CARE HOME ADULTS 18-65
Derby Crescent (16) Moorside, Consett Co Durham DH8 8DZ Lead Inspector
Gavin Purdon Unannounced Inspection 16 August 2005 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 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 Stationary 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. Derby Crescent (16) B54 S7540 Derby Crescent V228291 160805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service 16 Derby Crescent Address Moorside, Consett, Durham, DH8 8DZ 01207 502817 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Nigel Cardale Ms Susan Ishbel Stewart Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Derby Crescent (16) B54 S7540 Derby Crescent V228291 160805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: none Date of last inspection 14 December 2004 Brief Description of the Service: 16 Derby Crescent is one of two registered homes for people with learning disabilities owned by Mr Nigel Cardale. The homes are located on the same large housing estate at Moorside in the northwest area of County Durham. 16 Derby Crescent is managed by Ms Susan Stewart, who was present during this inspection. 16 Derby Crescent provides accommodation for up to 3 adults with learning disabilities. It does not provide a service or facilities for people with additional physical disabilities or for those in need of nursing care. The home is designed over two floors and is domestic in nature. Bathing and toilet facilities provided are shared by up to 3 residents. Personal accommodation consists of 3 single rooms. Garden areas are located to the front and rear of the property. At the time of the inspection 2 service users were in residence. Derby Crescent (16) B54 S7540 Derby Crescent V228291 160805 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced, lasted 2 and a half hours, and was carried out by one inspector. The inspection was assisted by Ms Susan Stewart, the registered manager of 16 Derby Crescent. The inspector met in private with the 2 residents presently living there, to talk about life at the home, and also spoke with a member of the home’s care staff on duty about the day to day care of residents. The inspector also looked at residents’ written assessments and care plans. The focus of this inspection was on how the care needs of residents are assessed, how care is planned and provided, and the general arrangements for daily living at the home, including how the home promotes individuality and the well being and protection of its residents. The overall findings were that the home works hard to provide a good standard of care for residents. Care is based on careful assessments and care plans, and geared towards understanding and providing for residents needs in a way that makes them safe, happy, comfortable, and recognises their status as adults and semi independent individuals. It was noted that a newly appointed member of staff did not have a new CRB check. The manager and provider are reminded that CRB checks provided by staff from previous employment elsewhere, no matter how recent, are no longer acceptable, and a new check must be made. Derby Crescent (16) B54 S7540 Derby Crescent V228291 160805 Stage 4.doc Version 1.40 Page 6 What the service does well: What has improved since the last inspection?
Residents’ terms and conditions documents have been reissued and training plans for staff put into place, in line with 2 previous inspection requirements. 16 Derby Crescent is satisfied with its present standards of care and has no in house proposals of its own to alter present practice arrangements. It considers its current approach to be tested, reliable and successful. Just prior to the previous inspection 16 Derby Crescent appointed its own manager rather than sharing a registered manager with another home. The manager made the important point that what was improving in the longer term at 16 Derby Crescent was the resident’s own abilities to take responsibility for their own actions and to behave more independtly. Derby Crescent (16) B54 S7540 Derby Crescent V228291 160805 Stage 4.doc Version 1.40 Page 7 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. Derby Crescent (16) B54 S7540 Derby Crescent V228291 160805 Stage 4.doc Version 1.40 Page 8 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 Standards Statutory Requirements Identified During the Inspection Derby Crescent (16) B54 S7540 Derby Crescent V228291 160805 Stage 4.doc Version 1.40 Page 9 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 standard(s) 2. Potential residents benefit from the fact that the home gathers a wide range of information about their needs and makes sure that there is a full and detailed plan to meet those needs. EVIDENCE: The inspector looked at 2 residents’ care files with the home’s registered manager. These contained social workers’ assessments of residents’ needs, and more detailed individual care plans for each resident, based on these assessments. Residents at 16 Derby Crescent are not highly dependent and do not have particularly severe or complex needs. The main purpose of the home is to help its residents lead a settled and semi independent life. The 2 residents who spoke to the inspector did know that they had care plans, what kind of things were in the care plans, and said that these plans had been discussed with them. One resident said, “ We have a discussion and make an agreement, it gets written down. We check that it says what it should. I might think something isn’t a risk and staff might think it is. If we see things differently we talk it over.” Derby Crescent (16) B54 S7540 Derby Crescent V228291 160805 Stage 4.doc Version 1.40 Page 10 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, & 9. Residents know that they have care plans and that these deal with important everyday things that are going on in their lives. Residents know that they can talk things over with staff and get their help to sort things out if they need it. Residents know that staff will help them try to do things for themselves, but will make sure they are safe and comfortable. Derby Crescent (16) B54 S7540 Derby Crescent V228291 160805 Stage 4.doc Version 1.40 Page 11 EVIDENCE: A resident told the inspector that they had a care plan, and said,“These are done every year. I do the plan with my key worker. Something might have changed slightly, probably nothing too much, but you put it in the plan. Some of the stuff is quite personal.” Residents told the inspector that they had good support from the care staff at the home. “We get around the table and talk. We have an open discussion, a house meeting, if you’re not happy about something. There’s ups and downs anywhere. If the thing’s not important you just let it blow over.” The inspector saw that detailed risk assessments had been completed for residents, looking at what situations residents were able to deal with, and whether or not these were thought to be safe and comfortable, and something the resident was capable of managing, either by themselves, or with help. Derby Crescent (16) B54 S7540 Derby Crescent V228291 160805 Stage 4.doc Version 1.40 Page 12 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 15, 16, and 17. Residents at 16 Derby Crescent are treated as adults and they are supported and encouraged to enjoy the normal everyday kinds of activities for people of their age living in the Moorside area. The residents of 16 Derby Crescent are a well known and accepted part of the local community. Residents who want to maintain family links and personal friendships are helped to do that by the staff of 16 Derby Crescent. Staff at 16 Derby Crescent respect residents’ rights and expect residents to do the same. Residents enjoy their meals in homely surroundings and in a relaxed and sociable atmosphere. Derby Crescent (16) B54 S7540 Derby Crescent V228291 160805 Stage 4.doc Version 1.40 Page 13 EVIDENCE: The inspector was told that residents are very much out and about and spend much of their time elsewhere and with other people and not just at 16 Derby Crescent with the staff. The home’s 2 residents met with the inspector and told of the kinds of things they had been doing, such working with computers, cooking, commercial printing, and playing in the local darts league. 16, Derby Crescent is an ordinary house in an ordinary street, with nothing to distinguish it from the other houses. The home blends in very well with its surroundings. Residents told the inspector that the home helped them maintain links with their families. “ I still get home and I’m still in touch with my family.” Residents are respected as individuals and expected to be fair with each other. Residents told the inspector, “We muck in, help each other out. We share the jobs out. We get on well.” Residents told the inspector about the good meals, “The foods good, there’s a 4 week rota. You can change it. You don’t both have to eat the same stuff. If you don’t like sweet corn you can have beans or peas.” Derby Crescent (16) B54 S7540 Derby Crescent V228291 160805 Stage 4.doc Version 1.40 Page 14 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, & 20. Residents are not highly dependent and benefit from working with staff that they trust and who have a good understanding of how best to support each resident without putting that resident at risk or making them over dependent. Residents have access to local healthcare services and are helped by the home’s staff to use these if needed. 1 resident manages their own medication with support, based on individual risk assessment. Use of medication in the home is supported by safe policies and procedures. Derby Crescent (16) B54 S7540 Derby Crescent V228291 160805 Stage 4.doc Version 1.40 Page 15 EVIDENCE: Care plans seen by the inspector contained details of what levels of support residents need and how best to provide that support. Residents told the inspector that staff helped them to do more for themselves and to be more independent, but gave them help if they needed it. Residents said that they did not need help all the time, but sometimes they did, and sometimes there could be an emergency, and it was really good to know that staff were there to back them up. 1 of the residents manages their own medication with support, and is very comfortable with that. The home does have a self medication policy based on individual assessment of the resident’s ability to be responsible for their medication. The member of staff spoken to by the inspector had completed a safe handling of medication course. Derby Crescent (16) B54 S7540 Derby Crescent V228291 160805 Stage 4.doc Version 1.40 Page 16 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22, & 23. Residents felt that what they had to say about things mattered and that they were taken notice of and well looked after. The home protects its residents by having the required policies and procedures covering concerns and complaints. EVIDENCE: Residents told the inspector they were happy with the way things are done at the home. In their view the staff are good and things are done in a fair way. Problems were talked over and solutions found. The inspector had separate discussion with the registered manager and with a member of staff on duty, and in both discussions the inspector was told about the home’s belief in listening to and involving residents, and in trying to build trust and to genuinely help them get more out of life. Residents, care staff, and management, told the inspector about the home’s key worker system, which they all thought worked really well. This is where a particular member of staff makes sure that each resident has some individual ongoing attention paid to their everyday care, and to how their needs might be changing, and to how plans are working out for that resident. Derby Crescent (16) B54 S7540 Derby Crescent V228291 160805 Stage 4.doc Version 1.40 Page 17 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 standard(s) Not assessed on this occasion. EVIDENCE: Derby Crescent (16) B54 S7540 Derby Crescent V228291 160805 Stage 4.doc Version 1.40 Page 18 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33. Staff work well together as a team for the benefit of the residents at 16 Derby Crescent. Staffing numbers, skills, roles and deployment mean that residents’ needs are well supported. It was noted that a newly appointed member of staff did not have a new CRB check. The manager and provider are reminded that CRB checks provided by staff from previous employment elsewhere, no matter how recent, are no longer acceptable, and a new check must be made. EVIDENCE: The registered manager told the inspector about the good teamwork at 16 Derby Crescent. In the registered manager’s view each member of staff makes a good individual contribution, but that all can work effectively together and to a common plan. Staffing levels remain as last reported in 2004, and broadly in line with those in force prior to 1 April 2002. One member of staff provides between an hour and an hour and a half’s support on weekday mornings and between 3 to 5 hours support on a weekday afternoon. On week ends one member of staff provides between 7 and 8 and a half hours support per day. Night support is covered through on call arrangements.
Derby Crescent (16) B54 S7540 Derby Crescent V228291 160805 Stage 4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Not assessed on this occasion. EVIDENCE: Derby Crescent (16) B54 S7540 Derby Crescent V228291 160805 Stage 4.doc Version 1.40 Page 20 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23
ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 3 x 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 x 4 3 x 3 4 3 Standard No 31 32 33 34 35 36 Score x x 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Derby Crescent (16) Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x x x B54 S7540 Derby Crescent V228291 160805 Stage 4.doc Version 1.40 Page 21 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. 1. Standard 34 Regulation 19 Requirement As CRB checks are no longer transferable, the newly recruited member of care staff for Derby Crescent must not be undertake direct care duties until POVA clearance has been received, although they may take part in induction training and general orientation. Timescale for action 16/10/05 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 2&6 Good Practice Recommendations The home should consider drawing up a simplified version of the resident’s assessment/care plan, in the way that it is explained to the resident by staff, and in a way that would more directly express the goals and aspirations of the resident. Derby Crescent (16) B54 S7540 Derby Crescent V228291 160805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection No.1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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