Inspection on 06/10/05 for Hallgate, 28

This inspection was carried out on 6th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Hallgate, 28 29/09/08

Hallgate, 28 31/10/06

Hallgate, 28 31/01/06

Hallgate, 28 10/03/05

Hallgate, 28 29/06/04

Hallgate, 28 04/02/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 Hallgate 28 Hallgate Hexham Northumberland NE46 1XD Lead Inspector Karena M. Reed Unannounced 6 October 2005 2:45 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. Hallgate B53-BO3 S672 Hallgate V241060 061005 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Hallgate Address 28 Hallgate Hexham Northumberland NE46 1XD 01434 600 465 N/A hallgate@hexham28.fsnet.co.uk At Home in the Community 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) Mr Ian Thomas James Duthie CRH 5 Category(ies) of LD - Learning Disability (5) registration, with number of places Hallgate B53-BO3 S672 Hallgate V241060 061005 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 10-3-2005 Brief Description of the Service: Hallgate is a small home , registered to provide personal care and support to five adults with learning disabilities. Nursing care is not provided. It is situated in the Northumbrian market town of Hexham and is conveniently placed for local amenities ,such as shopping, restaurants and leisure centeres as well as transport links to other parts of the North East such as Newcastle and the Coast. The home is not recognisable as a care home from the outside. The premises are a grade 2 listed building with access gained from the front street ,and an enclosed terrace type garden to the rear of the building. There is a large dining room and lounge. Bedrooms are all for single use and there are sufficient lavatories and bathrooms. Hallgate B53-BO3 S672 Hallgate V241060 061005 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over 1and a half hours. A partial tour of the premises took place and a sample of records were inspected which included: 2 care plans, 2 staff files, the fire log, accident book, admission/discharge register, complaints record, 2 personal allowance records, staff communication book, staff meeting minutes, service user meeting minutes. I spoke to the manager, senior carer and three support workers and two service users who were on the premises at the time of inspection. What the service does well: What has improved since the last inspection? There were no requirements or recommendations made at the previous inspection. Hallgate B53-BO3 S672 Hallgate V241060 061005 Stage 4.doc Version 1.40 Page 6 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. Hallgate B53-BO3 S672 Hallgate V241060 061005 Stage 4.doc Version 1.40 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 Hallgate B53-BO3 S672 Hallgate V241060 061005 Stage 4.doc Version 1.40 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) 1,2,3,4,5 Information is not currently made available from the home to potential service users to make them aware of the service the home provides. Detailed information is received about the care and support required when a referral is made, the home’s management team carry out their own detailed assessment prior to agreeing to deliver care to the individual in order to ensure that their needs can be met. Staff are well equipped with the necessary skills in order to meet the needs of the service users . Staff are responsive to the needs of service users and provide a flexible, responsive service to the people they provide care and support to. A contract is not available between the home and the service user detailing the services provided by the home to the individual service user. Hallgate B53-BO3 S672 Hallgate V241060 061005 Stage 4.doc Version 1.40 Page 9 EVIDENCE: A Statement of Purpose was not available detailing the services provided by the home. The service user guide is currently in draft form and needs to include more information to tell people who may wish to live at the home about the services provided. Inspection of records for two service users showed that full assessments had been carried out prior to their admission. Staff training records maintained they receive training to assist them to meet the various needs of the service users as individually as possible. New support workers follow the Learning Disability Awareness Framework as part of their induction. Other training includes the necessary statutory training, values and attitudes, epilepsy, mental health, infection control, time management, care planning and any training which may be required to assist staff to meet the needs of service users as individually as possible. Service users have the opportunity to visit the home as many times as they like to decide if they wish to live there. This may involve tea- time visits, day and overnight stays and can be adjusted to the pace of the service user. Hallgate B53-BO3 S672 Hallgate V241060 061005 Stage 4.doc Version 1.40 Page 10 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) 6,7,8,9,10 There are good arrangements in place to ensure that service users’ health and social care needs are met. Health and social care needs are clearly addressed and the staff team are fully informed. Service users are well supported by staff and the necessary levels of support are provided due to the detailed care plans that show the level of care and support that staff need to provide . Detailed risk assessments are carried out to assist service users to lead as fulfilled lives as possible and they are well supported by staff to take calculated risks as necessary. Service users are encouraged to be involved in decision making and they are encouraged to communicate and make their views known other than verbally . Hallgate B53-BO3 S672 Hallgate V241060 061005 Stage 4.doc Version 1.40 Page 11 EVIDENCE: Care plans inspected were found to contain relevant individuals plans of care. They also contained risk assessments outlining the agreed risk to ensure service users’ independence was promoted. Care plans were available in a written format only. Service users care and support needs are reviewed regularly by staff and the service user in case their care and support needs have changed . Meetings are held regularly with service users about the running of the home. Hallgate B53-BO3 S672 Hallgate V241060 061005 Stage 4.doc Version 1.40 Page 12 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) 11,12,13,14,15,16,17 The philosophy of the home is for service users to access and participate in community facilities wherever possible eg leisure, health, spiritual, social, educational needs, etc. Social activities are managed creatively and provide daily variation and interest for people living in the home. Visitors are made welcome or staff support service users to maintain contact with family and friends as they wish. Hallgate B53-BO3 S672 Hallgate V241060 061005 Stage 4.doc Version 1.40 Page 13 EVIDENCE: Staff assist and support service users to learn skills and become more self sufficient in aspects of every day living. One service user was living in a bed sitter with cooking facilities at the top of the house and she informed me she was learning skills to help prepare her for more independent living after she left the home. Service users all pursue their own individual hobbies and interests e.g College, sports club, football, horse riding, bowling, swimming, attending music concerts , kareoke and discos, coffee mornings, shopping etc. There was also a wide range of activities and entertainment available to choose from if service users wished to take part. Trips were also arranged to camp, to visit Kielder and where ever service users may express an interest in visiting. Service users have the opportunity to take holidays supported by staff in this country or abroad. A small group of service users were preparing to go on holiday on the following Monday to Keswick. Records provided evidence that all service users are consulted and asked their opinion and encouraged to make decisions. Hallgate B53-BO3 S672 Hallgate V241060 061005 Stage 4.doc Version 1.40 Page 14 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 There are excellent arrangements in place to ensure that residents’ health care needs are met. Care plans outline the needs to ensure that the staff team are fully informed and aware of the support they need to provide. EVIDENCE: Attention was paid to service users’ dignity and staff were seen to act respectfully at all times. The care plans and case records inspected contained relevant individual plans of care detailing care and support required for some complex needs. Records showed when service users had seen health professionals eg doctors, community nurses, etc. Service users are assisted to access dental and optical services at least annually or as often as required. Staff receive medication training before they administer medication although the medication system was not examined at this inspection. Hallgate B53-BO3 S672 Hallgate V241060 061005 Stage 4.doc Version 1.40 Page 15 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) 22,23 There is a suitable and accessible complaints procedure. Service users and their relatives have confidence that they can raise any issues and know that they will be dealt with. The home’s management team have a sound grasp of Protection of Vulnerable procedures. EVIDENCE: The home has a complaints procedure. There was evidence that any complaints are listened to and investigated and a written record kept. There have been no complaints about the home since the last inspection. A procedure for responding to allegations of abuse is available. It was confirmed from staff spoken to that staff are given training in Adult Protection. Hallgate B53-BO3 S672 Hallgate V241060 061005 Stage 4.doc Version 1.40 Page 16 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) 24,25,26,27,28,29,30 The building is comfortable and well maintained with good quality furnishings and décor. There is sufficient space for service users to enjoy internally and externally. There is a good standard of hygiene. It is equipped with specialist equipment as required by service users to meet their physical needs. EVIDENCE: A tour of the premises was undertaken and a small number of bedrooms viewed. Service users have their own bedrooms that are well decorated and personalized according to the wishes and tastes of the individual. A good standard of hygiene was evident. The home is located on a charming but busy public thorough fare leading from the car park to the centre of the town. It was noticeable how noisy it was even in the afternoon as the building has only single glazing. Bedrooms are situated to the front of the house and it is noisier at night therefore service users are disturbed, thought should be given to some secondary glazing to the building in the interests of the comfort of the service users. Hallgate B53-BO3 S672 Hallgate V241060 061005 Stage 4.doc Version 1.40 Page 17 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) 31,32,33,34,35,36 Good staffing levels are maintained which means that there are enough staff on duty to meet the needs of service users. There is a varied training programme that ensures staff have a good understanding of the service users support needs. The recruitment and vetting procedures carried out by the Organization for employing staff are not robust. Staff receive a thorough grounding in the areas they need to know to provide good care to service users and enhance their own personal development. A system is available to ensure the staff team are supervised within the home however there is no system to ensure the regular supervision for the registered managers’ of the Organization. EVIDENCE: Examination of staff rotas and discussion with the manager and members of the staff team provided evidence that the numbers of staff are as follows: 7.30am- 3.30pm 2-3 2.00 pm- 10.00pm 2 -3 1 sleep in person 3.00pm- 3.30pm Hallgate B53-BO3 S672 Hallgate V241060 061005 Stage 4.doc Version 1.40 Page 18 There are enough staff to meet the needs of service users. The manger’s hours are included in the above, staff also carry out food preparation, cleaning and laundry. It was confirmed from staff records and from discussion with staff that they receive induction training . Where new inexperienced staff are employed, they work as an extra member of the shift, which is good practice. It was evident however, a new member of staff was working on the premises with service users and receiving induction training, without the relevant CRB clearances or a POVA first check having been carried out by the Organization prior to his commencing employment. 95 of the care staff team have now achieved National Vocational Qualifications at level 2 or 3 . Records confirmed that staff also receive advice and /or training in other areas, such as challenging behaviour, values and rights of people with learning disabilities, mental health, care planning, etc. Hallgate B53-BO3 S672 Hallgate V241060 061005 Stage 4.doc Version 1.40 Page 19 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) 37,38,39,40,41,42,43 Service users and staff benefit from a well run home. The manager’s leadership and management approach ensures that service users are fully involved and at the heart of decision making in their own lives and involved in the running of the home. Record keeping showed that service users’ interests are safeguarded. Systems and procedures are in place to ensure the well running of the home and to ensure the safety of residents and staff for the most part. A quality assurance system has not been formed to gather the views of service users and other stake holders. Hallgate B53-BO3 S672 Hallgate V241060 061005 Stage 4.doc Version 1.40 Page 20 EVIDENCE: The manager had just returned from a long term absence on the day of inspection. The staff team were competent and managed the home in his absence. Systems were in place so this could happen, the remaining staff team receiving the support from other managers’ within the Organization. There is a system in place to ensure that the staff are given training in moving and handling skills, fire safety, first aid, infection control and food hygiene. The fire log book indicated that fire safety checks are carried out routinely. The financial records for service users personal allowance did not provide evidence of two signatures for any entries. The home does not have a formal quality assurance programme, which includes seeking the views of residents, relatives and other interested parties, to feedback on the quality of care provided on an annual basis. Service users meetings and staff meetings take place regularly. Hallgate B53-BO3 S672 Hallgate V241060 061005 Stage 4.doc Version 1.40 Page 21 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 2 3 3 4 1 Standard No 22 23 ENVIRONMENT Score 4 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 4 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 x Standard No 31 32 33 34 35 36 Score x 3 3 1 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Hallgate Score 4 3 x x Standard No 37 38 39 40 41 42 43 Score 3 3 1 3 3 2 x B53-BO3 S672 Hallgate V241060 061005 Stage 4.doc Version 1.40 Page 22 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. 3. 4. 5. Standard 1 5 34 36 39 Regulation Reg 4(1) Schedule 1 5 19(4)(a)( b) 18(2) 24 Requirement A Statement of Purpose and service user guide must be devized. An accessible contract must be provided between the service user and the home. The required vetting procedures must be carried out before starting new members of staff. To establish a regular supervision system for managers of the Organization. To form a quality assurance system. Timescale for action January 1st 2006 January 1st 2006 October 7th 2005 December 1st 2005 January 31st 2006 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. 2. 3. Refer to Standard 6 24 41 Good Practice Recommendations To make care plans accesibel to all service users where possible. To consider fitting secondary glazing to the bedrooms to the front of the building. To obtain a second signature when issuing service users finances, preferably from the service user. B53-BO3 S672 Hallgate V241060 061005 Stage 4.doc Version 1.40 Page 23 Hallgate Commission for Social Care Inspection Northumbria House Manor Walks, Cramlington Northumberland NE23 6UR 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 Hallgate B53-BO3 S672 Hallgate V241060 061005 Stage 4.doc Version 1.40 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!