Inspection on 10/01/06 for First Row, 31

This inspection was carried out on 10th January 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

First Row, 31 20/05/09

First Row, 31 05/06/07

First Row, 31 08/06/06

First Row, 31 19/03/05

First Row, 31 18/01/05

First Row, 31 15/11/04

First Row, 31 16/03/04

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

CARE HOME ADULTS 18-65 First Row, 31 31 First Row Linton Morpeth Northumberland NE61 5SH Lead Inspector Carole McKay Announced Inspection 10th January 2006 09:30 First Row, 31 DS0000000561.V261638.R01.S.doc Version 5.0 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 First Row, 31 DS0000000561.V261638.R01.S.doc Version 5.0 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. First Row, 31 DS0000000561.V261638.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service First Row, 31 Address 31 First Row Linton Morpeth Northumberland NE61 5SH 01670 861417 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 John Thomas Cole Mrs Delia Cole Mrs Theresa Lynn Slassor Care Home 3 Category(ies) of Learning disability (3) registration, with number of places First Row, 31 DS0000000561.V261638.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th November 2005 Brief Description of the Service: Linton is a small village situated in a rural ex coal mining area of Northumberland. The village is a small close-knit community comprising of rows of attractive terrace houses. The village has a small shop, which is run by the local community as a co-operative, and a local pub. 31 First Row Linton is a terraced house and has a large sitting room, dining area, kitchen and conservatory. The house has a large private garden. Three men live at the house and the home is a managed by Lynn Slassor, under the supervision of Mr Cole. The staff team is well established and also provides cover to the other homes in Linton. Mr and Mrs Cole also own these. First Row, 31 DS0000000561.V261638.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector talked to the manager, one of the staff and two service users. The service user plans and the on going records of care were examined. What the service does well: 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. First Row, 31 DS0000000561.V261638.R01.S.doc Version 5.0 Page 6 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 First Row, 31 DS0000000561.V261638.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 0 These standards were not examined at this inspection. The key standard will be examined at the next inspection. EVIDENCE: In light of matters detailed in the next section of the report the inspector requires the registered person to review the home’s Statement of Purpose and aims and objectives. This review should be used to determine whether it is appropriate for such a small and home like service to accept emergency admissions. The opinions of the existing service users should be taken into account about this. First Row, 31 DS0000000561.V261638.R01.S.doc Version 5.0 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8 Service users are encouraged to think and talk about their longer-term care needs. This is an informal process rather than a documented one. Service users are able to voice their opinions and wishes. The home supports their involvement in the running of the home. More participation in key decisions could be given to service users. EVIDENCE: At the last inspection a service user had been admitted under emergency arrangements and the home had failed to develop a service user plan in the required timescales. In response to a requirement made following the last inspection a service user plan was prepared. The admission of this person had proved to be a challenge to the service. This led to admission to hospital, under a Section of the Mental Health Act and the placement was ended. There was no evidence that other service users had had an opportunity to influence or take part in the decision to have this person admitted to the home. First Row, 31 DS0000000561.V261638.R01.S.doc Version 5.0 Page 9 There was evidence in the daily records that staff had found the person to be challenging and the Manager said that the admission had had a significant impact on the running of the home and the lives of other service users. The Inspector advised that the aims and objectives of the service should be reviewed. This should include taking account of the views of staff and service users about emergency admissions to the home and selection of service users. Service users participate in the running of the home in smaller ways, such as menu planning and choosing social activities. Service users talked to staff about their future hopes and ambitions. Forward planning for service users’ futures is not written into service user plans. Shortterm goals are identified. First Row, 31 DS0000000561.V261638.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 17 Service users are able to make choices about what they eat and influence the choice of food and mealtime arrangements. Staff talk to service users about their likes and dislikes. EVIDENCE: The menus at the home show that simple home cooking is provided. The staff said that meals are designed around the known likes and dislikes of the service users. The service users said that they enjoyed the food and take part in preparing meal and snacks. None of the service users have special dietary needs but records show that weight gain and loss is monitored as part of supporting service users in healthy eating and drinking. Service users took meals and snacks at times that suited their sleep pattern and daily routine. Service users prepared snacks, such as toast and tea. First Row, 31 DS0000000561.V261638.R01.S.doc Version 5.0 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,20 The staff understand how service users like to spend their time and respect service users’ choices and independence. Staff intervene in the personal care of service users as required to ensure their health and well-being. EVIDENCE: The home has a very relaxed regime. Service users chose when to get up. One service user stayed in bed late, as he was not feeling well. Staff arranged for the service user’s doctor to call. The records show that other specialists have also been involved. The manager described how care is coordinated between specialists. Since the last inspection the medication procedures have been amended to ensure the safety of service users. First Row, 31 DS0000000561.V261638.R01.S.doc Version 5.0 Page 12 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 The home has a complaints procedure and a complaints record. Service users and their representatives are informed of local procedures. The home has staff guidance and procedures in place to protect vulnerable adults from abuse. Local procedures and national guidance documents should also be available to the manager and her staff. EVIDENCE: The home’s complaints procedure is available in the home and is also included in the Service User Guide. The service users hold copies of this. The manager said that no complaints have ever been received by the service. None are recorded in the complaints record. The home’s procedure includes the contact details of The Commission for Social Care Inspection (CSCI). No complaints about the service have been received by CSCI since the last inspection. Service users and representatives who responded to the survey recorded that they knew who to speak to if they were unhappy with the service and were aware of the home’s complaints procedures. The home has written guidance and procedures for the staff to do with the protection of vulnerable adults (POVA). The manager said that all of the staff have received awareness training in this subject. The manager has copies of the local POVA procedures or a copy of the Government guidance document; “ No Secrets”. First Row, 31 DS0000000561.V261638.R01.S.doc Version 5.0 Page 13 The service users expressed clear opinions about the service and readily voiced their views. The manager said that most of the care staff had undertaken training in the protection of vulnerable adults, however the Inspector was unable to verify the details of this, as staff records were not available in the home. The staff on duty said that they had attended the training and found it informative. First Row, 31 DS0000000561.V261638.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 0 These standards were not examined at this inspection. The key standards were met at the last inspection. EVIDENCE: First Row, 31 DS0000000561.V261638.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34,35 A team of nine long –serving staff supports Service users. The employer’s recruitment procedures could not be verified because staff records are not available in the home. Staff records must be available for inspection at all times. EVIDENCE: Staff records are not kept at the home so the Inspector was not able to verify the level of training achieved and the recruitment procedures adopted at the home. The manager said that all staff undertake mandatory training through a training agency and this includes refresher training and updates. Training in the care needs of people with dementia is planned for the manager to take in April 2006. Three staff are enrolled for NVQ level 3 but no start date for this has been agreed. The staff receive training in non-violent crisis intervention from the owner of the service. The owner’s accreditation could not be verified because these records are not available in the home. The records show that physical restraint has been used in the home since the last inspection. There was no evidence that staff using this technique had First Row, 31 DS0000000561.V261638.R01.S.doc Version 5.0 Page 16 received instruction inline with the most recent guidance. There was no evidence in the home that the most recent guidance on restraint was available to staff. The records to do with the incident contained language that was not respectful of service user’s rights and dignity. The incident was not reported promptly to the Commission for Social Care Inspection. The manager said that this matter had been pursued with the member of staff in question, however the record was not available for inspection. The home has a policy about the use of physical intervention. First Row, 31 DS0000000561.V261638.R01.S.doc Version 5.0 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Service users and their representatives are satisfied with the way the service is run. The service is stable. Staff turnover is low. Service users are comfortable in expressing an opinion about the service they receive. The health and safety of staff and service users are promoted. EVIDENCE: The registered manager Lynn Slassor holds NVQ level 4 in management and care. The Manager said that during the current absence of the registered owners, Mr and Mrs Cole, she oversees the running of other homes in the group. During this period Ms Slassor has also managed a very difficult discharge of a service user from this service as well as covering her usual shifts on the rota. The manager has undertaken training in team building, time management, and stress management. Because staff records are not available in the services run First Row, 31 DS0000000561.V261638.R01.S.doc Version 5.0 Page 18 by Eldron Care the Inspector was not able to verify the qualifications of the manager overseeing the service. The Inspector saw the policies and procedures manual which covers: accident/incidents, health and safety at work, food safety, fire safety, smoking policy, guidelines for moving and handling, safety of vehicles, assessment of risk and risk management, dealing with aggression and unexplained absences, handling medicines safely. First Row, 31 DS0000000561.V261638.R01.S.doc Version 5.0 Page 19 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 3CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 x x x x x Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 2 2 x x x Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score x x x 3 2 x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 First Row, 31 Score 3 x 3 x Standard No 37 38 39 40 41 42 43 Score 3 x x x 2 3 x DS0000000561.V261638.R01.S.doc Version 5.0 Page 20 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA8YA1 Regulation 4,12 Requirement The Registered Person must review the Statement of Purpose and aims and objectives of the service in consultation with service users about the suitability of the service accepting emergency admissions. Staff records must be available in the home for inspection. The registered persons must confirm that they have taken action to ensure that staff provide care in a manner that respects the dignity of service users. The registered persons must provide evidence that staff have received up to date training in the use of physical intervention in line with current guidance. Timescale for action 31/05/06 2 3 YA41 YA35 17 Schedule 4 12 31/05/06 30/04/06 4 YA35 18 30/04/06 First Row, 31 DS0000000561.V261638.R01.S.doc Version 5.0 Page 21 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 7 Good Practice Recommendations Personal futures planning methods should be adopted by the service to support service users in longer-term life achievements. First Row, 31 DS0000000561.V261638.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR National Enquiry Line: 0845 015 0120 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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