Inspection on 04/04/07 for Errol House

This inspection was carried out on 4th April 2007.

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 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Errol House 19/10/05

Errol House 05/05/05

Errol House 12/10/04

Errol House 01/09/04

Errol House 04/03/04

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 Errol House 155 High Street Boston Spa Leeds West Yorkshire LS23 6BH Lead Inspector Dawn Navesey Key Unannounced Inspection 4th April 2007 09:30 Errol House DS0000001448.V329085.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 Errol House DS0000001448.V329085.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. Errol House DS0000001448.V329085.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Errol House Address 155 High Street Boston Spa Leeds West Yorkshire LS23 6BH 01937 849392 01937 849725 b.dowling@wilfward.org.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) Wilf Ward Family Trust Mrs Barbara Dowling Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Errol House DS0000001448.V329085.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th October 2005 Brief Description of the Service: The Wilf Ward Family Trust owns Errol House. The Trust was established in 1986 and has been providing services for people with learning and physical disabilities since 1988. The Trust provides a wide range of services which includes: Residential Respite Care, Residential Care, Supported Living, Day Services and Community Based Services. The organisation has a Board of Seven Trustees with a range of experience and skills, which include Corporate Management, Legal, Property Surveying, Accountancy, Social Work and Nursing. Errol House aims to provide an atmosphere where everyone can feel they have a useful role to play with dignity. It is their intention that the person with a disability will experience as high a quality of life as possible whilst resident and that this will have a positive impact on their lives. There are five single rooms plus an annex with a bedroom, activity room and bathroom. This can be used as part of the house or as a separate unit. One of the five rooms is on the second floor of the home. The home does not have a lift. The home is staffed on a 24-hour basis. The service is respite care only which offers a flexible approach to enable people to have from an overnight stay of one or two weeks. The house has its own minibus. This enables service users to have outings and visits to various community activities and events. The manager is currently in the process of applying for a variation to the current registration category in order that young people aged 16-17 can receive a service from Errol House. The scale of charges at the home is £383.32 - £435.89 per week. Additional charges are made for hairdressing, leisure activities, magazines and toiletries. Errol House DS0000001448.V329085.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. In April 2006 the Commission for Social Care Inspection (CSCI) made some changes to the way in which care services are inspected. Care services are now judged against outcome groups. The inspection report is divided into separate sections for each outcome group for example Choice of Home. An overall judgement is made for each outcome group based on the findings of the inspection. The judgements reflect how well the service delivers outcomes to the people using the service. The judgements categories are “excellent”, “good”, “adequate” and “poor”. The judgements are recorded within the main body of this report. More detailed information about these changes is available on our website – www.csci.org.uk One inspector between 9-30am and 5-35pm carried out this unannounced inspection. The purpose of this inspection was to make sure the home was providing a good standard of care for the people living there. The people who stay at the home prefer the term guest; therefore this will be used throughout the report. The methods used at this inspection included looking at care records, observing working practices and talking with guests and staff. Information gained from a pre-inspection questionnaire and the home’s service history records were also used. Before the visit, comment cards were sent out to guests, relatives and visiting professionals to the home. One of these has been returned and this information has also been used in the preparation of this report. Feedback was given to the manager at the end of the visit. Thank you to everyone for the pre-inspection information, returned comment card and for the hospitality and assistance on the day of the visit. Requirements and recommendations made during this visit can be found at the end of the report. What the service does well: The home has a friendly, relaxed and welcoming atmosphere. The manager offers a flexible respite service to guests and tries to accommodate individual needs. Guests who are friends with each other are given their respite care together to make their stay more enjoyable. Staff have a good knowledge of guests’ needs and respond well to them. Staff interact well with guests and treat them as individuals. A relative who had Errol House DS0000001448.V329085.R01.S.doc Version 5.2 Page 6 completed a questionnaire at the home said, “I feel staff and I have a good relationship to discuss aspects of physical care” another said, “he enjoys his stays, staff know him and he is well cared for”. Staff make sure that guests have regular and varied activity that suits them as individuals. A relative who had completed a questionnaire at the home said, “…..really enjoys his stays and always comes home smiling”. Staff make sure that they offer a good menu to guests. Guests said they always got whatever food choices they wanted and could help themselves to snacks and drinks whenever they wanted. Guests receive a good standard of health care when they stay at the home. The staff team work well with the health professionals involved with guests. A visiting community nurse said the home has good open communication with her. She said she finds the service, “Very flexible and all staff have a consistent approach to guests”. Staff are well supported by the manager of the home. All staff spoken to said the manager was approachable and was a good leader. What has improved since the last inspection? What they could do better: Pre-admission assessments must show how the home have been involved in this process. This will make sure all guests’ needs are fully identified. Errol House DS0000001448.V329085.R01.S.doc Version 5.2 Page 7 All guests must have an up to date detailed care plan. This will ensure that they receive person centred support that meets their needs. All identified risks for guests must have a detailed action plan in place in order to minimise or prevent the risk. Controlled drugs must be stored, administered, disposed of and recorded according to the regulations and guidance issued by the Royal Pharmaceutical Society of Great Britain. This will ensure safe practice. Also, codes must be used on medication administration record (MAR) sheets so that it is clear why a medication has not been administered. The organisation must make sure that all staff receive child protection training in order to properly protect young people aged 16-17. They must also make sure that 80 of the staff team achieve or are working towards NVQ 3 in Caring for Children and Young People. This will make sure that staff are competent to meet the needs of guests aged 16-17. 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. Errol House DS0000001448.V329085.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Errol House DS0000001448.V329085.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 5 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. Guests who may use the service and their representatives have enough information needed to make a choice on whether the home will meet their needs. Pre-admission assessments are completed by parents or carers but do not always show how the home’s staff have been involved in them. This means that some care needs could be overlooked. EVIDENCE: The home has a comprehensive Statement of Purpose with good information about the service and facilities it aims to provide. The manager is in the process of updating this information to show how the needs of 16-17 year olds will be met. A letter was sent to the CSCI Registration Team in March 2007 with details of the information to be included. This is important, as it will give any prospective guests or their representatives the information they need on the service and assist them in making decisions about using the service. The home has in the past provided a service to 16-17 year old young people and had a variation for those individuals. The home currently provides a service to two young people aged 16 and 17. The manager said this had been Errol House DS0000001448.V329085.R01.S.doc Version 5.2 Page 10 done in error, not realising the previous variations were for named people. The current variation application will now cover all young people aged 16-17 who use the service. The manager said she will aim to keep the age range between 16 and 25 whenever a young person aged 16-17 is staying at the home. The home has a Service User Guide, which is given to each guest to the home. This information has been produced in an easy read format and has an accessible complaints procedure within it. Pre-admission assessments are carried out for all guests before they stay at the home. This involves visits to the home, overnight stays and the manager going to visit the prospective guest in their own home. Parents, carers and guests are involved in this process. They complete the assessment form and any instructions on medication and nutritional needs. The manager said that she would add information to this assessment and consider whether the home could meet their needs. There is no written evidence to show that this has been done, which means some needs could be overlooked. One guest had stayed at the home without this information having been completed by his family. This meant that staff did not have any written pre-admission assessment information on his care and support needs. Some information that had been put on another assessment was not relevant when the guest was in the home. This could cause confusion for staff when they are supporting guests with their care needs. This type of assessment is completed every year for guests, so that the home is made aware of any changing needs. Care management or social work assessments are also obtained prior to guests staying at the home. Guests and their representatives are aware of the cost of the service. Letters are sent out to them showing the cost for their stay. Copies of these are kept on their personal file. A relative who had returned a quality assurance questionnaire to the home said, “Errol House gives us a very good service.” A guest staying at the home said, “It’s great here”. Errol House DS0000001448.V329085.R01.S.doc Version 5.2 Page 11 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, 8 and 9 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Despite the gaps in care planning and risk assessment documentation, staff are, in the main, aware of guests’ individual needs. The lack of care plans and risk management plans could however, lead to guests’ needs not being properly met. Guests are involved in decisions about their lives when staying at the home. EVIDENCE: Some guests have care plans that have been developed from the assessment of their needs. However, some of these care plans have not been reviewed or evaluated for some time. Some of the plans are detailed and give specific information on care needs. Others are not. Instruction such as “change regularly” and “full assistance” do not give staff the detail on how care tasks are to be carried out. A good care plan should give clear and detailed information on how and when care is given, taking particular notice of the Errol House DS0000001448.V329085.R01.S.doc Version 5.2 Page 12 guests’ preferences and choices. There is some good, person centred information in some of the care plans. For example, one guest, who has no verbal communication, has a checklist of options for staff to go through when they appear to be unhappy. This is good practice. For others, the assessment information is being used as a plan of care. This information is not always detailed enough and no care plans have been drawn up from the information. This could lead to important care needs being overlooked. In a questionnaires returned to the home by parents and carers, comments included, “I feel staff and I have a good relationship to discuss aspects of physical care”, “I would like more attention to be paid to teeth cleaning”, “information about guests does not always seem to be passed on to staff” and “he enjoys his stays, staff know him and he is well cared for”. Risks to guests have been identified through the assessment process. However, there are no action plans in place to show how risk is managed or minimised. The manager is aware of the need to have this in place and has started some work on risk assessments for some guests. This must be done for all guests in order to ensure safety and make sure guest’s needs are properly met. Despite the lack of documentation on care planning and risk assessment, staff have good knowledge on guests’ needs. They were able to accurately describe the care needs and were observed to be giving care in the way it was written down in some guests care plans. Staff said they always read the assessment information on guests prior to them coming to stay at the home. They said they did this at each stay in order to refresh their knowledge. Some staff said they didn’t feel the assessment information gave enough information on guests’ needs and how best to meet them. One staff said one of the guests had “A fantastic pen picture which gives you lots of information.” The guest’s parents have completed this. Staff also said that they could do with more information on risks and triggers for guests who have behaviour that challenges others, and how best to manage these. The manager intends to look at the systems in place for care planning and risk assessment. She said she intends to train and involve staff in this process and undertake further training herself. The manager attends reviews for guests. These can be statutory reviews held at schools or reviews held by care managers or social workers. The organisation has a Service User Group that guests to Errol House can access if they wish. There is a poster in the home giving details about the group and a picture and contact details of a local representative. The manager said that parents, carers and guests are invited to the organisation’s Annual Errol House DS0000001448.V329085.R01.S.doc Version 5.2 Page 13 General Meeting too. Guests are involved in the home as much as they wish to be. One guest likes to be involved in the shopping and cleaning in the home. Other guests did not wish to do this and see their time at the home as a holiday time. One guest has also been involved in recruiting staff for the home. Guests were given choices throughout the day on what to do, what to eat and where to go. One guest said she was happy with everything she did. Another guest said, “It’s up to you what you do.” Errol House DS0000001448.V329085.R01.S.doc Version 5.2 Page 14 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): 11, 12, 13, 14, 15, 16 and 17 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The home offers opportunities to guests for their personal development in addition to a range of leisure activities. Guests are able to make choices about their lifestyle. They also benefit from a good, healthy and varied diet. EVIDENCE: Guests are involved in a variety of activity during their stay at the home. This ranges from walking in the local area, shopping, going to the pub, meals out, trips to the garden centre, bowling and snooker. The home has its own minibus but only a few staff who can drive it. The manager is currently in the process of trying to swap this large vehicle for two smaller vehicles. This will mean that more staff are able to drive them and will give guests more choice on activities. Guests are also involved in activity within the home. Guests said they enjoy artwork, letter writing, watching DVD’s, games consoles and takeaway evenings. Other guests, who do not use verbal communication, Errol House DS0000001448.V329085.R01.S.doc Version 5.2 Page 15 were seen to be involved in activity such as hand massaging and listening to music. Staff are aware of guests’ likes and dislikes. They said they get to know them as they are getting to know guests better each time they stay. Relatives who had returned a quality assurance questionnaire to the home said, “…..really enjoys his stays and always comes home smiling”, “…..loves going out”, “would like other activities than walking” and “would like to go out more”. Guests who attend day centres and school are supported to maintain this while staying at the home. One guest said he had revision to do while staying this time. Each guest has their own room and facilities to enable them to do schoolwork if necessary. The manager said that any guest under the age of 18 would not have access to videos, DVD’s or games console games for over 18’s. Staff said they would monitor this carefully and any guest bringing in any of these would be asked to view it in their own room only. The home also has a no alcohol policy in the home; therefore anyone under 18 would not have access to it. There is also a no smoking policy in place. The manager tries to make sure that guests who are friends can stay at the same time. Two guests who were at the home at the time of the visit said they really appreciated this. Another guest has a friend in a nearby village and is supported by the home to go and see him and also to invite him to the home. Guests are supported to keep in contact with their family while visiting the home. Some guests send letters and cards, others make phone calls to their parents or carers. Some of the guests have made contacts in the local community and are well known in the local shops and pubs. Staff were seen to support people with courtesy and thought for their dignity. Staff said it was important to make sure guests are as independent as possible as this makes them feel good. One staff said, “it’s about treating people as you would like to be treated yourself.” They said they are encouraged to get involved in household tasks and to make drinks and snacks for themselves. There is plenty of social interaction between the staff and guests. The atmosphere is relaxed. Menus appear to be well balanced and nutritious. A good variety of food is available and the staff make sure there is a good selection of fresh produce. Food choices are made each day from asking guests what they would like. The lunchtime meal was relaxed and made into a social occasion for guests. Guests who needed assistance were given this discreetly and in a dignified manner. The meal was a choice of pizza, potato wedges and beans, a sandwich and potato wedges or a salad. Guests said they always get anything they ask for and the food is good. Guests said they could help themselves at anytime to snacks in the fridge or cupboards and drinks. The manager said that a diverse range of diets can be catered for at the home. She said Hal al Errol House DS0000001448.V329085.R01.S.doc Version 5.2 Page 16 food is bought in when a guest who is Muslim is staying. Also vegetarian or pureed diets are provided. Errol House DS0000001448.V329085.R01.S.doc Version 5.2 Page 17 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 and 20 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Despite the lack of written documentation, personal and health care support is provided in a way that meets guests’ needs and makes sure their privacy and dignity is respected. Guests are, in the main, protected by the home’s policies and procedures for dealing with medicines. EVIDENCE: Staff supported guests with their personal care needs discreetly and in private. Guests are encouraged to take part in this as much as they can. Staff said they encourage guests to do what they can for themselves, such as choosing their clothes and washing or bathing themselves. Staff were seen to give personal care as it was written in the guest’s assessment information. A guest who needs to use a hoist and sling for moving and handling had a diagram in her file showing staff how to do this correctly. A guest who had an epileptic fit was supported well by staff and all the correct procedures were followed. It was clear that staff have a good knowledge of guests’ personal care needs. Errol House DS0000001448.V329085.R01.S.doc Version 5.2 Page 18 Staff said they would ask the manager or other staff if they were unsure on any tasks they needed to do for guests. This could allow for some needs to be overlooked. As mentioned in the Individual Needs and Choices section of this report, detailed, specific care plans need to be drawn up for all the needs of the guests to make sure their care needs are fully and properly met at all times. In discussion with the manager, she said that the home could be responsive to guests needs as they arise. She said that any specialist training is sought before the guest stays at the home, for example, training is given by community nurses and dieticians for any guests who are PEG fed (tube fed directly into the stomach). Also the organisation provides training from a registered nurse on administration of rectal medications. Staff confirmed they are not able to do this without having received the training. The home is registered with a local GP who provides a temporary service for guests when they are staying at the home. The staff document any contact with health professionals on contact sheets in the guests’ files. This information is then passed on to parents or carers. The home can be flexible in assisting with any assessments from community health professionals. On the day of the visit, a community nurse was in the home carrying out an observation assessment of one of the guests. Staff at the home assisted with this. The community nurse said that the home has good open communication with her. She said she finds the service, “Very flexible and all staff have a consistent approach to guests”. Any reports or assessments carried out by health professionals, for example, speech and language therapist, are kept on the guests’ files. These are usually obtained from parents or carers or from the manager’s attendance at review meetings. Since the last inspection, the manager has introduced a new nutritional assessment that parents or carers complete before guests’ visits. This information is then used to make sure likes, dislikes and any special dietary requirements are catered for. The manager said she would monitor the specific health issues for 16-17 year olds, for example, access to alcohol and smoking. Staff will not be able to smoke outside the home in sight of guests and as mentioned before there is a no alcohol policy in the home. Medication is well managed in the home. Parents or carers complete a medication information sheet prior to the guests’ visit and sign this to say their instructions to staff are correct. Staff then book the medication into the home and draw up a medication administration record (MAR) sheet. This is done in two’s to avoid errors. This is good practice. Staff also administer medication in two’s and sign the MAR sheets as such. Staff were seen to administer medication safely and individually to each guest. The MAR sheets have a code to be used if guests refuse medication or miss a medication. On checking the Errol House DS0000001448.V329085.R01.S.doc Version 5.2 Page 19 MAR sheets, staff have not always been using the codes which means it is difficult to know why a guest has not had a medication. Also, one of the guest’s medications was a controlled drug and must be stored in a metal cupboard in line with the guidance of the Royal Pharmaceutical Society and recorded in a controlled drugs register. The MAR sheets would also benefit from having a photograph of each guest, for identification purposes, on them. All staff receive accredited medication training. Errol House DS0000001448.V329085.R01.S.doc Version 5.2 Page 20 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 and 23 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Guests and their relatives have their views listened to, taken seriously and acted upon. Guests are in the main, protected from abuse by the home’s policies and procedures. EVIDENCE: The home has a comprehensive complaints procedure and an easy read procedure with pictures and symbols. A copy of this is kept in the service user guide which each guest has a copy of. One guest said, “I know how to file a complaint if I needed to”, another said, “I would talk to the staff and manager” and another said, “I have always been treated well here and had no occasion to complain”. Any complaints the home has received are documented in the complaints book and the investigation and outcome are documented in the guests’ files. Any recent complaints have been responded to promptly and dealt with properly. The home also keeps a book for thank you letters and compliments received about the service. All staff have now received training in the protection of vulnerable adults. The manager has completed a training course which means she can now deliver this training. Staff said they are aware of the different types of abuse Errol House DS0000001448.V329085.R01.S.doc Version 5.2 Page 21 and any signs that might alert them to it. They are also aware of their responsibilities in reporting any allegations or suspicions of abuse. The organisation has a comprehensive adult protection procedure in place. As the home has applied for a variation to its registration and is wishing to be registered for 16-17 year olds, all staff must have a POCA (Protection of Children Act) check. The manager has already started this process for all staff. Child protection training must also be provided for all staff. The manager is currently in the process of arranging this training with training providers from within the organisation. The manager has obtained a copy of the Leeds Child Protection Policy, which refers to the Leeds area child protection committee procedures and has developed a child protection and bullying policy. There are good systems in place to manage guests’ monies. Guests who hand money over to the home for safekeeping are protected by these systems. Money is checked in on arrival at the home and records of any expenditure are kept. Errol House DS0000001448.V329085.R01.S.doc Version 5.2 Page 22 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, 29 and 30 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The environment in the home is suitable for guests’ needs and is clean, safe and hygienic. Staff’s practices control the spread of infection. EVIDENCE: A tour of the building was carried out, accompanied by the manager. The home is spacious and well laid out, providing sufficient room for all guests. One part of the home has been separated to form an annexe that can accommodate guests who need support of a quieter environment. The annexe can also be opened up to the rest of the house for guests to socialise if they wish. Bedrooms have been decorated and furnished, to a high standard and soft furnishings and pictures give them a homely feel. Guests can bring personal items in with them if they want. All bedrooms are individual and provide space for any guests who may have schoolwork to do. One guest said he had revision to do during his stay at the home, in preparation for returning to school after the holidays. Errol House DS0000001448.V329085.R01.S.doc Version 5.2 Page 23 The home is clean, warm and fresh smelling throughout. Fixtures and fittings are of a good quality. Some specialist seating is provided in the lounge area for any guests who may need this. The dining room area has been personalised by guests during their stays; the walls display their artwork. The kitchen is well equipped and domestic in style. This encourages guests to help themselves to snacks and drinks. There is a bathroom and shower room which have both been attractively decorated. The bathroom has an adapted bath and shower trolley, giving guests a choice of this specialist equipment. There is a mobile hoist and guests bring their own hoist slings in with them for use with this hoist. The home has a large, well-kept garden which guests make good use of. Some upgrading of the garden has recently been done and the manager has plans for a summerhouse to be built to go with the new seating and table area. Clinical waste is properly managed and staff wear protective clothing when attending to service users’ personal care needs. Staff have received training in infection control and are able to say what infection control measures are in place. Disposable towels for hand drying are not available at all sinks. The manager said she would make sure they were placed there. This will ensure good hand washing and reduce the risk of cross infection. Errol House DS0000001448.V329085.R01.S.doc Version 5.2 Page 24 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, 33, 35 and 36 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Staff are, in the main, trained and competent to meet the needs of guests and are well supervised. Guests are protected by the home’s recruitment procedures. EVIDENCE: There are staff on duty throughout the day and night. There are usually three staff on the morning and afternoon shifts. At night there is one waking member of staff and one sleeping in, who can be called upon in emergency. There is also an out of hours on call manager. The manager is available through the day Monday to Friday and works one weekend each month to work alongside staff. Staffing for the guests who use the annexe is worked out on an individual basis according to guests’ needs. Staff said there was always enough staff on duty. Guests also said they felt there was always enough staff around. All staff are currently over the age of 21 and can therefore be left in charge of young people aged 16-17. Errol House DS0000001448.V329085.R01.S.doc Version 5.2 Page 25 Relatives who had returned a quality assurance questionnaire to the home said, “I usually find staff to be polite and courteous” and “Errol House staff give us a very good service”. The home keeps a pro-forma of staff information to show that recruitment is properly managed. The manager signs this to show it has been checked against the original records which are held at the organisation’s head office. Interviews are held; references and CRB (Criminal Record Bureau) checks are obtained before staff start work and checks are made to make sure staff are eligible for work. Staff’s training was mostly up to date. Records are kept of staff’s training and when their updates are due. The manager assesses this regularly to make sure training doesn’t get missed. A couple of training courses had not been recorded for some staff. The manager said she would look at her systems for recording staff’s training and make sure she obtained regular information from the organisation’s training department. Staff spoke highly of their training and the support they get from the manager. One said, “I am very happy with the training, they are keen and keep us up to date”. The manager is aware of the training updates that are needed and has nominated staff for training courses in the near future. The organisation has just sent out their annual training calendar to the home. This is comprehensive and covers many the training needs of the staff. Any specialist training is arranged by the home manager, for example, dementia, epilepsy, autism and PEG feeding. The manager is currently looking into training on supporting people who need assistance at meal times. She is working with a dietician on this. About 38 of the staff team have achieved an NVQ (National Vocational Qualification) in level 2 or above. Another three staff are to start on this once they have completed their LDAF, (Learning Disability Award Framework) which forms the basis of their induction training. The manager is also looking into how the NVQ 3 Caring for Children and Young People can be delivered by the organisation. It is hoped that a number of staff, including the manager and assistant manager will commence this training in the near future in order to meet the standard of 80 of the staff team having this qualification. All staff said they felt they have a good team and the manager is very supportive. Staff said they felt communication and teamwork within the home is good. Staff said they receive supervision from the manager every six weeks. Records also showed this. Regular staff meetings also take place. Errol House DS0000001448.V329085.R01.S.doc Version 5.2 Page 26 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, 38, 39 and 42 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. The home is well managed, the interests of the guests are seen as important to the manager and staff and are safeguarded and respected at all times. EVIDENCE: The home has an experienced manager who has completed the NVQ level 4 and Registered Managers Award. She has good organisational skills and can be flexible to meet the diverse needs of the guests. She has also completed some leadership training provided by the organisation. Staff said she was very approachable and spoke highly of the support they receive from her. A relative who returned a CSCI survey said they didn’t think the home needed to Errol House DS0000001448.V329085.R01.S.doc Version 5.2 Page 27 improve and that the home does a good job. The manager is aware of her responsibilities with regard to records that must be kept for young people aged 16-17. The area manager carries out monthly regulation 26 visits at the home. A report of these visits is made showing details of any action to be taken to improve the service. In addition to this, the organisation carries out a quality assurance programme. This also includes gaining the views and opinions of guests and relatives through the use of questionnaires. The results of the questionnaire surveys are then sent out to guests and relatives, showing what action has been taken in response to their comments. An example of something that has improved recently is that the manager has introduced a new system for laundry sorting to try and ensure guests’ items of clothing do not get washed wrongly. Staff carry out weekly or monthly health and safety checks around the home such as fire alarms, emergency lighting and water temperatures. Maintenance records are well kept. Environmental risk assessments are completed and were up to date. Accident or incident reports are completed, however there is no space on the form to record any follow up action taken after any accidents or injuries. The home has a comprehensive range of policies and procedures in place, which promote and protect service users’ health and safety. Gas safety and electrical wiring certificates are up to date. Errol House DS0000001448.V329085.R01.S.doc Version 5.2 Page 28 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 3 2 2 3 3 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 2 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 4 3 X X 3 X Errol House DS0000001448.V329085.R01.S.doc Version 5.2 Page 29 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 YA2 Regulation 14.1 Requirement The manager must make sure that pre-admission assessments show how the home have been involved in this process. This will make sure all guests’ needs are fully identified. The manager must make sure that all guests using the service have an up to date detailed care plan. This will ensure that they receive person centred support that meets their needs. The manager must make sure that all identified risks for guests have a detailed action plan in place in order to minimise or prevent the risk. The manager must make sure that controlled drugs are stored, administered, disposed of and recorded according to the regulations and guidance issued by the Royal Pharmaceutical Society of Great Britain. This will ensure safe practice. The manager must also make Errol House DS0000001448.V329085.R01.S.doc Version 5.2 Page 30 Timescale for action 30/06/07 2. YA6 15.1 30/06/07 3. YA9 13.4 30/06/07 4. YA20 13.2 30/04/07 sure that codes are used on medication administration record (MAR) sheets so that it is clear why a medication has not been administered. 5. YA23 13.6 The organisation must make sure that all staff receive child protection training in order to properly protect young people aged 16-17. The organisation must make sure that 80 of the staff team achieve or are working towards NVQ 3 in Caring for Children and Young People. This will make sure that staff are competent to meet the needs of guests aged 16-17. 30/08/07 6. YA32 18.1 30/08/07 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 YA20 Good Practice Recommendations The manager should consider the use of photographs of guests on the MAR sheets in order that they can be properly identified when medication is administered. Errol House DS0000001448.V329085.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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