Inspection on 06/01/09 for Cuthbert Close

This inspection was carried out on 6th January 2009.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cuthbert Close 26/01/07

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Muston Road (70)

Grayling

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Cuthbert Close 1/2 Cuthbert Close Queensbury Bradford West Yorkshire BD13 2DF     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Caroline Long     Date: 0 6 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Cuthbert Close 1/2 Cuthbert Close Queensbury Bradford West Yorkshire BD13 2DF 01274884427 01274884427 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mr Kenneth Beaumont Hillyard Type of registration: Number of places registered: Saint John of God Hospitaller Services care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home 1 and 2 Cuthbert Close is made up of two bungalows each with six single bedrooms offering nursing care and support for people with learning and physical disabilities. Each individual has their own private room decorated to their own personal taste, which is provided with all necessary aids and adaptations to suit individuals needs. The bungalows are purpose built are located within the community of Queensbury, which has easy access to all facilities within Bradford, and is only a few miles from open countryside. It is situated in a quiet residential area, and is surrounded by welltended gardens. The home has a mini bus. 12 Over 65 12 Care Homes for Adults (18-65 years) Page 4 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: Information provided by the manager on 6th January 2009 indicated that the current weekly fee for the home is from 980 to 1,170 pounds per week dependent upon peoples care needs. Additional costs include the provision of extra support by staff, toiletries, hairdressing, holidays, leisure activities and clothes. This is what we used to write this report. We looked at information we have received about the home since the last key inspection. We sent surveys to people living in the home. Staff helped five people complete and Care Homes for Adults (18-65 years) Page 5 of 30 return their surveys to us. One inspector visited the home unannounced. This visit lasted over six hours and included talking to the staff and the registered manager about their work and the training they have completed, and checking some of the records, policies and procedures the home has to keep. We spent time observing and talking with people who live in the home and a group of relatives. We looked at three peoples care records to check that a plan had been formulated which helped staff provide support to people according to their needs and wishes. We focused on the key standards and what the outcomes are for people living in the home, as well as matters, which were raised at the last inspection. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 Care Homes for Adults (18-65 years) Page 7 of 30 240 7535. Care Homes for Adults (18-65 years) Page 8 of 30 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs will be assessed before they move into Cuthbert Close. Evidence: The home has been fully occupied since 1993, therefore we could not talk to anyone who had recently moved into the home about their experience or look at their records. However the registered manager told us that people are normally referred to Cuthbert Close from Bradford District Care Trust. He will normally visit them and carry out a full assessment of their health and personal care needs and gather other information from relatives and any other agencies involved. Following this if he believes the person has the potential to settle in and staff have the necessary skills and the home has the proper equipment to meet the persons needs, they will be invited to visit. The visits are taken at the persons pace and can be for a day or overnight and last up to three months. This provides them with the opportunity to meet everyone and to get a feel for the home and helps the staff to be confident they will settle in. Care Homes for Adults (18-65 years) Page 10 of 30 Evidence: The registered manager told us how one of the main factors of whether a person was suitable was how compatible they are with the other people already living in the home. Staff told us and the records confirmed they had the necessary training; to enable them to look after people properly Care Homes for Adults (18-65 years) Page 11 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are aware of peoples needs and choices but this is compromised by the inadequate record keeping. Evidence: People living at Cuthbert Close have very complex needs, which can mean they have difficulty in communicating their views verbally. However staff told us about how they are able to recognise a persons preferred choice by how they are behaving. We found one of the support plans had very good information about a persons behaviour and what thier behaviour meant. A relative also told us that people do make some choices about their lives and described how their relative liked to stay up in a evening and get up late. They talked about the home and staff as a family and said how supportive and helpful the staff were to people. Care Homes for Adults (18-65 years) Page 12 of 30 Evidence: Five people who the staff helped to return their surveys told us that they were able to make choices. Three peoples case records were looked at in order to check that a plan had been formulated which would help staff provide support to people according to their needs and wishes. Overall the information found in the three plans differed one had very good person centred information in the assessment but this was not reflected the support plans. Others lacked information or plans were not in place. We found there were different formats in each of the plans and everyone had three separate files where information was kept. These were one general plan, one for nursing notes and one for support workers notes. This meant there was occasional duplication of information and vital information could be missed if the nurse or support worker did not read all the files. However staff told us they had a handover meeting that informed them about any changes when they started work and they were able to tell us in detail about peoples needs. Assessments of risk are made to protect people from potential harm and to provide staff with the actions they need to take to minimise any risks to individuals. We looked at three peoples risk assessments at Cuthbert Close and found some risk assessments were in place but these had not always been reviewed, examples of these were:For one person who needed considerable help to bath each morning there was no risk assessment in place about the actions the staff needed to take to help them with their bath. For a second person where they had recently fallen the assessments had not been updated. However for one person there was a risk assessment, which showed us they had been supported by staff to take risks to enable them to lead a independent lifestyle. We talked to the registered manager about the support plans and the risk assessment and he told us this was an area that he had recognised needed improving and was working with the staff to make sure improvements were made. The registered manager told us the home has regular meetings where people living in the home can make their views known. Care Homes for Adults (18-65 years) Page 13 of 30 Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The opportunity to take part in a wider choice of daily activities needs to be offered to be sure everyone is leading a full and active life. Evidence: Staff explained that people do go to day centres, on holidays, and the everybody goes out on a day trip in the summer and people occasionally go out to get the shopping. During our visit we saw staff sitting and talking to people in a happy and jovial manner. Relatives who visit regularly told us how they are made very welcome at Cuthbert Close. The records showed us that the staff had enabled one person to visit their relatives at home regularly. Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: However from the three peoples records we looked at we found all the support plans lacked information about peoples weekly activities and they did not indicate they were being regularly escorted into the community by staff but showed us the majority of their time was spent in the bungalows. Also during our visit although we were told a person went to a day centre twice a week, had been on holiday in November to Spain, and had been out for a Christmas meal. We saw they remained in the communal lounge for most of the day watching the same repetitive video and we were unable to find any evidence of any other regular weekly activities. Another person who was visually impaired was in the communal lounge area watching the same repetitive video tearing up magazines for most of our visit. However we were told they like to go out shopping and enjoyed sensory stimulation (touching things). We asked staff if there were enough to enable them to take people out more or engage them in other activities. We had a mixed response but all told us people could go out more as the home had recently employed a full time support worker to drive the mini bus. People living at Cuthbert Close need to be consistently offered the opportunity to a take part in regular activities, which will improve their lifestyle and maintain their daily life skills. We discussed this with the registered manager who explained that the lack of activities available in the home had been recognised and a member of staff was working with people to ask their views about the activities they would prefer and arranging them. In each of the bungalows the support staff cook the food. People told us the food was good, a relative told us it always smelled very good. Three staff told us people can make a choice of what they have to eat and there is always enough food available. We asked how staff were aware of peoples preferences they explained they knew from experience and if a person did not like what was offered they would often refuse to eat it. If this did happen an alternative would be offered. Care Homes for Adults (18-65 years) Page 16 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that the health and personal care they receive is based on their individual needs. The principles of respect, dignity and privacy are followed. Evidence: Relatives described the care people receive as excellent. People were observed to be clean, in matching clothes and relatives told us this was normally the case when they visited. Support staff were also seen to treat people with warmth and respect and kindness. A relative described how people were treated with dignity and like a brother or sister. Although peoples health care records were not up to date we found staff were aware of peoples health care needs and they were generally being met. Examples of this are where a health professional had advised that a persons food should be cut up and this was not recorded in the persons support plan, staff were fully aware of this. Also where a person had fallen and the risk assessments were not up to date, they had been referred to the falls clinic. Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: Relatives confirmed staff do promote peoples access to the health care they need and they regularly see the GP, podiatrist and dentist. Medication is locked away and a monitored dosage system is used. Staff who give out medication have received training. A sample of medication administration sheets were checked and found to be correct. Care Homes for Adults (18-65 years) Page 18 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are helped to express their concerns and are safeguarded from harm. Evidence: One person told us they would speak to the manager if they have any concerns or complaints. Five surveys returned all said they knew how to make a complaint. Staff explained how they would be able to see if a person was unhappy by their body language. A group of relatives told us they would be comfortable in speaking to the registered manager if they had any concerns. The home has a complaints policy in the reception areas of both bungalows. There is a record of all complaints and compliments. There has been one complaint since the last inspection, which was investigated and resolved by the registered manager. There are regular meetings in the home where people can make their views known. The registered manager explained one person has access to the independent advocacy service and he has tried to enable other people access to the local advocacy service but has found this difficult due to a lack of resources. A copy of the local policy and procedure, No Secrets, is available for reference. Discussion with the registered manager showed he was aware of the actions to take to safeguard adults. Staff have received training in adult protection and safeguarding Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: issues either during induction or as part of their national vocational qualifications. Three staff were aware of whom to alert if an incident occurred. People are supported with their finances. Detailed records are kept of all financial transactions carried out by the individual or by staff on their behalf. Care Homes for Adults (18-65 years) Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean and well maintained home. Evidence: 1 and 2 Cuthbert Close are two bungalows that accommodate six people in each bungalow. There are communal lounges and dining areas, and toilet and bath facilities and all the bedrooms are single. The bungalows have been adapted for peoples needs and there is specialist equipment available to help people move around the home. We looked at two peoples rooms which were clean, and comfortable, and relatives told us they have been decorated and furnished to peoples personal interests and tastes. Five people who returned their surveys told us the home was always fresh and clean. At the previous inspection we asked the provider to replace the fridge as the seals were broken. The registered manager told us about the improvements which had been made to the home. These were the kitchens in both bungalows had been replaced, and the baths had been replaced with baths with whirlpools which people can sit in. One person enjoyed using these every day. We saw that two way baby monitors were in use for some people, so that staff could Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: listen and make sure they were all right, when alone. These devices are not appropriate for use with adults as they can be overheard by anyone else who is in the room with the receiver and, in some cases, can also be heard on similar devices outside the home. This is a breach of peoples right to privacy. A more suitable system needs to be provided. To help prevent the spread of infections and to make the home a clean and comfortable place to live a cleaner is employed. We were saw gloves are available and anti bacterial soap despensers are installed at wash points and staff are receiving infection control training. Care Homes for Adults (18-65 years) Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are trained and skilled to support people who use the service. Evidence: Staff told us each bungalow has two support staff during the day and one nurse and one at night to support them and a registered nurse who covers all the bungalows. Three staff told us they felt this was enough staff to meet peoples needs. We looked at three staff records to make sure the home is employing suitable people for the job. We found that the home are taking the necessary precautions to make sure only suitable people are recruited to work at Cuthbert Close. Two staff told us there is an induction programme in place that ensures new staff members are given the right information to be able to do their jobs well, this was confirmed by looking at staff records. The registered manager explained that staff have generally received regular supervision and yearly appraisal and staff told us they do feel supported by the management. Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: Staff explained they receive regular up dates of any training which is essential for their job, the organisations head office inform them of the date they need to attend the training. The three records we looked at confirmed staff have received regular training. However staff have not received training about the mental capacity act, staff need to be provided with this training to enable them to be aware of how this may affect their work and peoples rights. Staff confirmed they have regular meetings and the registered manager explained these are used as an opportunity to recap policies and to make sure staff are kept up to date and able to carry out their roles properly. A staff meeting took place on the day we visited. The registered manager told us most of the staff have their National Vocational Qualification level two or above in care, this qualification helps to make sure staff are properly trained to carry out the work. Care Homes for Adults (18-65 years) Page 24 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Cuthbert Close is generally managed in peoples best interest. Evidence: The registered manager has worked at Cuthbert Close since the home was opened in 1993. He became the registered manager in 2001 and is a qualified nurse and has the registered managers award. Staff told us they felt extremely well supported by him and relatives said he was very approachable. Quality assurance systems consisted of an regular visit from the operational manager, regular house meetings, care reviews, and reviews of the complaints and accidents records to identify any patterns etc. However the registered manager told us that they do not seek the views annually of people and organisations involved in the service. To be sure the service is always run in peoples best interest their views should be sought annually. The registered manager told us the maintenance and service records are in order. He Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: was able to show us that all the bedrails are checked regularly by the night staff. A sample of two records was checked and found to be in order. When we visited the staff were having a update of their fire training. Accidents are recorded and reviewed by the registered manager to identify and resolve any potential risk. Care Homes for Adults (18-65 years) Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 9 13 People should have a risk 02/03/2009 assessment in place which is person centred and relevant to the individual and regularly updated. To prevent people from possible risks. 2 12 16 You must carry out a review of everyones daily life and activities to make sure people are offered activities are tailored to peoples individual needs. This will provide people with a fuller and more active lifestyle of their choice. 02/03/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 6 Where a person support plan identifies a need there should be a upto date support plan in place which reflects what people want now and in the future and the actions the staff need to make to enable people to do this. Page 28 of 30 Care Homes for Adults (18-65 years) 2 19 Peoples records should be always be regularly reviewed to be sure they receive a consistent approach by staff to their health care. An alternative should be found for the baby monitors. These devices are not appropriate for use with adults as they can be overheard by anyone else who is in the room with the receiver and, in some cases, can also be heard on similar devices outside the home. Staff should have training about the mental capacity act to enable them to be aware how this affect the way the work. To make sure the home is always managed in peoples best interests the views of people and organisation involved in the service should be asked for annually. 3 29 4 5 35 39 Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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