CARE HOME ADULTS 18-65
Hallfield Guest House 50 Hall Street Stockport Cheshire SK1 4DA Lead Inspector
Jackie Kelly Unannounced Inspection 26 March 2007 18:00 Hallfield Guest House DS0000064383.V334341.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 Hallfield Guest House DS0000064383.V334341.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. Hallfield Guest House DS0000064383.V334341.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Hallfield Guest House Address 50 Hall Street Stockport Cheshire SK1 4DA 0161 456 6502 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) Independent Options (Stockport Limited) Elizabeth Cunliffe Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Hallfield Guest House DS0000064383.V334341.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The home is registered for a maximum of 6 service users to include: *up to 6 service users in the category of LD (Learning Disability). The ratios of care staff to service users must be determined according to the assessed needs of residents and in accordance with guidance issued by the Department of Health. 14/03/06 Date of last inspection Brief Description of the Service: Hallfield Guest House is a care home that is owned by Independent Options (Stockport) Limited and is one of two short stay homes that provide respite care to service users with a learning disability. Hallfield Guest House is registered to accommodate up to six service users between the ages of 18 and 65 years at any one time. Service users are referred to as guests and are encouraged to see their break at the home as a holiday. The property is a large three storey detached building. Accommodation comprises of six bedrooms with en suite facilities, five are situated on the first floor and one on the ground floor. A separate bathroom with a bath is also available for those service users who prefer a bath. The kitchen is situated on the ground floor, along with a large comfortable lounge area and a separate dining room. There is car parking space to the rear of the property and garden areas situated to the front and side of the building. There is ramp access to the front of the property. Hallfield Guest House is situated close to the town centre with good access to cinemas, local shops, library and park. Stockport town centre, motorway network and public transport are easily accessible. There is a statement of purpose and service user guide. The service user guide is also produced in a picture format, which is helpful to the service users. Inspection reports were available on request. The fees range from £128.63 to £194.60. An additional fee of £14.40 is required if service users require extra ‘tea visits’ during the assessment and introduction stage or for one to one support. Hallfield Guest House DS0000064383.V334341.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an announced inspection (three hours notice was given) that took place early evening. The registered manager accompanied the inspector throughout the inspection process. Care plans; assessment documentation and medication records were examined. A tour of the premises also took place. At the time of the inspection Hallfield Guest House was providing a service to seventy-four people in total. The number of permanent support workers employed to cover the home was eleven. However there were relief support workers to provide extra support when necessary. The inspector met five of the six service users who were staying at the home. They said that they enjoyed staying at Hallfield Guest House and liked the staff team. There were two support workers on duty who were taking the five service users out for a drink and a game of pool. The support workers had worked for the organisation for twelve and five years. Both said that they loved the work and liked it at Hallfield Guest House. They were also pleased with the training and support that the organisation provided. Hallfield Guest house is very much like a small hotel, which is what the organisation is trying to achieve so that service users feel like they are experiencing a holiday. The Commission for Social Care Inspection had received one notification of concern regarding a matter of health and safety. There had been five other complaints made to Independent Options. All had been recorded and dealt with in a satisfactory manner and required no further action. The agency had received the ‘Investors in People Award’ and the ‘Positive about Disability Award’ from Employment Services. The organisation also used the quality assurance system PQASSO (Practical Quality Assurance System for Small Organisations) and was currently working through Level 3. The executive board met every two months with the sub-committees meeting in the intervening months. People were welcome to attend the meetings but could be asked to leave if there were personal or confidential items to be discussed. Hallfield Guest House DS0000064383.V334341.R01.S.doc Version 5.2 Page 6 Members of the executive board and the Chief Executive visited the home on a monthly basis and wrote a report of their findings. Copies were available for the inspector to read. What the service does well:
All service users are given a service user guide, which has been produced in a picture and word format to help service users understand what they can expect from Halfield Guest House. The home offers comfortable accommodation, which is clean and well maintained throughout; service users are encouraged to enjoy their stay at the home and to view their time spent there as a short holiday break. Assessment and care planning procedures in the home are very good with potential users of the service encouraged to visit as often as they like before making a commitment to spend a night. The recruitment, selection and induction for new workers was good and included a probationary period of six months. This helped to make sure that only suitable people were employed at Independent Options. The training programme was comprehensive with support workers being given the opportunity to attend courses and put forward ideas for training that would meet their individual needs. Eight of the eleven support workers working at Hallfield Guest House had completed either a National Vocational Qualification (NVQ) Level 2 or Level 3. All the managers of the divisions had a professional qualification in either social work and/or nursing or a NVQ Level 4 in Management. One of the managers had completed the registered managers award with two almost completed and a further two recently commenced. The organisation had also registered for the Learning Disability Award Framework (LDAF). Two of the new support workers were in the process of completing the induction and foundation training. Questionnaires had been distributed to service users and their relatives to give feedback on the service being provided. All the views and opinions would be taken into account. One suggestion recently from a service user was to replace the three dining tables for one big one. A survey was being conducted of all the service users. The organisation had received a review of its leadership and management under Investors in People and had been awarded a level four which is very good. Fifty of the eighty total staff compliment employed had been interviewed
Hallfield Guest House DS0000064383.V334341.R01.S.doc Version 5.2 Page 7 and the responses from the staff team had been extremely positive. Investors In People had recommended that the organisation apply for the remaining three elements ‘work life balance’, ‘recruitment and selection’ and ethical business’. This was being looked at for sometime next year. The organisation had devised an internal audit system, which was to start in April 2007. There was a business plan in place. All qualified social workers employed by Independent Options had registered with the General Social Care Council. What has improved since the last inspection?
A booklet titled ‘All about me’ had been produced which contained information about the service users likes, dislikes and particular needs. The key workers and service users were in the process of completing the booklets. A new training and development booklet had been devised which related the course content and learning to the relevant policies and procedures. The recruitment and selection process now included a group interview for all potential employees. A health and safety ‘quiz’ to ensure that the support workers were up to date with health and safety matters had been introduced and would be used during team meetings. New medication policies and procedures had been devised by Independent Options. An external trainer who was a qualified pharmacist had provided training for all staff. The training organisation had provided a booklet, certificate and an internal competency check list to be used by the agency. The external training will be renewed approximately every three years with the competency check in between. Fifty percent of the staff team at Hallfield Guest House were now trained to a National Vocational Qualification at either level 2 or level 3. Hallfield Guest House DS0000064383.V334341.R01.S.doc Version 5.2 Page 8 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 summary of this inspection report can be made available in other formats on request. Hallfield Guest House DS0000064383.V334341.R01.S.doc Version 5.2 Page 9 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 Hallfield Guest House DS0000064383.V334341.R01.S.doc Version 5.2 Page 10 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): 2 Quality in this outcome area is excellent. The assessments ensured that service users received appropriate care and their needs were met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All service users had received a full assessment from both Social Services and Independent Options prior to their being offered a respite care bed at the home. Updated Individual Service Agreements for existing service users were being sent to the organisation from Stockport Social Services. Each service user had a care plan, which had been put together from the care needs assessments. The organisation had recently introduced a booklet called ‘All about me’, which had been produced in both words and pictures. The service user and key worker were completing the booklets with information about the service users likes and dislikes. All of the above documents were seen by the inspector and were found to be satisfactory. The booklet ‘All about me’ was particularly useful for both service users and support workers. Hallfield Guest House DS0000064383.V334341.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): Standards 6,7,9 Quality in this outcome area is good. Service users’ health and safety together with their personal care needs were identified through care planning and risk assessments. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector saw two care plans of service users who were currently staying at the home both of which were satisfactory. Care workers reviewed the care plans at each visit. Each file had an ‘quick points sheet’ which summarised a service users likes and dislikes, any particular risks, and their weekly timetable for instance day care or work commitments. Other information included any specific medical conditions or medication. The checklist was slightly different for Hallfield Guest House from that of Beech Avenue as it contained a section for the waking night staff. The sheet was also used as a guide to further information contained within the file.
Hallfield Guest House DS0000064383.V334341.R01.S.doc Version 5.2 Page 12 Service users were encouraged to make their own decisions and choices, within their capabilities, whilst staying at Hallfield Guest House. Risk assessments had been done where necessary and copies were placed on the service users file. Hallfield Guest House DS0000064383.V334341.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): Standards 12,13,15,16,17 Quality in this outcome area is good. Service users were able to follow their normal routines of work and leisure activities within the community. Service users were offered a healthy diet appropriate to their cultural requirements. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users who lived with a relative or long-term adult placement carer used the accommodation at Hallfield Guest House for short breaks ranging from one night to two weeks. The service provided a break for both the service user and the main carer therefore the service user did not often receive visits from friends or family during their stay at the home. Any activity they attended whilst at home such as a day centre, adult education classes or employment was carried on during their stay. Hallfield Guest House DS0000064383.V334341.R01.S.doc Version 5.2 Page 14 Service users also took part in leisure activities organised by the support workers at Hallfield Guest House for instance meals out, trips to local ‘working men’s club’, swimming and cinema or whatever the service users were interested in. The home had a computer, which had broadband for those service users who were interested in computers and the Internet. At the end of a service users stay a letter was sent home to parents or main carer informing them of how the service user had spent their time. The support workers kept small amounts of ‘pocket money’ for which a record was kept and a copy of the account sent home at the end of the service users stay. The routines of the home were for the most part set around the service users daily activities which they took part in when living at home. At other times the support workers were flexible and respected the service users preferences. The home did not have a set menu, as the meals were planned around the service users who were visiting that week. Shopping was done at the local supermarket. Halal meat was purchased from an appropriate butcher to support those service users who required a Halal diet. Hallfield Guest House DS0000064383.V334341.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): Standards 18,19,20. Quality in this outcome area is good. Service users had their personal support and health care needs met according to their wishes and requirements. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information gained from assessments done before a person was offered a place for respite care covered personal preferences and specific health and personal care needs. The information was transferred onto the care plan for the support workers to follow. All the service users had their own room, which had an en-suite facility including a shower. If the service user required assistance with their personal care needs this was done in private. The main carers were the people responsible for obtaining health care, which the support workers followed whilst the service users were staying at the home. The local GP would see a service user if they became ill during their stay at Hallfield. Hallfield Guest House DS0000064383.V334341.R01.S.doc Version 5.2 Page 16 New medication policies and procedures had been devised by Independent Options and approved by the pharmacist from the Commission for Social Care Inspection. An external trainer who was a qualified pharmacist had provided training for all staff. The training organisation had provided a booklet, certificate and an internal competency check list to be used by the agency. The external training will be renewed approximately every three years with the competency check in between. Hallfield Guest House DS0000064383.V334341.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): Standards 22,23. Quality in this outcome area is good. The organisation had training, policies and procedures in place to protect the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The organisation had a complaints policy and procedure in place. Service users and relatives were given a service user guide, which contained information on how to complain. There had been five complaints documented in the complaints record since the previous inspection of March 2006. All of which had been dealt with in a satisfactory manner. The Commission for Social Care Inspection had received notification of an incident, which had taken place. This was dealt with by the organisation appropriately and a new system implemented. There were also policies and procedures regarding adult protection and whistle blowing. All support workers had received training in safe guarding adults. Hallfield Guest House DS0000064383.V334341.R01.S.doc Version 5.2 Page 18 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): Standards 24,30. Quality in this outcome area is excellent. The home was well maintained and provided comfortable living accommodation for the service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is a six-bedroom detached house. The ground floor consists of an entrance hall, lounge, dining room, kitchen and one bedroom. The first floor had a further five bedrooms all with en-suite shower, toilet and wash hand basin. There was also a bathroom for those service users who may like a bath instead of a shower. On the second floor there was a staff sleeping in room, which also doubled up as an office. The front of the house, which faces onto a busy main road, had a small garden. The rear had a patio area and parking facilities for a small number of cars.
Hallfield Guest House DS0000064383.V334341.R01.S.doc Version 5.2 Page 19 The home was decorated and furnished to a high standard; it was clean, tidy, bright and airy. There were three small round dining tables in the dining room. At the time of the inspection a survey was being conducted amongst the service users as some had said they would like one big table instead. Hallfield Guest House DS0000064383.V334341.R01.S.doc Version 5.2 Page 20 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): Standards 32,34,35. Quality in this outcome area is excellent. The recruitment and selection procedures, training and development programme, formal supervision ensured that the service users are protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Eight of the eleven support workers who were employed at Hallfield Guest House had a National Vocational Qualification (NVQ) at either level 2 or level 3. All of the support workers had completed the Learning Disability Award Framework (LDAF) foundation training. The home had met the 50 target of staff trained to NVQ level. Other core training such as moving and handling, health & safety, adult protection, food hygiene and medication was on going. The manager was to conduct a health and safety quiz at the next team meeting to ensure that the support workers were up to date with health and safety matters. The induction and training and development programme was comprehensive. Hallfield Guest House DS0000064383.V334341.R01.S.doc Version 5.2 Page 21 The agency now had a two-staged recruitment procedure that included a group interview followed by a face-to-face personal interview with a minimum of two managers. Staff files and Criminal Record Bureau disclosures were looked at on a previous visit to the office of Independent Options and were found to be satisfactory. However the manager of Hallfield Guest House did bring a staff file for the inspector to look at on the day of the inspection. There were no staff vacancies; two new staff had commenced since the previous inspection of March 2006. When service users were present in the home there were two support workers on duty. Staffing levels were increased if necessary when service users’ needs demanded extra support. The manager and the support workers said that they had regular supervision and team meetings all of which were recorded. Hallfield Guest House DS0000064383.V334341.R01.S.doc Version 5.2 Page 22 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): Standards 37,39,42. Quality in this outcome area is excellent. The organisation and running of the business, which includes quality assurance monitoring, ensures that there is continual assessment and striving for improvement to the service being provided. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Ms Elizabeth Cunliffe has been the registered manager for almost two years and is responsible for the ‘short breaks’ service, which includes 55a Beech Avenue and Hallfield Guest House. Ms Cunliffe is qualified, competent and experienced to run the home. She holds a Masters Degree in Social Work, a Diploma in Social Work, an assessor’s award and should complete the Registered Managers Award within the next few months. Hallfield Guest House DS0000064383.V334341.R01.S.doc Version 5.2 Page 23 The organisation used a quality assurance system that allowed service users and others to have a say in the running of the organisation. The agency frequently sent out questionnaires to service users to obtain their views. Other quality assurance procedures included Investors In People and Positive about Disability from Employment Services. An annual report was produced which was distributed to all service uses, relatives and other interested parties. Ways of updating support workers on health and safety issues such as moving and handling and fire safety included formal training, team meetings, one to one supervision and written policies and procedures. The organisation had a detailed procedure for reporting of accidents. The home met the requirements of the fire authority and maintained records in respect of fire safety at the home. Hallfield Guest House DS0000064383.V334341.R01.S.doc Version 5.2 Page 24 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 x 2 4 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 4 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 4 35 4 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 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 4 x x 3 x Hallfield Guest House DS0000064383.V334341.R01.S.doc Version 5.2 Page 25 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. Refer to Standard Good Practice Recommendations Hallfield Guest House DS0000064383.V334341.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection North West Regional Office 11th Floor West Point 501 Chester Road Old Trafford M16 9HU 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
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