CARE HOME ADULTS 18-65
Daniel Yorath House 1 Shaw Close Garforth Leeds West Yorkshire LS25 2HA Lead Inspector
Nadia Jejna Unannounced Inspection 14 February 2006 1:15
th Daniel Yorath House DS0000001443.V278175.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 Daniel Yorath House DS0000001443.V278175.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. Daniel Yorath House DS0000001443.V278175.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Daniel Yorath House Address 1 Shaw Close Garforth Leeds West Yorkshire LS25 2HA 0113 287 3871 0113 287 3278 dyhirt.co.uk 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) The Brain Injury Rehabilitation Trust Mrs Ann Buckler Care Home 20 Category(ies) of Physical disability (20), Physical disability over registration, with number 65 years of age (20) of places Daniel Yorath House DS0000001443.V278175.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Shaw Close 20 Service Users - No more than two service users aged 16 or 17 years of age 20th October 2005 Date of last inspection Brief Description of the Service: Daniel Yorath House is situated in a quiet cul-de-sac in the village of Garforth. Its position allows easy access to local amenities and services. Accommodation is provided on two floors assisted by the provision of an internal lift. The home has an extensive rear garden and a small garden to the front. There are ample parking facilities to the front and side of the building as well as the availability of on road parking. The unit provides a specialist rehabilitation service to people with acquired brain injury. Their aim is to help and support individuals to be able to live in the community as they did before. A complete psychological and rehabilitation support care package is provided to the residents, and to their relatives if needed. The multidisciplinary team within the home is made up of professional medical and healthcare workers who can best assist the needs of the resident group. Daniel Yorath House DS0000001443.V278175.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Over an inspection year from April until March, care homes have a minimum of two inspections a year; these may be announced or unannounced. The last inspection was unannounced and took place on the 20th October 2005. This inspection was unannounced; it started at 1:15pm and ended at 5:00pm. The people who live in the home prefer the term residents and for the establishment to be classed as a unit, these are the terms that will be used throughout this report. The purpose of this inspection was to monitor the unit’s progress and to assess whether the care given to residents meets minimum standards. The manager had completed a pre inspection questionnaire (PIQ), which provided information about the unit including maintenance schedules, staff details, training given and policies and procedures. During the inspection records were examined and support workers were seen carrying out their work. Discussions were held with members of staff, the manager and resident’s. Comment cards/questionnaires were left for residents and visitors so that they can share their views of the home with the CSCI. None had been returned when this report was written. What the service does well:
Residents and their relatives are provided with detailed information, which helps them to make an informed choice about the unit and the specialist service it offers. Support is provided in a clean, tidy and well-maintained environment. The atmosphere in the unit was warm and welcoming and it was clear that good relationships were in place between residents and staff. Residents are helped to maintain appropriate relationships with their relatives and partners as well as with each other. They are involved with the running of the home and monthly meetings are held to discuss any issues that may come up. Residents meetings are held every month and all aspects of living in the unit are discussed. The minutes of these meetings are displayed on a notice board in one of the communal areas. One of the residents is the nominated residents representative and will take issues to the management team in between meetings. The residents are supported by well informed and knowledgeable support workers as well as a team of clinical specialists. There is a comprehensive training programme in place, which includes induction training, health and safety and abuse awareness, as well as specialist training about head injury,
Daniel Yorath House DS0000001443.V278175.R01.S.doc Version 5.1 Page 6 behavioural training and crisis prevention intervention. In order to support one of the residents palliative care training has been provided. The staff were very positive about their roles within the unit and showed commitment towards helping the residents with their rehabilitation programmes. 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. Daniel Yorath House DS0000001443.V278175.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 Daniel Yorath House DS0000001443.V278175.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): 1 Residents and their relatives are provided with detailed information, which helps them to make an informed choice about the unit and the specialist service it offers. EVIDENCE: The manager has revised the Service User and Family Guide, making it more informative and reader friendly. It clearly tells people about the service, what they do and how they help and support people to overcome the problems that can arise after brain injury so that they can move forward with the help of individual rehabilitation programmes. Daniel Yorath House DS0000001443.V278175.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): None of these standards were assessed during this inspection. EVIDENCE: Daniel Yorath House DS0000001443.V278175.R01.S.doc Version 5.1 Page 10 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): 15 and 16 Resident’s rights are respected and they are supported to maintain appropriate personal, family and sexual relationships. EVIDENCE: Residents are helped to maintain appropriate relationships with their relatives and partners as well as with each other. Because acquired brain injury can alter a person’s ability to deal with relationships the staff team and clinical psychologists support the relatives to understand and work through some of the difficulties that may occur. One of the residents said that this aspect of the service was helping to save their marriage and that they wished they had known about the service much sooner. Another client is supported to go home regularly and spend quality time with their partner. Residents rights and responsibilities are included as part of the Service User and family information guide. An education guide has also been produced which gives residents information about self-advocacy and how to access an advocate if needed. It also tells them how they will be supported to maintain
Daniel Yorath House DS0000001443.V278175.R01.S.doc Version 5.1 Page 11 their sexuality and how to get information to help with sexual problems that can occur after brain injury. Meals are served in a cafeteria style dining room. Menus are in place which reflect meal choices and preferences of the people who live in the unit. At lunchtime it was clear that independence is encouraged and promoted. Residents and staff eat together so that support and encouragement can be given as needed. Residents said that they enjoyed their meals. The cook gets feedback from residents after each meal and from the regular service users meetings and this is used to alter the planned menus. The kitchen was clean, tidy and well organised. Kitchen areas are also provided on each floor for residents to make their own meals as part of their rehabilitation programmes. One resident had prepared pizza for their lunch. Daniel Yorath House DS0000001443.V278175.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): 21 The illness and death of a resident would be handled with dignity and respect for their wishes and feelings. EVIDENCE: Policies and procedures are in place around dealing with illness and death. Because it is a rehabilitation service this is an aspect of caring for people that does not happen regularly. One of the residents has been diagnosed with a serious illness and the unit is working closely with the palliative care team to make sure that they can respond appropriately to changes in their needs and condition. The manager said that every week staff carry out a cognitive pain assessment and if changes were needed to pain relieving medication they would contact the palliative care team. Palliative care training has also been arranged for the staff team so that they will be able to support the resident and their family. This is good practice. Daniel Yorath House DS0000001443.V278175.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 assessed during this inspection. EVIDENCE: Daniel Yorath House DS0000001443.V278175.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): None of these standards were assessed during this inspection. EVIDENCE: Daniel Yorath House DS0000001443.V278175.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): 35 Well trained, competent staff meet residents needs. EVIDENCE: The manager said that a comprehensive training plan has been put in place for 2006. This includes topics related to the health, safety and welfare of residents and staff as well as training appropriate to the specialist service provided by the unit. If a resident had other specialist medical or physical needs such as diabetes the manager said that training would be given. An example given was the McMillan nurses coming to the unit to provide sessions on palliative care because one of the residents has recently been diagnosed with a serious illness. This training will help staff to care for the client and their relatives. Staff said that they had received induction training as well as introduction to brain injury, epilepsy and crisis prevention intervention. They said that most weeks they could attend tutorials at lunchtime that were led by senior and specialist staff in the unit on a variety of work related topics. Staff said that they enjoyed working at the unit because it was interesting and different every day. They were very clear and positive about their roles promoting residents independence and working with them so they return to living in the community. Daniel Yorath House DS0000001443.V278175.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 and 42 The unit is managed and run in the best interests of the residents. EVIDENCE: The residents are very involved with the running of the home. Regular meetings are held for residents and staff. One of the residents has been nominated as the service user representative and can be approached to deal with queries and issues in between the monthly meetings. The residents meetings are held monthly and from the notes kept on a notice board in one of the communal areas it was clear that they are client led. The results of the most recent service user survey were also displayed on one of the notice boards along with an action plan that was put in place to deal with issues raised. The PIQ showed that regular safety and maintenance checks are carried out on all electrical and gas appliances. Daniel Yorath House DS0000001443.V278175.R01.S.doc Version 5.1 Page 17 The PIQ showed that health and safety policies and procedures were in place and that appropriate risk assessments have been carried out. Daniel Yorath House DS0000001443.V278175.R01.S.doc Version 5.1 Page 18 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 4 2 X 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 X 23 X ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 4 16 4 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X 4 X X 4 X X 4 X Daniel Yorath House DS0000001443.V278175.R01.S.doc Version 5.1 Page 19 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. Refer to Standard YA37 Good Practice Recommendations The registered manager should be qualified to NVQ level 4 in Management and Care. (This standard was not assessed during this inspection and has been carried forward.) Daniel Yorath House DS0000001443.V278175.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Daniel Yorath House DS0000001443.V278175.R01.S.doc Version 5.1 Page 21 - 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!
