Inspection on 06/12/05 for Gargrave Road (24) - North Yorkshire County Council

This inspection was carried out on 6th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Gargrave Road (24) - North... 13/11/08

Gargrave Road (24) - North... 15/01/07

Gargrave Road (24) - North... 17/05/05

Gargrave Road (24) - North... 18/11/04

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

CARE HOME ADULTS 18-65 Gargrave Road (24) - North Yorkshire County Council 24 Gargrave Road Skipton North Yorkshire BD23 1QJ Lead Inspector Terry Downey. Unannounced Inspection 6th December 2005 09:30 Gargrave Road (24) - North Yorkshire County Council DS0000034639.V267970.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 Gargrave Road (24) - North Yorkshire County Council DS0000034639.V267970.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. Gargrave Road (24) - North Yorkshire County Council DS0000034639.V267970.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Gargrave Road (24) - North Yorkshire County Council 24 Gargrave Road Skipton North Yorkshire BD23 1QJ 01756 700720 01756 795 981 Address 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) North Yorkshire County Council Miss Catherine Simms Care Home 5 Category(ies) of Learning disability (5), Learning disability over registration, with number 65 years of age (5) of places Gargrave Road (24) - North Yorkshire County Council DS0000034639.V267970.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service Users up to 5 LD and up to 5 LD(E) up to a maximum of 5 Service Users 17th May 2005 Date of last inspection Brief Description of the Service: 24 Gargrave Road is a care home owned and operated by North Yorkshire County Council and registered to provide a service for 5 adults of either gender aged over 18 years who have a learning disability. It concentrates exclusively on providing a respite service for people living in the Craven area. There are 35 service users currently using the project. The home is located in a mid-terrace late Victorian property within walking distance of the centre of Skipton. There is a wide range of local amenities close by. All bedrooms are intended for single occupancy. Gargrave Road (24) - North Yorkshire County Council DS0000034639.V267970.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out as part of the inspection process on 6th December 2005. The manager Miss Catherine Simms was available to assist with the inspection, and it was also possible to speak to one member of staff, and one service user. As this was the second inspection for the home this year, this inspection concentrated on the home’s records available for the service user I could speak to, and those standards not previously checked. The inspection also involved a check on the requirements from the previous inspection, a tour of the premises, and a check on some of the records. The inspection took 5.5 hours which includes preparation time. The home was clean, well decorated and furnished. The inspection showed that the home was well organised and that the staff were aware of their duties, and the residents were well cared for but that there was a problem ensuring that up to date information about services users was available to the home, from care managers. What the service does well: Prospective service users are given as much time as they need to make a decision as to whether they want to use the home for short stays. They are able to participate in day-to-day activities in the home as part of the decisionmaking process. Staffing arrangements are flexible allowing rotas to be adjusted to meet the needs of service users staying in the home on a day-to-day basis Service users are consulted and are actively involved in the development of the new service. The ‘transitions’ work and links with the appropriate services ensure that the home plays a pivotal role in the development of young adults with disabilities. Gargrave Road (24) - North Yorkshire County Council DS0000034639.V267970.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Gargrave Road (24) - North Yorkshire County Council DS0000034639.V267970.R01.S.doc Version 5.0 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 Gargrave Road (24) - North Yorkshire County Council DS0000034639.V267970.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Prospective service users are able to make informed choices but the home must ensure that up to date information is available for each service user. EVIDENCE: Each prospective service user is enabled to make a decision about spending time at 24 Gargrave Road. There is an introduction programme that includes visits to the home, the opportunity to have meals with other service users and to participate in social activities. The introductory period is not fixed but is tailored to suit individuals. An assessment of a recent admission showed that the information was out of date. Some other assessments were not dated or signed which made the information less reliable. Gargrave Road (24) - North Yorkshire County Council DS0000034639.V267970.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,10. Care plans are generally good but insufficient information in the individual plan inspected, makes it difficult for the home to demonstrate it can meet the changing needs of the service user. EVIDENCE: The information regarding the service user in the home was not up to date and did not reflect her changing needs. The manager said it was very difficult to obtain up to date information, or reviews, from care managers despite making several requests. The plan of care for the service user in the home had only limited information about the needs and levels of care required. The plan was not signed by the service user or dated and in conversation the service user said she was not aware of the care plan. Staff meeting minutes record information about individual service users albeit in note form. Ways of recording this information to ensure confidentiality, and compliance with data protection, were discussed. Gargrave Road (24) - North Yorkshire County Council DS0000034639.V267970.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): 11,12,15. Service users do have a range of appropriate activities available but for the plan the inspection concentrated on, there was insufficient information available to show that opportunities for personal development were available. EVIDENCE: The service user in the home at the time of the inspection did not have a timetable of activities but was able to make decisions daily about what she wanted to do and staff were able to support her. There was no information available to show any programme for development. The service user was able to go out regularly with family and this was encouraged and supported by the staff in the home. Gargrave Road (24) - North Yorkshire County Council DS0000034639.V267970.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): 19,20. Service users health and emotional care needs are met. EVIDENCE: Service Users, their families/main carers and other social and health care professionals retain responsibility for health and social care needs. All staff are taking accredited training in the safe administration of medication and the manager considered that course to be very useful. Seven of the 35 service users are able to self medicate and lockable facilities are available in the rooms to ensure that the medication is stored safely. Gargrave Road (24) - North Yorkshire County Council DS0000034639.V267970.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. Residents are protected from abuse, neglect, and self harm. EVIDENCE: Policies and procedures are available to ensure that service users are protected from abuse. The manager was aware of the procedure and said it is regularly reinforced with staff. The home has a complaints procedure which is well publicised. The service user spoken to said if she had any concerns she would speak to the manager and felt satisfied that help and support would be available. Gargrave Road (24) - North Yorkshire County Council DS0000034639.V267970.R01.S.doc Version 5.0 Page 13 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): 24,27,30. The building is not suitable for all the service users but a new purpose built property is underway. EVIDENCE: The home was well decorated and furnished and all the rooms were comfortable and clean. The lack of access and specialist facilities is being addressed by the provision of a purpose built home. The manager said that the finances have been approved and the site allocated but some planning issues have still to be resolved. Some of the service users have taken part in the design of the building and staff were encouraged that the service users views have been listened to and incorporated into the design. Gargrave Road (24) - North Yorkshire County Council DS0000034639.V267970.R01.S.doc Version 5.0 Page 14 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): 32,34,35. The staff are well trained and well organised which ensures that residents feel supported and staff are aware of their duties. EVIDENCE: The staff rota is organised around the needs of the service user and the resident spoken to felt well supported by them. Staff also felt that there were enough staff on each duty to meet the needs of the residents. A link worker system operates in the home which provides the service user with someone to work closely with. Staff also felt that it helped the residents especially with communicating their individual needs. Staff training is on going and relates to the specific needs of the residents which makes staff more confident in their role. A robust recruitment procedure offers protection for the residents in the home. Gargrave Road (24) - North Yorkshire County Council DS0000034639.V267970.R01.S.doc Version 5.0 Page 15 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. The service users benefit from a service which is flexible to their needs. EVIDENCE: There was evidence that service users were consulted and that their views were listened to and used to develop the service and especially the new premises being considered. Fire records indicated that regular checks and tests ensure the safety of the staff and service users. Health and safety is a high priority in the home and monthly checks are carried out by an area manager and also a manager from another home. There is also an annual audit done by an independent agency. This ensures the safety of service users and staff. There were however two shortfalls in the records inspected:1 The homes electrical certificate was out of date. DS0000034639.V267970.R01.S.doc Version 5.0 Page 16 Gargrave Road (24) - North Yorkshire County Council 2. Hot water temperature checks have not been carried out since September which may put service users at risk. The manager explained that this was a temporary slip due the retirement of the person who had previously maintained the records regularly for the past 4 years. Gargrave Road (24) - North Yorkshire County Council DS0000034639.V267970.R01.S.doc Version 5.0 Page 17 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 1 X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 1 3 X X 2 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X 3 X X 3 LIFESTYLES Standard No Score 11 1 12 3 13 X 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 3 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 1 x Gargrave Road (24) - North Yorkshire County Council DS0000034639.V267970.R01.S.doc Version 5.0 Page 18 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. 2 Standard YA2 YA6YA11 Regulation 14 12 15 Timescale for action Assessments must be up to date, 31/01/06 signed and dated. The care plan highlighted must 31/01/06 be more detailed and show evidence of development needs being addressed. An up to date electrical 31/01/06 certificate must be available. Hot water temperatures must be regularly checked and any action taken to amend them, recorded. Requirement 3 YA42 13 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 YA10 Good Practice Recommendations The records of service users in the staff meetings minutes should be recorded in line with the confidentiality and Data Protection procedures. Gargrave Road (24) - North Yorkshire County Council DS0000034639.V267970.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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. Extracts may not be used or reproduced without the express permission of CSCI Gargrave Road (24) - North Yorkshire County Council DS0000034639.V267970.R01.S.doc Version 5.0 Page 20 - 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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