Inspection on 26/10/05 for Grayling

This inspection was carried out on 26th October 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Grayling 11/04/07

Grayling 23/11/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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

CARE HOME ADULTS 18-65 Grayling Back Lane South Middleton Pickering North Yorkshire YO18 8NU Lead Inspector David Blackburn Unannounced Inspection 26th October 2005 09:30 Grayling DS0000007836.V261163.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 Grayling DS0000007836.V261163.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. Grayling DS0000007836.V261163.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Grayling Address Back Lane South Middleton Pickering North Yorkshire YO18 8NU 01751 477209 01751 477209 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) The Wilf Ward Family Trust Mrs Mary Doreen Stannard Care Home 4 Category(ies) of Learning disability (4), Learning disability over registration, with number 65 years of age (4) of places Grayling DS0000007836.V261163.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered for 4 Service Users with Learning Disabilities some or all of whom may also have Physical Disability 19th May 2005 Date of last inspection Brief Description of the Service: Grayling is a large detached bungalow situated in the village of Middleton approximately one mile from Pickering. A former private dwelling it now offers suitable accommodation for four residents. There are gardens to the front and rear accessible to residents. There are four bedrooms offering residents single room accommodation, one of which has an en-suite facility. A communal lounge is provided with television, video and music system. There is a dining kitchen, communal bathroom and toilet facilities. The staff provide personal care to the four residents accommodated by virtue of a severe learning difficulty together with some physical disabilities. Appropriate aids and equipment are provided to assist residents. The staff seek to provide a holistic care regime offering personal care, advice and guidance with daily living skills and activities, a catering service, a laundry service and domestic services. All services are offered in conjunction with input from the residents. Social activities are arranged in-house and at external locations. Some residents attend day care placements. All residents are registered with a local medical practitioner who can access the more specialised health services when required. The staff team have developed a very good relationship with the Community Learning Disability Team (CLDT). Grayling is owned by the local health authority. The care input is provided by the Wilf Ward Family Trust, a registered charity. Grayling DS0000007836.V261163.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection upon which this report is based was the second to be undertaken in the inspection year April 2005 to March 2006. It was carried out over four hours including preparation time. The focus was on those key standards not assessed at the first inspection in May 2005 together with those parts of other standards that were subject to a requirement or recommendation. Care plans were examined together with some policies and procedures. Discussions were entered into with the registered manager and the one other staff member on duty. Three residents were spoken with though their ability to communicate was very limited. Their feedback was mainly one-word answers, gestures or facial expressions. Observation showed a good rapport between residents and staff. What the service does well: A very good level of care and service was provided to the four residents. The manager and staff were pro-active in questioning and challenging the way care and services were offered. Pre-conceptions, long-held beliefs and presumptions were all scrutinised, analysed and questioned. Those not seen to promote and maintain the overall care of the residents were dismissed and new ways of working introduced. A number of improvements were noted that could only enhance the care and service on offer. Good attention to detail in how care was offered and procedures followed was noted. Residents were assured their needs and choices would be recorded and acted upon through good assessment and care planning procedures. Residents’ activities and involvement in the community were being increased and improved. Residents’ personal and social care were well organised, delivered in an appropriate manner and ensured their overall wellbeing. Residents were protected from harm through staff’s clear understanding of adult protection policies and procedures. Residents lived in a clean and safe environment. Residents were cared for by a conscientious manager and a well-trained and committed staff team. Grayling DS0000007836.V261163.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. Grayling DS0000007836.V261163.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 Grayling DS0000007836.V261163.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 Residents could remain assured that their needs and choices would be properly assessed and recorded. EVIDENCE: The file of the resident admitted after the last inspection was examined. This resident had been transferred from another registered care home managed by the same provider. His needs had been re-assessed and found to be greater than could be met in his then present location. Information was on file about his changing needs and the difficulties staff in that home were having in meeting them. Details were on file about his transfer and introduction to the home. This showed clearly his changed needs, his preferences and choices and how staff at his current home would be more able to meet them. Grayling DS0000007836.V261163.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. Residents were assured their needs and choices would be recorded and acted upon through good care planning and review procedures. EVIDENCE: Two case files including current care plans were examined. Both files were indexed and colour coded for ease of use and retrieval of information. The files contained a wealth of information on the particular resident giving a clear picture of the person, their needs, choices, preferences and strengths. The care plans were well-detailed and showed evidence of regular review. A personal support plan had been compiled for each resident. The plans enabled any member of staff to understand the care needed, when needed, how it was to be provided and by whom. Grayling DS0000007836.V261163.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): 12, 13 and 17. Residents had the opportunity through activities inside and outside the home to broaden their life experiences. Dietary needs were met through the provision of varied and nutritious meals. EVIDENCE: None of the residents was able to undertake paid or voluntary employment. Similarly none had been assessed as being able to benefit from any formal further education classes. Two residents were above retirement age. Day care placements had been secured for two of the residents. Leisure activities in the home were devised and introduced according to each resident’s individual wishes and choices. These included sensory stimulation, beauty therapy, looking at books and photographs, watching television and videos. A record of activities undertaken was maintained and was seen. Good use was made of local facilities and amenities. The replacement of the mini-bus with two multi-purpose vehicles would substantially broaden the Grayling DS0000007836.V261163.R01.S.doc Version 5.0 Page 11 outings available to residents enabling individual trips to be undertaken, as well as those organised on a group basis. A three weekly menu was in operation. This had been devised by staff, one of whom had catering experience and was based on the known likes, dislikes, preferences and choices of the residents. New dishes were tried regularly and added to the menu if enjoyed by the residents. Similarly menu items were deleted where it was found residents had tired of it. A good selection of food was on offer, the majority of which was prepared in the home. Little pre-packaged food was brought in. Fresh fruit was in evidence being available throughout the day and not just at mealtimes. The main meal of the day was taken in the evening to enable residents to participate in daytime activities. Grayling DS0000007836.V261163.R01.S.doc Version 5.0 Page 12 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, 19 and 20. Residents’ personal and health care including medication were well organised, delivered in an appropriate manner and ensured their needs were met and their overall wellbeing maintained. EVIDENCE: The activities and routines of daily living as they affected the individual were well recorded in each resident’s file. Their choices and preferences on how care was to be offered, when and by whom were clearly detailed in the care plans, reviews and visiting professionals’ assessments. An occupational therapist had visited to advise on specialist bathing techniques and to ensure the necessary aids and adaptations were in place. The main focus of staff was the promotion and maintenance of each resident’s independence, dignity and privacy. Systems were in place to ensure these ideals were regularly and constantly met. Residents were taken shopping for clothing, toiletries and other personal items. Staff advised as to the appropriateness of items bought in terms of the age, sex and personality of the resident. Health care needs were well recorded in a discrete section within the file. They showed the need for medical intervention, the outcomes and the times of any Grayling DS0000007836.V261163.R01.S.doc Version 5.0 Page 13 follow-up. The involvement of primary care professionals and specialist medical staff were recorded. All residents were registered with a local general medical practice. Dental and optical services were provided locally. Proper procedures and systems were in place for the receipt, storage, administration, recording and return of medicines. Observation showed these procedures were being followed. All staff who administered medication had undertaken an external training course. Grayling DS0000007836.V261163.R01.S.doc Version 5.0 Page 14 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 and 23. Residents were assured their concerns would be acted upon through a relevant complaints procedure. They were protected from harm by staff’s clear understanding of adult protection policies and procedures. EVIDENCE: A complaints procedure was available in written and pictorial form. It detailed how to complain, to whom and gave timescales for response. It showed the name and address of the current regulatory authority. An “abuse” policy and procedure was seen. It was written with specific reference to dealing with disclosures concerning people with disabilities. Staff confirmed training in adult protection was given at induction and when undergoing LDAF training (Learning Disability Award Framework). The registered manager said staff undertaking National Vocational Qualifications in care had to complete a compulsory unit on adult protection issues. The registered manager had a copy of the original multi-agency agreement on adult protection. She was advised to obtain a copy of the revised protocol, discuss this with staff and then implement its recommendations. Grayling DS0000007836.V261163.R01.S.doc Version 5.0 Page 15 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 and 30. On-going improvements to the premises ensured residents continued to live in a clean and safe home. EVIDENCE: Further improvements had been made to premises including re-decoration and re-carpeting of some bedrooms, new overhead ceiling tracking to the main bathroom, widening of doors and attention to the outside woodwork. Other work was planned for the near future including re-decoration and re-carpeting of the main sitting room. Some of the work had been undertaken by staff. The installation of equipment had been undertaken by specialist contractors. The premises were clean, tidy, warm and free from unpleasant smells. Good attention was being paid to matters of hygiene and infection control. Grayling DS0000007836.V261163.R01.S.doc Version 5.0 Page 16 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 and 34. Residents were supported by a properly recruited, competent, motivated and trained staff team. EVIDENCE: The registered manager was supported by an assistant manager and 11 care staff. Two posts were vacant totalling 39 hours. Male and female staff were employed from different backgrounds bringing with them a range of skills, knowledge, expertise and life experiences. The staff on duty were seen to interact well with residents and there was an evident rapport between the two. Staff displayed a commitment to the residents in their care. Staff confirmed they had undertaken in-house induction and external LDAF training. Two had achieved a National Vocational Qualification in care to level 2 while 5 others were working towards this award. All recruitment to the home was done through the selection procedures of the registered provider. They followed proper arrangements for the recruitment, selection, interview and appointment of staff. The necessary clearances, for example references and enhanced disclosures from the Criminal Records Bureau, had been obtained. Grayling DS0000007836.V261163.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, 41 and 42. Residents were able to live in a well-managed, secure environment. EVIDENCE: The registered manager continued her work towards the Registered Manager (Adults) Award NVQ4. A number of improvements in the management of the home were noted. The registered manager continued to question the way care was given and to make changes as she saw necessary following discussion and agreement from her staff. These changes had served to further improve the service and care on offer. She continued to challenge preconceptions, presumptions and wrongly – held beliefs about people with disabilities. All care and service provided had at their head the residents and their needs. Nothing appeared to be too much trouble. This positive attitude could only serve to improve the life experiences of the residents and to break down some of the barriers between people outside the home and the residents. Those records seen were being maintained in an appropriate manner. Grayling DS0000007836.V261163.R01.S.doc Version 5.0 Page 18 Staff files had been seen earlier in the year at the registered provider’s headquarters. They were found to be satisfactory. Proper attention was being given to matters of health and safety. Staff confirmed attendance on a number of courses including manual handling, first aid and food hygiene. A number of safety reports and certificates were examined. All were satisfactory. Grayling DS0000007836.V261163.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 CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Grayling Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 X X X 3 3 X DS0000007836.V261163.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. Standard Regulation Requirement Timescale for action 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 YA23 Good Practice Recommendations The registered manager should obtain a copy of the revised multi-agency protocol on adult protection, discuss this with staff and implement its recommendations. Grayling DS0000007836.V261163.R01.S.doc Version 5.0 Page 21 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 Grayling DS0000007836.V261163.R01.S.doc Version 5.0 Page 22 - 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. 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