CARE HOME ADULTS 18-65
Cumbrae and Arran Houses 28 Redcar Road Guisborough TS14 6DB Lead Inspector
Jackie Herring Unannounced Inspection 14th February 2006 10:00 Cumbrae and Arran Houses DS0000060456.V272376.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 Cumbrae and Arran Houses DS0000060456.V272376.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. Cumbrae and Arran Houses DS0000060456.V272376.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Cumbrae and Arran Houses Address 28 Redcar Road Guisborough TS14 6DB 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) 01287 280511 01287 280522 Mrs Jane Dexter-Smith Mr R Dexter-Smith Brenda Anne Harland Care Home 7 Category(ies) of Learning disability (7), Mental disorder, registration, with number excluding learning disability or dementia (7) of places Cumbrae and Arran Houses DS0000060456.V272376.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Core and Cluster Home - 4 beds at Arran House and 3 beds at Cumbrae House 2nd November 2005 Date of last inspection Brief Description of the Service: Cumbrae was registered June 2004 as a core and cluster arrangement with Arran House, which had previously been registered, offering up to seven places for adults with both a learning disability and a mental health problem. Cumbrae has three single bedrooms one of which is on the ground floor. Arran House can accommodate four people in single rooms, one of which is situated on the ground floor with an ensuite facility. There is a small lounge available on the third floor. Both houses offer domestic, homely accommodation with ground floor lounges and well appointed kitchens/dining areas. Cumbrae and Arran House are situated near the centre of Guisborough and close to local amenities. Cumbrae and Arran Houses DS0000060456.V272376.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection and took place over one inspection day, three and a half inspection hours in total. Resident’s records were examined along with staff training records and two residents were involved in discussion about Arran House. The manager and one staff member were also involved in discussions. A very good inspection in which the inspector was extremely warmly welcomed and it was evident that the resident were very comfortable and were well able to talk freely abut life within Arran House. At the start the inspection, the manager was not available, however the support worker took the inspection process in her stride and managed very well. What the service does well:
Resident’s benefit from a very warm, homely, friendly family atmosphere in which well trained, knowledgeable staff deliver a high level of care to residents in an inclusive and consultative way. The houses are very well managed and there is clearly an enthusiasm from the staff for their own personal growth and development, which ultimately impacts on the life’s of the residents who have clearly achieved much both personally and within their healthcare needs. Resident’s records are well written, very personal and individual and residents are clearly involved in their individual assessment of need and plans of care. It is very clear the good relationships exist between staff and residents and residents said, “the staff are really nice, they are helpful and supportive and I can talk to them”, “the staff definitely understand my needs and they are supportive in assisting me to meet them”. Staff are enthusiastic about the work that they do, one staff member said, “I love my job, it is really rewarding and residents needs are really well met, they have individual needs which are met on an individual basis”, “as a keyworker there is a great deal of importance of developing relationships”. The houses are well managed and there is a very open culture within the organisation in which vision and drive for continuous improvement was very evident. Cumbrae and Arran Houses DS0000060456.V272376.R01.S.doc Version 5.1 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. Cumbrae and Arran Houses DS0000060456.V272376.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 Cumbrae and Arran Houses DS0000060456.V272376.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): 2 Whilst a detailed service users guide was available and contained information to enable prospective service users it was about the whole organisation rather than specifically about Arran and Cumbrae Houses. It is evident that assessment of resident needs and aspirations are paramount to any admission. EVIDENCE: The Statement of Purpose had been reviewed and updated prior to the last inspection and contained all of the required information. The information was not service specific to Arran and Cumbrae; it also included organisational information and included details about Miltoun and Brunswick House. It was recommended that a briefer more service specific Statement of Purpose be reviewed, which accurately reflects information about the specific registered homes and their individual structures and management arrangements. Three sets of resident’s records were examined during the inspection and there was also discussion with residents. It was confirmed that pre admission assessments take place and copies of other agencies or care management assessments are obtained. It was clear from the details obtained that individual needs are fully assessed and that the home can well able provide the care and environment to meet those assessed needs. Cumbrae and Arran Houses DS0000060456.V272376.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, 7, 9 The home plans well for and is good at meeting the health, personal and social care needs of the people who live there. Residents are well aware of their assessed needs and care plans, they are active in decision making both on an individual basis as a result their independence is promoted and care needs are clearly met. EVIDENCE: Three sets of resident’s records were examined and they contained very detailed information about individual needs, how to meet the needs and by whom. The care documentation was very personal and individual to the particular resident and it was clear that the resident had actively been involved in the process of discussing needs and there was clear evidence of choice and consultation, which was recorded and signed up to by the residents. Very good life histories were detailed as well as hobbies and interest and any areas of risk. Individual weekly planners were also very detailed and included areas of personal care for individual residents as well as activities of daily living such as, washing clothes, ironing and changing the bed. This also included day activities such as arts and crafts and assisting with the weekly shopping for the house.
Cumbrae and Arran Houses DS0000060456.V272376.R01.S.doc Version 5.1 Page 10 Daily records were well written and contained detailed information, which reflected mood, needs and any issues and also confirmed the activities as detailed within the weekly plans. It was clear from the records examined, that resident’s had made significant personal development and healthcare improvements. Some advice was given regarding the dating of documents such as the weekly planners and the importance of having dates on all documentation. Whilst there was some evidence of review of assessment of need and care plans, this needed to be recorded in more detail. During discussion with residents, they said, “Like it here much better than where I was previous, I am able to get out more, I am much more settled and happy and believe I am my own person”, “The staff definitely understand what my needs are, they are very helpful and supportive and give me assistance when I need it. Residents also said, “I like it here, I feel safe and I know I am being cared for, I have my own freedom, my own bedroom and a key for my own room, I am not going to move from here”. Staff said, “Residents needs are really well met here, they get looked after as individuals, each has their own needs, which are met on an individual basis”. Cumbrae and Arran Houses DS0000060456.V272376.R01.S.doc Version 5.1 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): None of these standards were examined during this inspection. EVIDENCE: Cumbrae and Arran Houses DS0000060456.V272376.R01.S.doc Version 5.1 Page 12 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): None of these standards were examined during this inspection. EVIDENCE: Cumbrae and Arran Houses DS0000060456.V272376.R01.S.doc Version 5.1 Page 13 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): None of these standards were examined during this inspection. EVIDENCE: Cumbrae and Arran Houses DS0000060456.V272376.R01.S.doc Version 5.1 Page 14 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, 27 Residents of both houses benefit from a well-maintained, comfortable and homely environment in which to live, although some slight improvements could be made. EVIDENCE: During this inspection, Arran House was visited, not Cumbrae however there was discussion about the environment at Cumbrae House and it was confirmed by the manager, that it remains very pleasant and homely. At the last inspection, it was identified that there would be huge benefits to residents at Cumbrae House if the laundry could be moved from the upstairs bathroom into the kitchen. Formal authorisation was given for this, however as yet the requested alterations have not taken place although this has been discussed and plans are underway. The environment at Arran has improved since the last inspection with the refurbishment of the bathroom which is very tasteful and which everyone spoke highly about. A carpet had been laid in the ground floor hallway as an interim arrangement until the actual flooring could be attended to, although this is an improvement, the floor still is in need of attention as it remains uneven.
Cumbrae and Arran Houses DS0000060456.V272376.R01.S.doc Version 5.1 Page 15 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): None of these standards were examined during this inspection. EVIDENCE: Although these standards were not formally examined during this inspection, discussion took place with the manager who is also the training co-ordinator for the organisation. Excellent and detailed training records are in place and it is very clear that there is a real enthusiasm and commitment to training and individual development. Plans for additional training includes topics, such as Supervision for staff, to increase their understanding and value of supervision, Challenging Behaviour and Death and Dying. These topics have been identified as a need throughout the organisation and all staff will be receiving this training. Again, as in the sister home’s within the organisation, staff members spoke positively about their job role and extended job role. Staff said, “I love my job, it’s a rewarding job, training is very good, I have just finished my NVQ level 2 and will be starting NVQ level 3 in May, I am learning something new all of the time”, “My confidence has increased tremendously, it is an enabling and encouraging environment”. Cumbrae and Arran Houses DS0000060456.V272376.R01.S.doc Version 5.1 Page 16 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): 39 Good systems are in place for continuous monitoring and development within the houses, which ensures aims, and objectives are being met. EVIDENCE: Good quality assurance systems exists within throughout the organisation as was identified at a previous inspection of sister home, Miltoun House. It was identified that key staff undertake additional responsibilities for ensuring quality for a number of areas throughout the organisation, this includes the environment, medication, training and health and safety. A well-written newsletter is also produced which is extremely informative and again demonstrate a sense of value and inclusion for the residents cared for by this organisation. Cumbrae and Arran Houses DS0000060456.V272376.R01.S.doc Version 5.1 Page 17 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 2 X 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 3 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X X X X 3 X X X X Cumbrae and Arran Houses DS0000060456.V272376.R01.S.doc Version 5.1 Page 18 NO 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. 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. 2. 3. Refer to Standard YA1 YA6 YA24 Good Practice Recommendations The statement of purpose should be reviewed and be service specific to Arran and Cumbrae Houses. The six-month review of care plans should be recorded in more detail. The planned refurbishment programme should be continued and should include action to be taken in respect of the hallway floor at Arran House. The laundry should be moved into the kitchen at Cumbrae House. Cumbrae and Arran Houses DS0000060456.V272376.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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