CARE HOME ADULTS 18-65
Doublegates Green (47) 47 Doublegates Green Ripon North Yorkshire HG4 2TS Lead Inspector
Terry Downey. Unannounced Inspection 24th January 2006 10:00 Doublegates Green (47) DS0000007893.V279920.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 Doublegates Green (47) DS0000007893.V279920.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. Doublegates Green (47) DS0000007893.V279920.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Doublegates Green (47) Address 47 Doublegates Green Ripon North Yorkshire HG4 2TS 01765 607381 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) None United Response Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Doublegates Green (47) DS0000007893.V279920.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Registered for 5 Service Users with Learning Disabilities some or all of whom may also have Physical Disabilities. 26th July 2005 Date of last inspection Brief Description of the Service: 47 Doublegate Green is registered to provide residential, personal and social care for 5 people under 65 years of age who have learning disabilities and may also have physical disabilities. The home is a purpose built bungalow with five single bedrooms. It is situated close to Ripon City centre and provides good access to the citys services and amenities. The home is part of the United Response organisation. The responsible individual is Ms Naomi Atkinson. At present the home does not have a registered manager but the acting manager Mrs Stephanie Thornton will be applying for registration. Doublegates Green (47) DS0000007893.V279920.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 carried out as part of the inspection process on 24h January 2006. The residents and staff were all out at various day activities but the manager, Mrs Stephanie Thornton, was available. Most of the key standards had been met at the previous inspection so this inspection concentrated on the requirement and three recommendations made following that inspection, and a discussion with the manager about the home It was clear that the home was well organised and that the residents are encouraged and supported to take control of their lives. The home offers a comfortable and accessible place for the residents to live and plans are being considered to extend the lounge which will provide more space for wheelchair access. Some concerns were expressed about the plans for care plan training of staff and further consultation is taking place on this. What the service does well: What has improved since the last inspection?
The Adult Protection Procedure is reinforced with staff regularly which ensures that staff are aware of the procedure and the residents are protected from abuse. The recording of information regarding residents at staff meetings has been improved to meet the guidelines of confidentiality and data protection. The manager considered that the training of staff had helped the staff to look at providing support rather than care for the residents so making them more independent. The manager also felt that the staff had concentrated on ensuring that the philosophy of the home was about instilling respect and treating people as Doublegates Green (47) DS0000007893.V279920.R01.S.doc Version 5.1 Page 6 individuals and equals. She felt that this had helped to focus on the things residents could do rather than being unable to do. 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. Doublegates Green (47) DS0000007893.V279920.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 Doublegates Green (47) DS0000007893.V279920.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): Not inspected at this visit. EVIDENCE: Doublegates Green (47) DS0000007893.V279920.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 support plans are good but help is required to ensure that all staff can achieve the consistency of care required. EVIDENCE: Care plans identify the residents’ personal and social care needs. Some plans were not up to date and some were being written in the first person and not being signed by the writer who clearly was not the resident. A recommendation about this was made at the previous inspection but the home consider that they wish to consider the practice. Risk assessments are included in the care plans so that both staff and residents are aware of the support required. The manager explained that she is trying to encourage the staff to look more at the things residents can do for themselves. She felt that they all read the support plans slightly differently and so was proposing to put them onto DVD. This would mean taking videos of the ways the residents are cared for and she considered that the visual training would be easier for the staff to follow and
Doublegates Green (47) DS0000007893.V279920.R01.S.doc Version 5.1 Page 10 therefore provide a greater consistency of care. The manager said that necessary approvals had been obtained but in discussion she was very unclear about which care practices would be filmed and the inspector considered that further consideration must be given to this practice. The manager agreed and no action will be taken until the situation is resolved. Doublegates Green (47) DS0000007893.V279920.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): 12,13,15,16. Residents enjoy a wide range of activities both inside and out of the home and are part of the local community. EVIDENCE: Each resident had an individual programme aimed at developing their skills and staff are available to support them. This was demonstrated on the day of the inspection when all the residents and staff were out of the home involved in a range of individual activities. Doublegates Green (47) DS0000007893.V279920.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): Not inspected at this visit EVIDENCE: Doublegates Green (47) DS0000007893.V279920.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): 22,23. Residents are protected from abuse, neglect, and self harm. EVIDENCE: The protection of vulnerable adults procedure is available in the home and training of staff has been recorded. Since the previous inspection further staff training has taken place and the procedure is on the staff agenda and reinforced quarterly. There are no concerns about adult protection in the home. All the residents go out regularly and meet with many people who could be advocates for them if they were not being cared for properly. The home has a robust recruitment procedure to help to protect residents. Doublegates Green (47) DS0000007893.V279920.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): 24,30. The residents live in a safe, comfortable and clean environment, which meets their needs. EVIDENCE: The home was clean and well maintained and provided comfortable living accommodation for the residents. The manager explained that plans are being considered to extend the lounge to provide more wheelchair accessible space. All residents had personalised their rooms to make them homely. The space provided was flexible enough to cater for a range of activities. Doublegates Green (47) DS0000007893.V279920.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): 32,35,36. Staff are available to meet the needs of the residents. EVIDENCE: Two staff are leaving the team but appointments are being made and the manager was very aware of the need to provide time and training for new staff to get to know the residents. The home has a core of well trained and settled staff. Some shifts are covered by agency staff but the manager tries to ensure that the same people are used to provide consistency. Doublegates Green (47) DS0000007893.V279920.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): 39,42. The health, safety and welfare of the residents is promoted at all times. EVIDENCE: The residents’ needs take priority in the home and the manager and staff maintain the records to safeguard their best interests. Health and safety is a high priority in the home and regular checks and audits ensure that it is a safe place to live and work. Doublegates Green (47) DS0000007893.V279920.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 X 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 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 X 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 1 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X X X X 3 X X 3 X Doublegates Green (47) DS0000007893.V279920.R01.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA6 Regulation 12 Requirement The home must not video the residents until confirmation has been submitted to the Commission that the practice follows the United Response protocol Timescale for action 24/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Doublegates Green (47) DS0000007893.V279920.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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