Inspection on 04/10/06 for Doublegates Green (47)

This inspection was carried out on 4th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Doublegates Green (47) 01/10/08

Doublegates Green (47) 24/01/06

Doublegates Green (47) 26/07/05

Doublegates Green (47) 17/02/05

Doublegates Green (47) 01/09/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Doublegates Green (47) 47 Doublegates Green Ripon North Yorkshire HG4 2TS Lead Inspector Terry Downey Key Unannounced Inspection 4th October 2006 09:30 Doublegates Green (47) DS0000007893.V315689.R01.S.doc Version 5.2 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.V315689.R01.S.doc Version 5.2 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.V315689.R01.S.doc Version 5.2 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 Mrs Stephanie Edith Thornton Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Doublegates Green (47) DS0000007893.V315689.R01.S.doc Version 5.2 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. 24th January 2006 Date of last inspection Brief Description of the Service: 47 Doublegates 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 and the registered manager is Mrs Stephanie Thornton. On the 4th October the fees for the home were £1378.95. Doublegates Green (47) DS0000007893.V315689.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection consisted of a review of the information held on the homes file since the previous inspection, information submitted by the home in the Pre Inspection Questionnaire, and a 5 hour unannounced site visit to the home on 4th October 2006. At the time of the site visit the manager Mrs S Thornton was available, with two members of staff, and one service user. They all assisted with the inspection, and were very helpful. It was difficult to communicate with the resident but care staff assisted, which was very helpful, but some of the comments are also based on observation. The site visit also included discussion with the staff, a check on the recommendations from the previous inspection, a tour of the premises and a check on the records kept by the home. Survey forms were completed by two people who know the home well, and both were very complimentary about the home, the staff and the care provided. The inspection showed that the residents were well cared for in a clean, well maintained, home. There is a well trained and committed staff team, and a manager, who work hard to improve the residents’ quality of life. What the service does well: The residents live in a clean, well maintained home. Staff are kind and helpful and make an effort to provide the service the residents’ want. Residents are able to make choices in many areas of their lives. Examples included rising and retiring times, activities, clothes, and food. This ensures that they maintain some control. The residents are able to access the primary health care team and other professionals ensuring that their health care needs are met. A good choice of well prepared food, and drinks are available. This ensures that they receive a varied and nutritious diet. The home gets the views of the residents and others, about the service provided so as to make changes that improve the residents’ quality of life. The staff are provided with comprehensive training to improve their knowledge and skills. This promotes best practice and ensures that residents receive a good quality service. Staff are recruited in a way that seeks to make sure that only suitable people are employed and ensuring the safety and protection of the residents Doublegates Green (47) DS0000007893.V315689.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Doublegates Green (47) DS0000007893.V315689.R01.S.doc Version 5.2 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.V315689.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and their representatives have the information required to choose a home which meets their needs. EVIDENCE: There haven’t been any recent admissions to the home requiring a full pre admission assessment. Two service users files examined showed that the needs of people who use the service are regularly reviewed and that every effort is made to ensure that service users are involved in determining how their needs and aspirations will be met. Written admission documentation was good and included a copy of the care management assessment. There was a lot of information available about the home to give to prospective residents, which included the Service User Guide, and an information pack with photographs. Very good information was available to staff to ensure they could meet the social, emotional and care needs of new residents. Doublegates Green (47) DS0000007893.V315689.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Good care planning and risk assessments ensure that the lifestyle needs of the residents are met. EVIDENCE: The care plans have improved and have been developed using person centred planning principles. They contain the information required to help the staff meet the needs of the individual resident and are set out in an easy to read and understand format. No video evidence is used and the manager considers that this idea has been shelved. Two residents were casetracked and this indicated that their personal care needs were met appropriately. Some efforts had been made to involve residents in their care plan, but it would be difficult to verify their understanding of it. Doublegates Green (47) DS0000007893.V315689.R01.S.doc Version 5.2 Page 10 Staff had a very good understanding of the needs of residents and were knowledgeable about the contents of their care plans, and risk assessments. They were seen to be patient and kind when interacting with the resident, and clearly provided individual care. Surveys confirmed the staff commitment to providing quality care. The resident was unable to communicate verbally but with the help of staff expressed levels of satisfaction with the home and the care. Doublegates Green (47) DS0000007893.V315689.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. The social and recreational activities meet the residents’ needs and they eat a healthy and varied diet. EVIDENCE: Each resident has an individual timetable designed to ensure that they are given the opportunity to take part in a variety of activities both within the home and the community, and staff are available to support them. The staff are constantly looking for new activities that will interest the residents and provide further stimulation and development to enable them to live an ordinary and meaningful life. Four residents were at day services during the inspection and information in the home showed very good liaison between the home and the day service to ensure continuity and development of skills. Doublegates Green (47) DS0000007893.V315689.R01.S.doc Version 5.2 Page 12 There was a lot of evidence in the daily records relevant to the activities they enjoyed and participated in, which demonstrates the homes commitment to ensure that the residents are able to achieve their goals. The home has had contact with an Occupational Therapist regarding appropriate activities and proposes to send a member of staff on a course to develop craft skills. There was evidence that the disability equipment required has been obtained and environmental adaptations made to meet the needs of the service users. Menus were varied and nutritionally balanced. Mealtimes were said to be relaxed and social events. Two residents are involved each week to choose the menus for the following week. This is done with staff and the pictures from various cookery books to enable residents to make the choices. Doublegates Green (47) DS0000007893.V315689.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The residents are well supported and the medication procedures ensure that their health care needs are met. EVIDENCE: There was a lot of evidence to demonstrate good liaison with the healthcare services and this clearly benefits the residents and gives the staff the support and guidance they require to meet the complex needs of the residents. Specialist health and dietary requirements are recorded and provide an overview of each resident’s health needs. They also act as an indicator of the change in their healthcare needs. Staff understand the principles of giving personal support and are responsive to the individual requirements of each resident. Attention is given to ensuring privacy and dignity when delivering personal care and staff are sensitive to the changing needs of residents. Doublegates Green (47) DS0000007893.V315689.R01.S.doc Version 5.2 Page 14 The home’s medication procedure was observed and staff were able to explain the individual procedure for each resident. Medication was safely stored and records were well maintained and up to date. Information for each resident was clearly marked and contained information about their individual medicines. None of the residents self medicate. Doublegates Green (47) DS0000007893.V315689.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected from abuse because staff are trained, work closely together and are well managed EVIDENCE: The complaints procedure is available to all the residents in varying formats and is easily available. Because of the residents’ complex needs the staff explained that they have to be alert to subtle changes in behaviour and check out the causes to establish if a resident is not happy. Staff had a good understanding of service users’ rights as citizens. The evidence indicated that residents are protected from abuse, the staff had done a training course in adult abuse and they were aware of the procedure. This training is regularly reinforced at staff meetings. The recruitment procedure is good and ensures that only suitable people are employed in the home. Doublegates Green (47) DS0000007893.V315689.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home enables residents to live in a safe, well maintained and comfortable environment EVIDENCE: The home was clean, well decorated and furnished and very appropriate to the needs of the residents. Residents had all personalised their bedrooms and some had purchased some of their own furniture. A new floor covering was being laid in one bedroom and this was of good quality, attractive and also wheelchair friendly. New furnishings had also been provided in the lounge and the area was comfortable and welcoming. There was very good access to the garden which was very tidy and well maintained. Doublegates Green (47) DS0000007893.V315689.R01.S.doc Version 5.2 Page 17 There was a programme of routine maintenance and decoration for the home, and a good infection control policy that ensures that it is always a safe and comfortable place to live. Specialist equipment was provided in the home and all was of good quality and serviced regularly and met the needs of the residents. Doublegates Green (47) DS0000007893.V315689.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents benefit from a well trained and committed staff team. EVIDENCE: The rota showed that there were sufficient staff on duty and this was confirmed during the inspection. Staff were observed assisting the resident and also having time to spend talking and caring for him. It was clear observing the interactions between the staff and the resident that there was a mutual respect and staff tried to help the resident, and involve him in his care rather than do it for him. Three staff files were inspected but not all the records were kept in the home some were in the main office in York. The full records must be kept in the home and available for inspection. It was however clear that there was a robust recruitment procedure, although a recommendation was made that care should be taken to ensure that references are obtained from appropriate sources. One member of staff had given her GP as a referee when a previous care agency she had worked for would have been more appropriate. Doublegates Green (47) DS0000007893.V315689.R01.S.doc Version 5.2 Page 19 A lot of Agency staff have been employed in the home during the past 6 months and the manager explained that it had been very difficult to recruit suitable staff. It is not ideal for the residents in this home to have staff who do not know them well, but the manager said that she had tried to ensure that the Agency sent staff that were known to the residents. The home has recently appointed three new members of staff and this will provide more stability for the residents. The staff spoken to were very encouraged by the appointments and were happy to have a settled team again. A good induction and training programme is in place to ensure that staff are equipped to carry out their jobs well. This training includes the protection of vulnerable adults as well as the mandatory training to meet service users basic needs, such as manual handling and health and safety. Specific training relevant to the needs of the residents was also provided and one of the carers on duty was the home’s representative on the specialist communication workshop. Staff were clear about their role and knew what was expected from them. They said they worked well as a team and that the manager was very good, approachable, and supportive. Doublegates Green (47) DS0000007893.V315689.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good management arrangements ensure that the home is run to meet the needs of the residents EVIDENCE: The manager was available on the day of the inspection and was well organised and helpful. She has the required qualifications and experience and is competent to run the home. There were two staff members on duty and they were aware of their responsibilities. Staff said that they were kept informed of relevant management issues, and they considered the manager to be very approachable and supportive. Survey forms mentioned good communication, good organisation, and satisfaction with the care being provided. Staff considered that they were well supported by the management and that they worked well together as a team. Staff had regular supervision, which was clearly recorded. Doublegates Green (47) DS0000007893.V315689.R01.S.doc Version 5.2 Page 21 The quality assurance systems in place are very effective and the manager is proactive in addressing quality issues within the home. The views of service users, staff members, relatives and professionals visiting the home are sought on how the service can be improved. The home has a Health and Safety policy and regular checks and staff training ensure that the home is a safe place to live and work. A senior manager visits the home monthly and talks to residents and staff, and completes a quality audit. Doublegates Green (47) DS0000007893.V315689.R01.S.doc Version 5.2 Page 22 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 3 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 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Doublegates Green (47) DS0000007893.V315689.R01.S.doc Version 5.2 Page 23 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 YA34 Regulation 19 Sched 4 Requirement All records relating to the recruitment of staff must be kept in the home. Timescale for action 31/10/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA34 Good Practice Recommendations If staff have previously worked in a care situation references should be obtained from that setting. 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