 Creykes Lodge DS0000062522.V312970.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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