Inspection on 17/04/07 for Fell Close (4)

This inspection was carried out on 17th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Fell Close (4) 10/05/06

Fell Close (4) 11/10/05

Fell Close (4) 28/09/04

Fell Close (4) 13/04/04

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 Fell Close (4) 4 Fell Close Scarborough North Yorkshire YO12 6ST Lead Inspector Pauline O`Rourke Key Unannounced Inspection 17TH April 2007 10:30 DS0000007835.V333215.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 DS0000007835.V333215.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. DS0000007835.V333215.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fell Close (4) Address 4 Fell Close Scarborough North Yorkshire YO12 6ST 01751 474740 01723 364310 fellclose@wilfward.org.uk www.wilfward.org.uk The Wilf Ward Family Trust 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) Mr Lionel Aubrey Bede Linley Care Home 4 Category(ies) of Learning disability (4) registration, with number of places DS0000007835.V333215.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered for 4 residents with Learning Disabilities some or all of whom may have Physical Disabilities 10th May 2006 Date of last inspection Brief Description of the Service: Fell Close is registered to provide long-term accommodation to 4 younger adults who have a learning disability and/or a physical disability. Lionel Linley is the Registered Manager and the local health authority owns it with care provided by the Wilf Ward Family Trust a registered charity. Fell Close is a dormer style bungalow situated in a residential district of Scarborough. It is conveniently located for the main community amenities such as shops, churches and the public transport network. A former private dwelling it provides accommodation for a maximum of four residents. There are gardens to the front and rear accessible to residents. Dedicated car parking is available to the front of the property. Three of the four bedrooms are located on the ground floor. All bedrooms are for single occupancy. No bedroom has an en-suite facility although one of the rooms can directly access the bathing facilities. There are a number of communal areas including sitting and dining rooms. Information about the service is available on request and it can be provided in a variety of formats. On the 17th April 2007 the cost to the residents was between £108.95 and £143.60 per week, this is determined through a financial assessment. This covers the accommodation costs, the local health authority and social services departments meet the cost of the personal care. They and their carer are informed of this cost prior to their admission. DS0000007835.V333215.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is based on information gathered from the provider, service users and relatives. A site visit to the home was carried out on 17th April 2007. It focused on the key standards. An inspection of some of the premises was undertaken. A number of records were also examined. Discussions were held with the three members of staff on duty. The manager in the form of a pre-inspection questionnaire supplied information and surveys were sent out to relatives. Feedback was received from 4 relatives. Time was also spent observing the interactions between the staff and residents. What the service does well: Anyone moving in to Fell Close would have met the staff and other residents before they moved. They would be able to decide that they wanted to live there with the help of their families and/or the staff. The residents all have a care plan, this gives the staff detailed information on how they like to be helped when they are doing anything. The staff look at these plans every month to make sure they are right for the resident. The residents can see a doctor or nurse if they need to and are encouraged to make their own decisions every day. The current residents all have some difficulties in making the staff understand them but the staff are patient and take time to make sure they get their message across. The residents can go on outings and enjoy games, music and films at home and the staff make sure that they do the things they enjoy. Several of the residents enjoy going to day centres with support from the staff. The staff are always trying to arrange events based on what the residents like to do either as individuals or as a group. The staff keep families informed of what is going on and feedback from the families was very positive: It simply needs to maintain its present high standards. We live so far away we rarely visit but when we do we are always impressed by improvements made to provide better care. I am always invited to meetings, clinic, hospital appointments if I can’t attend staff inform me of the outcome. I am allowed to visit my daughter any time. The home is continually improving to ensure the clients get the best possible care. There is enough staff on duty and if anybody needs extra help then the manger will ask for more staff to be provided. Currently two of the residents DS0000007835.V333215.R01.S.doc Version 5.2 Page 6 need 2 staff to help them. The staff have plenty of training and supervision so that they have the skills to help the residents. The manager is approachable, and knows the residents very well. The Wilf Ward Family Trust and an assistant manager support him. 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. DS0000007835.V333215.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 DS0000007835.V333215.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. People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who decide to use this service have the information needed to ensure their needs can be met. EVIDENCE: There have been no admissions to the home since 1990, but a discussion was held with the staff how new admissions would take place. The Wilf Ward Family Trust has a proven admissions policy and this ensures that a multi disciplinary assessment is undertaken prior to any admission. The home usually receives an assessment and makes as initial decision about suitability before the person who requires support and their family are contacted. The process then becomes a series of visits and short stays to determine whether the placement is suitable. A trial period is then planned and the length of this trial is dependent on the needs of the individual. As part of the assessment process the wishes of the established residents are taken in to account. The case files seen of current residents contained comprehensive assessments and evidence of regular reviews of the care plans. DS0000007835.V333215.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 and 9. People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service are able to make decisions on a day-to-day basis about their lives and this allows them to remain as independent as possible. EVIDENCE: All the residents in the home have a comprehensive care plan and there is evidence to show these are reviewed when necessary. Whilst no feedback was received from other professionals there was evidence is the residents file to show that they have provided extra assessments and have been included in the review process where necessary. The staff spoken with were knowledgeable about the care plans and they involve the residents and their relatives, where appropriate, in all reviews. One relative said that they are always invited to the reviews and attend when they can. DS0000007835.V333215.R01.S.doc Version 5.2 Page 10 The residents were seen during the visit making their own choices about what they wanted staff to do for them and with them. The care plans contained detailed information about how the residents could communicate their wishes to the staff and they were seen communicating positively with staff during the visit. A daily diary and a portfolio of activities are maintained for each resident that informs the staff and the review process. All of the residents had up to date risk assessments in place in relation to their individual needs and their differing daily living abilities. These documents are reviewed regularly incorporating specialist assistance when necessary. The staff manage the variety of needs very well and endeavour to make all downstairs areas of the home, garden and community accessible to all. DS0000007835.V333215.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 and 17. People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are encouraged to make decisions about their daily life and the staff provide appropriate support and encouragement for them to remain independent. EVIDENCE: Each resident has an activity folder outlining a personal profile of likes and dislikes. A daily calendar is kept showing what the residents do each day. The activities available are pertinent to the individual. The activity files show that the ability of the residents to take part in a lot of external activities has changed along with their changing needs. The key workers know the likes and dislikes of the residents and activities planned are based on this knowledge. Current staffing levels and availability of transport means that residents and staff can work on a one-to-one basis. DS0000007835.V333215.R01.S.doc Version 5.2 Page 12 There is a visitor’s policy in place and this is included in the information available to potential residents and their families. One resident sees their father twice a week and the home provides a male carer to accompany them on outings. This is at his request so that he has male company to talk to during his visit. Questionnaires received from relatives indicated that they are kept informed of any changes to their situation. During the site visit it was clear that the residents could choose their own daily routines and their preferences were identified in their care plans. Whilst not all of the residents communicate through speech their communication with the staff was clear. They have a varied diet and where necessary advice has been sought from the dietician and speech therapist to ensure that their needs are met. On the day of the site visit two of the residents went out for lunch with staff. The menus are planned around the likes and dislikes of the residents. They try new foods and if the residents enjoy them then they are introduced in the main menu. DS0000007835.V333215.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 and 20. People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents’ health and personal care needs are met on an individual basis. The staff employ the principles of respect, dignity and privacy in all interactions with the residents. EVIDENCE: Residents care plans seen were pertinent to the individual concerned. They are detailed and evidence was available to show they are reviewed on a regular basis. One family indicated that they are always invited to the review and staff do ask if they are meeting their relatives needs. They also indicated that the staff provide good care and met the medical needs of the residents. One relative said ‘My brother has a happy and full life and they give excellent medical care.’ Staff were observed treating the residents with respect and endeavoured to maintain their dignity at all times. DS0000007835.V333215.R01.S.doc Version 5.2 Page 14 The residents’ files also contained detailed health information and contained evidence that they access specialist health care when necessary. The medication is stored in a locked cupboard. Medication is dispensed a NOMAD system although some of the medication that could not be administered from this system was being set up on a weekly basis for staff to administer. An immediate requirement was made:’ To cease the removal of medication from its original packaging and placing in to a box for dispensing over the week. Medication must be dispensed from original containers. This advice follows the guidelines as issued by the Royal Pharmaceutical Society of Great Britain in the document ‘The administration and Control of Medicines in Care Homes and Children’s Services’ 6.2.3 Medicine should never be removed from the original container in which a pharmacist or dispensing doctor supplied it until the time of administration. Medication should never be secondary dispensed for someone else to administer to the service user at a later time or date. (Section 6.2.3) Care Home Regulations 2001; Regulation 13 (2) The Registered Manager contacted the Inspector on 18th April 2007 to confirm that the practice of decanting medication had stopped immediately after the inspection and staff had been informed of the new procedure. The records seen were up to date and accurate. There is a stock control record and two members of staff sign all medication records. All staff have completed a learning distance course in The Safe Handling of Medicines, they also cover the topic on the LDAF Nation Vocational Qualification level 2 training. The Wilf Ward Family Trust has also provided supplement training for the staff to ensure they continue to manage the medication appropriately. DS0000007835.V333215.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 and 23. People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and their representatives are able to express their concerns through the complaints procedure and are protected from abuse, so their rights are protected EVIDENCE: There is a robust complaints procedure in place, a copy of which is available in the residents file. They are in large print and picture format. The Wilf Ward Family Trust also has a resident Group, which meets to discuss how residents might like to improve the services available. A representative is named and contact details are displayed in the hallway of the home. The Wilf Ward Family Trust or the Commission has received no complaints. An Adult Protection protocol is in place and staff were aware of their responsibilities under this procedure. Staff have received training through Nation Vocational Qualification and their induction and foundation training. The manager also reinforces the training in the monthly staff meetings. DS0000007835.V333215.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 and 30. People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents live in a well-maintained, clean property that allows them to access all areas, helping to promote their independence. EVIDENCE: The home is a 4 bed-roomed house and is clean, comfortable and well maintained. The residents each have their own rooms and the rooms seen during the visit were personalised and reflected the interests and personality of the occupant. One resident had a ceiling hoist system that allowed easy access to the bathroom. One of the bedrooms is upstairs and this room is currently vacant as none of the residents are ambulant enough to access it. All of the residents are able to access all downstairs areas of the home and there is appropriate equipment available to ensure their needs can be met. DS0000007835.V333215.R01.S.doc Version 5.2 Page 17 The staff were aware of the infection control policy and were seen to be implementing this during the visit. Staff also encouraged a resident to wash their hands prior to entering the kitchen. DS0000007835.V333215.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 and 35. People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents are supported by well-trained staff in sufficient numbers that they are seen as individuals and the care provided id pertinent to their needs. EVIDENCE: The Wilf Ward Family Trust has a well established and robust recruitment process and all necessary checks have been carried out prior to anyone being deployed in the home. The rota’s received prior to the inspection indicated that the home is staffed appropriately. During the site visit the residents plans provided the staff with clear instruction including where two members of staff were required for one resident. The staff spoken with said that they felt the staffing was adequate and that they had time to spend with the residents on a one-to-one basis. Each resident has five key workers so that there is always someone on duty who knows the resident very well. The whole routine during the visit was relaxed and staff were seen interacting positively with the residents DS0000007835.V333215.R01.S.doc Version 5.2 Page 19 The pre-inspection questionnaire showed that the staff have received training in Safe Handling of medicines, fire training, first aid, food hygiene and use of wheelchairs in a mini bus. Future planned training includes epilepsy and rectal medication and dementia training. Staff spoken with said that they had access to training on a regular basis. Staff have monthly supervision where they are expected to set their own learning goals and identify training needs. Team meetings are an opportunity to ensure everyone is aware of any changes to the residents’ plans and to put forward ideas for future activity plans. One of the relatives said ‘All the staff are very friendly and always make us very welcome when we visit. DS0000007835.V333215.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 and 42. People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents live in a well managed home where the administration of the home is based on openness and respect. This allows the residents to retain their individuality and independence. EVIDENCE: The Registered Manager was not available during the site visit. The staff spoken with said that the Registered Manager and the deputy manager were always available if they had any concerns. They operate an open door policy the staff also said that he asks for their ideas and opinions on issues and listens to them although cannot always incorporate their ideas in to the home. DS0000007835.V333215.R01.S.doc Version 5.2 Page 21 The Trust had a sound Quality Assurance Monitoring procedure that ‘linked’ all levels of the organisation. The members of staff as well as the manager of the home had to submit monthly ‘objectives or aims’ to the their line management to ensure that progress and achievement was adequately monitored. This process also incorporated elements of equality and diversity with regards to meeting the needs of the service users. The records available in the home and the Trust’s headquarters confirmed this. Overall the relatives of the residents were very complementary regarding the service provided by the home and in particular the attitude and helpfulness of the staff. The pre-inspection questionnaire provided all the dates for the testing of equipment in the home. Those checked were accurate. There were risk assessments in place and these covered the environment as well as the residents. The fire procedures were well highlighted and all the relevant testing was carried out in accordance with guidance. Accidents are recorded and stored in the resident’s own file, this information is used to help determine the need for extra support or a change in the care plan. All staff have health and safety training covering first aid, manual handling, food hygiene, and infection control. DS0000007835.V333215.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 4 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 4 23 4 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 4 33 X 34 4 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 2 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 4 X 4 X 4 X X 4 X DS0000007835.V333215.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 YA20 Regulation 13(2) Requirement To cease the removal of medication from its original packaging and placing in to a box for dispensing over the week. Medication must be dispensed from original containers. This advice follows the guidelines as issued by the Royal Pharmaceutical Society of Great Britain in the document ‘The administration and Control of Medicines in Care Homes and Children’s Services’ Timescale for action 17/04/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations DS0000007835.V333215.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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. Extracts may not be used or reproduced without the express permission of CSCI DS0000007835.V333215.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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