Inspection on 05/06/07 for First Row, 31

This inspection was carried out on 5th June 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 3 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 08/06/06

First Row, 31 10/01/06

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 Anne Brown Key Unannounced Inspection 5th and 7th June 2007 10:00 First Row, 31 DS0000000561.V338275.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 First Row, 31 DS0000000561.V338275.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. First Row, 31 DS0000000561.V338275.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service First Row, 31 Address 31 First Row Linton Morpeth Northumberland NE61 5SH 01670 861690 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) coley@eldcare.fsnet.co.uk 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.V338275.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th June 2006 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 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. The fees range from £622.79 to £675.44. Information about the home and inspection reports are readily available. First Row, 31 DS0000000561.V338275.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over five hours. A tour of the premises took place and a sample of records was inspected. These included care plans, fire log, accident book, complaints, minutes of meetings, finance and medication records. Staff records are not kept at the home. This has been accepted under arrangement with the Commission for Social Care Inspection and is reviewed at each inspection. The staff records were examined during the second date of the inspection at the owner’s office. The manager, two staff members and three residents were spoken to during the inspection. Questionnaires were sent to the residents and their relatives. A resident and two relatives returned questionnaires. What the service does well: The service is a home for three people in an ordinary community setting on a domestic scale. The size and nature of the service is not obvious from the outside. The home blends totally with neighbouring properties. The home is well decorated and furnished and provides a homely place for the residents to live. The staff know the residents well and have developed very positive relationships. The service is part of the local community. The residents have regular contact with other people of their age and a wider staff team from other neighbouring services. The regime of the home is very relaxed and informal. The residents can make decisions about when they get up, what, when and where they eat and they are supported to make decisions which are responsible and in their best interests. The service involves other specialist services for support in caring for the residents. One relative commented that ‘in areas where the staff are not skilled they always contact the appropriate specialist – i.e. doctor, dentist’. Residents are supported to enjoy an active lifestyle and risk taking is part of this. First Row, 31 DS0000000561.V338275.R01.S.doc Version 5.2 Page 6 Contact with family and friends is encouraged. One relative said ‘the staff always make you feel welcome. They encourage you to visit at any time. Nothing is a problem to them. The care and concern for our brother is second to none. His welfare and well being is their priority which gives us great peace of mind’. What has improved since the last inspection? What they could do better: Produce a Service User Guide that is more suitable for people who may come to live at the service. Continue to develop a more comprehensive care planning system using a person centred approach. Help residents identify their social care strengths and needs and together produce plans for meeting these. This should cover the longer and shorter-term matters. This will demonstrate that residents are involved in drawing up the care plans. Ensure staff receive formal supervision sessions at appropriate intervals to make sure they receive guidance and support to carry out their roles. All entries in the recording systems should be dated and signed. First Row, 31 DS0000000561.V338275.R01.S.doc Version 5.2 Page 7 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. First Row, 31 DS0000000561.V338275.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 First Row, 31 DS0000000561.V338275.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 and 2. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Information is available for prospective residents to help them decide where to live. Residents have their individual needs assessed prior to admission. This ensures that the staff are aware of individual needs and helps them to meet these. EVIDENCE: Each resident has a copy of the Service User Guide. This is a written document and is not yet available in a style that is suitable for the people for whom the home is intended. Video and audio versions were discussed with the manager, as well as the possibility of residents being involved in producing these. The manager confirmed that a member of staff was working on producing these as part of their training programme. First Row, 31 DS0000000561.V338275.R01.S.doc Version 5.2 Page 10 The home conducts a pre-admission assessment. This includes obtaining the Care Management Assessment and, where applicable, information is sought from carers/relatives and relevant health care professionals. Copies were available on the individual case files so staff can refer to these to help ensure individual needs are met. The manager is currently evaluating the assessed needs of the residents to make sure any changes are taken into consideration. Some documents were not dated. First Row, 31 DS0000000561.V338275.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 and 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are care plans that contain guidelines for dealing with needs, which explain what staff need to do. Residents are encouraged to make decisions. The care staff support the residents to take risks as part of their lifestyle. EVIDENCE: The care plans for the three residents were examined. These are evaluated on a regular basis. A discussion was held with the manager on ways of involving the residents in their care plan. The manager confirmed that she is in the process of introducing person centred planning to the home. The care managers from the Local Authority are to assist in this process and service users will be actively involved. First Row, 31 DS0000000561.V338275.R01.S.doc Version 5.2 Page 12 Recordings are made on a daily basis for each resident, however some entries have not been signed by the staff. The residents are encouraged and supported to make decisions and relevant information is provided. Residents are supported to take risks in their day-to-day lives. Risk assessments were available on the care plan for each activity but some were not dated. First Row, 31 DS0000000561.V338275.R01.S.doc Version 5.2 Page 13 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Links with the community and opportunities to participate in social and personal development activities are good. Residents are encouraged to keep in touch with family and friends. Residents’ rights are respected in all aspects of their lives. Meals are varied and healthy eating is encouraged. EVIDENCE: None of the residents are employed, however daytime activities are offered. One resident attends the day care activities arranged by the provider of this First Row, 31 DS0000000561.V338275.R01.S.doc Version 5.2 Page 14 service. Another resident attends a horticultural skills unit and college every week. The residents are encouraged and supported to take part in community life, within their abilities. For example a service user regularly goes shopping independently to a nearby town, using public transport. Another person has been supported to go to the local shop and to use public transport. One resident attended a meeting held in the community centre regarding developments taking place in the village. Residents received voting cards to enable them to vote in a recent political election. One of the residents regularly goes to the local pub at weekends for a social drink with local people from the community. Staff provide the level of support that is suited to the person’s needs. Support for residents to go out of the home is part of the daily activity plan. A car is available and extra staff are provided to enable individual activities to take place. Holidays are planned for later in the year. Relationships with family are encouraged. Two residents regularly spend time with relatives. One resident was proud to show his new clothes that had been bought to attend a family wedding. He also was proud of the photographs of his family. Comments received from one relative said the staff always made them feel welcome and they were encouraged to visit at any time. Residents were observed to be spending time in all areas of the home according to their own choice. Routines were relaxed and staff were interacting with the residents. The residents are encouraged to become involved in household tasks according to their capabilities. Menus are varied and nutritious. The residents confirmed that they enjoyed their food and alternatives are always available. They also enjoy meals out at local pubs and cafes. The staff were very aware of the residents’ individual likes and dislikes. Mealtimes are flexible to suit the individual schedules of the residents. First Row, 31 DS0000000561.V338275.R01.S.doc Version 5.2 Page 15 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are given the personal support they require and according to their preferences. Professional medical advice is sought, and reassessments are requested when necessary. An appropriate system is in place for dealing with medications, which protects the residents. EVIDENCE: On resident confirmed that their privacy and dignity was respected. They confirmed that they could get up and go to bed when they pleased. The residents confirmed that they choose their own clothes and one had been shopping for new clothes on the day of the inspection. The records confirmed that support and guidance is provided for personal hygiene according to the residents’ capabilities. First Row, 31 DS0000000561.V338275.R01.S.doc Version 5.2 Page 16 There was evidence within the care records that residents have access to external health care services. The residents are registered with local GP practices and referrals are made to specialist health care services if appropriate. The care manager completes a health action plan annually. All the residents attend the Well Man Clinic every six months when they receive routine health tests. The ability of the residents to look after their medications themselves has been assessed. Staff at the home administer medication to residents. The home has a policy and procedure for staff to follow. A separate protocol has been produced for the giving of medications on an ‘as required’ basis. The staff keep records of medications as they receive them, administer them and dispose of them. These are properly maintained. The home has secure storage arrangements. The manager and staff on duty confirmed that they had received training for administering medications. First Row, 31 DS0000000561.V338275.R01.S.doc Version 5.2 Page 17 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their relatives know who to contact with their concerns and felt these would be taken seriously. Staff training and policies and procedures protect residents from abuse. EVIDENCE: The home has a complaints procedure and a 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 since the last inspection. Residents 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 Service User Guide contains a copy of the Complaints Procedure. One resident said that if he had complaints he would talk to the staff, the manager or the owner. The home has staff guidance and procedures in place to protect vulnerable adults from abuse, (POVA). The manager said that all of the staff had received awareness training in this subject. The staff on duty confirmed this and said they would not hesitate to report any bad practice. First Row, 31 DS0000000561.V338275.R01.S.doc Version 5.2 Page 18 The system for dealing with service users’ finances was examined. The Home maintains financial records on behalf of the residents; each has an individual bank account. There was evidence of personal spending and receipts are kept. First Row, 31 DS0000000561.V338275.R01.S.doc Version 5.2 Page 19 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a homely and comfortable environment for the residents to live. All areas of the home are clean and hygienic. EVIDENCE: The home is a small mid terrace house and is totally in keeping with the local community. The home is attractively decorated throughout. Two residents were proud to show their bedrooms and confirmed that they had chosen the décor and other personal items. There is sufficient space for service users to enjoy internally and externally. First Row, 31 DS0000000561.V338275.R01.S.doc Version 5.2 Page 20 The home has a domestic washing machine located off the kitchen. The local environmental health department accepted this arrangement when the home was registered, as it is in keeping with the scale of the service. The manager confirmed that the staff have been provided with information on infection control. All areas of the home were seen to be clean, hygienic and free from unpleasant odours. First Row, 31 DS0000000561.V338275.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The staff team are well trained and competent to support the residents. The recruitment policy and practice supports and protects the residents. The needs of the residents are met by appropriately trained staff. Formal supervision sessions are out of date which could mean staff are not fully supported to carry out their roles. EVIDENCE: Staffing arrangements are flexible to meet the needs of the residents. The owner has other services based in Linton. Staff from these services cover for holidays and other special circumstances. The manager said that in this way the residents always have someone they already know working with them. First Row, 31 DS0000000561.V338275.R01.S.doc Version 5.2 Page 22 Staff records are not kept at the home. This has been accepted under arrangement with the Commission for Social Care Inspection and is reviewed at each inspection. The records were examined during the second date of the inspection at the owners’ office. They showed that appropriate checks are carried out prior to staff being employed, which protects the residents. Training programmes are in place for staff to receive up to date health and safety training. The staff also confirmed that they receive specialist training to meet the individual needs of the residents. Seven permanent staff are employed in the home, five of which have completed National Vocational Qualification (NVQ) Level 2 or above. The manager stated the owner has a certificate to train staff in the use of physical intervention. The majority of staff have now completed this training. The manager maintains a file of courses available to the staff team. Since the last inspection some staff have attended courses on activity planning, equality and diversity, stress management and the Mental Capacity Act. Although the staff confirmed that the proprietor and the manager are supportive, formal staff supervision sessions were out of date. Mr Cole, the owner, stated that the structure of the sessions is to change and an appropriate form for recording these is being introduced. The staff on duty stated the manager and the owners are supportive and approachable. Comments received from one relative said nothing was a problem to the staff. They stated ‘the care and concern they show to our brother is second to none’. First Row, 31 DS0000000561.V338275.R01.S.doc Version 5.2 Page 23 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run with a focus on the residents. The management and staff team respect the residents’ views regarding the running of the home. The health, safety and welfare of residents are protected by the systems the home has in place. First Row, 31 DS0000000561.V338275.R01.S.doc Version 5.2 Page 24 EVIDENCE: The manager has experience in working with adults with learning disabilities and has completed the Registered Managers Award. She has recently completed a course on person centred planning and is booked to attend a seven-day course on team development. Meetings are held in the home on a regular basis. The minutes showed that residents are asked their opinion on the day-to-day running of the home. The manager stated that a member of staff now arranges the meetings. Policies and procedures are discussed with the residents in an effort to encourage them to become more involved. There is a Quality Assurance policy statement. The owner makes monthly visits and reports of these visits are available. He visits the service frequently and is in day-to-day contact with staff, residents and residents’ families and friends. The manager issues questionnaires to the residents every three months to find out their opinion of the service. One resident can complete these and the others are helped by their relatives. Maintenance contracts and test certificates are in place and fire safety equipment is tested at the appropriate intervals. This helps to ensure the residents’ safety. The staff confirmed that they had received up to date health and safety training. The fire officer has provided the home with user-friendly information for the residents regarding fire safety and procedures. No safety hazards or unsafe practices were observed during the inspection. First Row, 31 DS0000000561.V338275.R01.S.doc Version 5.2 Page 25 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 2 2 2 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 x First Row, 31 DS0000000561.V338275.R01.S.doc Version 5.2 Page 26 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 YA2 Regulation 14 Requirement The registered manager must ensure all assessments of needs are dated. The registered manager must continue to update the care plans to address all aspects of the residents’ care and involve them in this process. Timescale for action 20/07/07 2. YA6 15 30/11/07 3. YA36 18(2) The registered manager must 31/08/07 ensure all care staff receive formal supervision at appropriate intervals. First Row, 31 DS0000000561.V338275.R01.S.doc Version 5.2 Page 27 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 YA1 Good Practice Recommendations The service users’ guide should be produced in a style that is easy to understand by people for whom the service is intended. The residents should, if they wish, be involved in producing this version. The manager should continue to encourage residents to control and contribute to service user meetings. 2. YA39 First Row, 31 DS0000000561.V338275.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 First Row, 31 DS0000000561.V338275.R01.S.doc Version 5.2 Page 29 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!