CARE HOME ADULTS 18-65
The Granary Church Lane Brandesburton Driffield, East Yorkshire YO25 8QZ Lead Inspector
Brian Hallgate Unannounced 13 June 2005 13:15 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 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 Stationary 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. The Granary J53_J04_S19742_Granary_V231143_210605_Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service The Granary Address Church Lane, Brandesburton, Driffield, East Yorkshire, YO25 8QZ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01962 543332 01964 543332 Milbury Care Services Limited Mr Kenneth Charles Bates Care Home 15 Category(ies) of Learning disability (15) registration, with number of places The Granary J53_J04_S19742_Granary_V231143_210605_Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 4th November 2004 The Granary J53_J04_S19742_Granary_V231143_210605_Stage 4.doc Version 1.30 Page 5 Brief Description of the Service: The Granary is a care home providing accommodation and care for up to 15 adults with learning disabilities. It is located in the village of Brandesburton. It is a short walk into the village and allows access to hairdressers, shops, post office, pubs and a fish and chip shop. The main road through the village allows access to pblic transport. The home was opened in 1990. There are 12 single bedrooms, three of which have en-suite facilities and a double room. The home has a well-maintained front garden and is surrounded on two sides by fields. Garden furniture is available for service users to sit outside. The Granary J53_J04_S19742_Granary_V231143_210605_Stage 4.doc Version 1.30 Page 6 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place over four hours, including preparation time, and was an unannounced inspection that commenced at 13.15 hours on the 13th June 2005. A tour of the home was made with the senior support worker on duty and a number of records were inspected. Four service users, the senior support worker and two support workers were spoken to. The staff were observed interacting with the service users at home. A group of service users were on a week’s holiday. 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.
The Granary J53_J04_S19742_Granary_V231143_210605_Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection The Granary J53_J04_S19742_Granary_V231143_210605_Stage 4.doc Version 1.30 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 standard(s) 2 Information published by the home, together with a detailed pre-admission assessment procedure provides service users, prospective service users and relatives with a clear indication of the services available. EVIDENCE: All prospective service users have a comprehensive care management assessment completed by a care manager prior to admission. Good assessments were on the files inspected. The Granary J53_J04_S19742_Granary_V231143_210605_Stage 4.doc Version 1.30 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 standard(s) 6, 7 and 9 The service users’ needs are met in a well-structured and considered way and generally kept under regular review. EVIDENCE: Care plans are available on each service users file with adequate details on how staff should care for them as individuals and the activities that they wish to participate in. Service users spoken to know about their plans and were happy about the way staff supported them when necessary. All service users considered that they had choices about how they lived their lives and appreciated staff allowing them to be as independent as possible. Some service users were more dependent on staff and staff had to assist them to make decisions. Risk assessments had been undertaken on activities in and out of the home for individual service users. The majority of case files read had regular reviews of their care plans. Service users attend their own reviews. One file examined showed that the last review had been held in July 2004. The registered person must ensure that reviews are held at least once every six months. The Granary J53_J04_S19742_Granary_V231143_210605_Stage 4.doc Version 1.30 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 standard(s) None EVIDENCE: The Granary J53_J04_S19742_Granary_V231143_210605_Stage 4.doc Version 1.30 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 standard(s) 18, 19 and 20 The staff have a good understanding of the service users’ support needs. This is evident from the positive relationships that have been formed between the staff and service users. EVIDENCE: Staff spoken to were enthusiastic about their work with service users. The staff are fully aware of the care plans and personal needs of the service users. Ten service users require some assistance with their personal care needs. Service users spoken to considered that staff provided appropriate care and only assisted them if they needed assistance. From discussions with service users, staff and from reading individual case files it appears that service users physical and emotional needs are met. All service users are registered with a GP. Specialist medical services if required are obtained through the GP. A nurse specialising in epilepsy treatment visits the home on a regular basis. Service users receive chiropody either by a home visit or visiting the chiropodist at the surgery. Visits to dentists and opticians are made as required. No service user self medicates. The medication records and medication checked were in order and correctly recorded. The Granary J53_J04_S19742_Granary_V231143_210605_Stage 4.doc Version 1.30 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 standard(s) 22 and 23 Staff have an understanding and knowledge of the abuse procedures. The complaints policy needs improving. EVIDENCE: There is a policy on adult abuse and there is a copy of the East Riding of Yorkshire adult abuse procedures. All staff spoken to were fully aware of the action that they need to take in the event of a case of suspected abuse. There is a policy document provided by Milbury Care but this has not been adapted for use locally. The name, address and telephone number of the Commission for Social Care Inspection has not been included in the policy document. This is an outstanding issue from the previous inspection. The Milbury policy states that copies of a complaints leaflet should be available within the home. No leaflets were found during the inspection. There is a complaints book available. No complaints have been recorded. The Granary J53_J04_S19742_Granary_V231143_210605_Stage 4.doc Version 1.30 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 standard(s) None EVIDENCE: The Granary J53_J04_S19742_Granary_V231143_210605_Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None EVIDENCE: The Granary J53_J04_S19742_Granary_V231143_210605_Stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 39 and 42 The registered person does not review the performance of the home on a regular basis. There is no formal procedure for seeking the views of service users, staff and relatives. EVIDENCE: There is no evidence in the home that a quality assurance/quality monitoring system takes place on a regular basis that includes seeking the views of service users, staff and relatives. This should be undertaken on at least an annual basis and a development plan for the home produced from the views of service users, staff and relatives. This is an outstanding requirement from the previous inspection. The registered manager has not yet obtained Level 4 NVQ in management. From discussions with service users and staff the home is managed in an open and inclusive manner by the present manager who enjoys the support of the staff and the service users’. There was evidence from the fire logbook, gas and electric safety certificates and the hot water temperature that proper attention is being given to health and safety, promoting a safe environment in which service users can live.
The Granary J53_J04_S19742_Granary_V231143_210605_Stage 4.doc Version 1.30 Page 16 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 3 x x x Standard No 22 23
ENVIRONMENT Score 1 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 1 3 x 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 x x x x x x x Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
The Granary Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 x 1 x x 3 x
Version 1.30 Page 17 J53_J04_S19742_Granary_V231143_210605_Stage 4.doc YES 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 6 22 Regulation 15 22 Requirement Care plans must be reviewed at least every six months Complaint policy must include the address and telephone number of the Commission for Social Care Inspection and copies made available in the home (previous timescale of 07/11/04 not met) A quality assurance/quality monitoring system based on the views of service users, staff and relatives must be developed(previous timescale of 30/12/04 not met) Timescale for action 30/06/05 30/06/05 3. 39 24 30/06/05 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 37 Good Practice Recommendations The registered manager should obtain an NVQ Level 4 in management by the end of 2005 The Granary J53_J04_S19742_Granary_V231143_210605_Stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection York Area Office Unit 4, Triune Court Monks Cross YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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