CARE HOME ADULTS 18-65
Handley Drive 12 Handley Drive Brindley Ford Stoke-on-Trent Staffordshire ST8 7QZ Lead Inspector
Wendy Snell Unannounced Inspection 26 January 2006 10:45 Handley Drive DS0000028916.V280406.R01.S.doc Version 5.1 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 Handley Drive DS0000028916.V280406.R01.S.doc Version 5.1 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. Handley Drive DS0000028916.V280406.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Handley Drive Address 12 Handley Drive Brindley Ford Stoke-on-Trent Staffordshire ST8 7QZ 01782 517079 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) Stoke on Trent City Council Care Home 11 Category(ies) of Dementia (3), Learning disability (11), Physical registration, with number disability (2) of places Handley Drive DS0000028916.V280406.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 27th July 2005 Brief Description of the Service: Handley Drive is a two storey local authority home built in the 1960s and operated by Stoke on Trent City Council. It provides comfortable accommodation for up to 11 younger adults with learning disabilities, of whom 3 may require dementia care and 2, a physical disability. Communal space offers two group living areas. On the ground floor there is a lounge dining area and a separate large lounge and separate dining area. There are also four bedrooms, laundry, office and walk in shower area on the ground floor. On the first floor there are seven further bedrooms, one assisted bathroom, one unassisted bathroom and also a shower room. There is a lounge/diner/kitchenette, which is used as a daily living skills training facility. Several toilets are located throughout the home. All bedrooms are single and none are en suite. The home is located in a small village community on the outskirts of Stoke on Trent with local village shops within walking distance. Access to the wider community is provided by the use of the home’s own transport and local buses. Handley Drive DS0000028916.V280406.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection, which took place during a Thursday morning and afternoon. Three service users, two staff members and the manager were spoken with. Paperwork relating to staff recruitment and training was examined, as were three service user’s care files. What the service does well: What has improved since the last inspection?
The manager has addressed most of the areas from the previous report. The statement of purpose has been updated and information is now available to service users about complaints. There are improved medication recording systems and all service records are now kept within the home. Handley Drive DS0000028916.V280406.R01.S.doc Version 5.1 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. Handley Drive DS0000028916.V280406.R01.S.doc Version 5.1 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 Handley Drive DS0000028916.V280406.R01.S.doc Version 5.1 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 The home has clear assessments of service users’ needs, which enables the staff to support them appropriately. EVIDENCE: Four service user’s care files were inspected at the last inspection. Care management assessment documentation was in place, which outlined care needs and potential risks. Handley Drive DS0000028916.V280406.R01.S.doc Version 5.1 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): 7 Service users are supported by staff to make decisions about their lives. EVIDENCE: Three service users were spoken with. The service users said that staff ask them for their opinions and support them to make decisions. It is acknowledged that some service users who live at Handley Drive require more assistance from staff in making decisions than others. In previous discussions with CSCI the manager has stated that advocates presently support two service users. Quality assurance questionnaires completed by ten service users indicated that all service users felt able to talk with staff. There was evidence that the home have regular service user meetings. These usually take place once a month. Agenda and minutes from these meetings were examined. There was evidence that service users are encouraged to express opinions about some aspects of the running of the home. The manager was able to give an example of how something was changed within the home as a direct result of a service user raising the issue in a meeting. He also said that issues raised within service user meetings are also discussed at staff meetings. It is recommended that the manager seek ways to evidence that service user views are listened to and acted upon.
Handley Drive DS0000028916.V280406.R01.S.doc Version 5.1 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 More structured activities for some service users could further enhance their quality of life. Service users are able to access the local community. EVIDENCE: Three service users were spoken with about activities. One service user said that he used to attend day service and college but that ‘it was too much’ for him now. He said that he enjoys being at home. Another service user said that she had retired and no longer went to day services. A third service user said that he does get ‘bored’ and would like to have an afternoon job at the local kennels. He said he has asked staff if this could be arranged for him. The structured educational and occupational activities of the service users were discussed with the manager and staff. There are a number of service users who have a more structured day than others. The manager explained that voluntary work was being explored for some service users but nothing had been finalised. This must now be pursued. Two staff members said that some service users do not want to be involved in structured activities. It is acknowledged that there are a number of older service users, the oldest being
Handley Drive DS0000028916.V280406.R01.S.doc Version 5.1 Page 11 65, who may not want to take part in full-time occupational or educational activities, however some fulfilling activities should be in place. The service users from the home are able to access the local community with the support of staff. There is one service user who is able to do this independently. The service users said that the local community was ‘generally quiet’ and that the neighbours were ‘friendly’. One service user said that he likes going out on the local bus. This is something that the manager said he would like to encourage as some of the service users enjoy using public transport. A staff member stated that three service users regularly attend the local church service on a Sunday. Handley Drive DS0000028916.V280406.R01.S.doc Version 5.1 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 The service users receive support in a way they prefer and require. EVIDENCE: Three service users were asked about the personal support they receive from staff. Two service users said that staff assist them with bathing. Both service users were happy with the way staff support them with this task. One service user was able to shower independently. Three service user files were examined. It was noted that there were guidance notes in each of the files, which set out how the service users liked to be supported. The support needs of one service user were discussed in depth with a staff member and the manager. There appeared to be some confusion regarding the number of staff required to support the service user whilst in the community and within the home. The manager agreed to clarify this area with staff members and to update the risk assessment. At the time of writing this report, clarification has been received that this has now been done. There appeared to be some confusion as to how and where staff should record service users’ health information. In one service user’s file there was no clear audit trail of appointments and outcomes. This was discussed with the manager. The recording of an appointment had been omitted, and information for other appointments recorded on a contact sheet rather than the medical outcome record, which should be the system within the home. This must be
Handley Drive DS0000028916.V280406.R01.S.doc Version 5.1 Page 13 addressed to ensure that all information relating to the health needs of service users is easily accessible. The service users said that the staff support them when they go shopping for clothes. One said ‘we have a look at them (clothes) and then buy what we like’. The manager and two staff members were spoken with all demonstrated a good understanding of the support needs, likes and dislikes of the service users within the home. Handley Drive DS0000028916.V280406.R01.S.doc Version 5.1 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): 23 There are procedures in place to protect service users from abuse. EVIDENCE: The home has a vulnerable adults policy. The manager said that this policy had been discussed at staff and management meetings. It was noted that a flow chart was available in the back of the manager’s handbook, which highlighted the corrected reporting procedure. Three service users were spoken with. All said that they felt safe living at Handley Drive. Staff training files were examined. There was evidence that all staff attended vulnerable adults training in July 2005. Four staff personnel files were also examined there was evidence that appropriate checks, including CRB checks had taken place. The manager said that there are no ongoing or outstanding adult protection investigations. Handley Drive DS0000028916.V280406.R01.S.doc Version 5.1 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 The standard of the environment within this home is good, providing service users with an attractive and homely place to live. EVIDENCE: The environment was checked during the previous inspection. The environment remains warm, clean, homely and furnished to a good standard. The service users spoke very positively about their home. Handley Drive DS0000028916.V280406.R01.S.doc Version 5.1 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 & 34 Staff have identified the need for training in the management of challenging behaviours and assessment and completion of NVQs, to ensure they have the skills to meet the needs of the service users. Appropriately recruited and vetted staff support service users at Handley Drive. EVIDENCE: Three service users were spoken with. They all said that the staff listen to them and support them. The staff-training matrix was examined and cross-referenced with individual training certificates. There was evidence that a range of training is offered to staff to equip them to do their jobs well. It was noted, however, that staff had not received training in managing challenging behaviours. Concerns were raised in respect of this and were discussed with the manager and service manager of Handley Drive in August 2005. The manager said that there had been some difficulties in securing this training but this would be available to all staff by October 2006. This must now be pursued and arranged. NVQ qualifications were discussed with the manager. There was evidence that most of the staff team have completed or are in the process of completing NVQ awards. In discussion with two staff however, it was revealed that whilst theoretical work has been completed the practical work has not been assessed. The manager said that they have not had enough assessors to complete this task. The manager should pursue this to ensure that staff are supported to develop and progress.
Handley Drive DS0000028916.V280406.R01.S.doc Version 5.1 Page 17 The home has an equal opportunities recruitment policy. Recruitment procedures have been discussed with the manager. The manager is aware of the need to ensure that previous work history is checked for gaps and that references, CRB and POVA clearance is in place prior to a potential employee commencing work. Four staff files were examined. The files were well ordered. There was evidence that the appropriate vetting, identification recruitment checks had taken place such as CRB checks. There was evidence that all staff have a contract of employment. Handley Drive DS0000028916.V280406.R01.S.doc Version 5.1 Page 18 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 & 39 Service users benefit from a well run home, however, frequent and regular monitoring by a representative of Stoke on Trent City Council is required to measure the home’s success in achieving the aims and objectives set out in the statement of purpose. EVIDENCE: The manager has a range of experience of working with adults with learning disabilities. He has been in post at Handley Drive for five months. He is qualified, competent and experienced to run the home and to meet the aims as outlined in the statement of purpose. The service users and staff spoken with during the inspection spoke positively about the manager and confirmed that he has an ‘open door policy’ and is always ‘approachable and understanding’. Quality assurance systems were discussed with the manager. There was evidence that service users and relatives had completed questionnaires in January 2006. The service user questionnaires were well constructed and had pictorial illustrations to the questions. It was noted that in some cases staff had supported service users to complete the questionnaires. It is
Handley Drive DS0000028916.V280406.R01.S.doc Version 5.1 Page 19 recommended that, where possible, a third party is sought to help service users complete the forms. The manager stated that the results of the feedback would be discussed with the service manager. The manager was also able to evidence an example of where something had changed within the home as a result of feedback from the survey. It is recommended that the results of the surveys and any actions taken are made available to service users and relatives. The CSCI have discussed with the manager and the service manager, Stoke on Trent’s monitoring arrangements for this home. Monitoring by a representative of Stoke on Trent City council must take place on a monthly basis. The service users within the home are encouraged by staff to participate in CSCI inspections. The home has a regular record of service user meetings which take place. One service user confirmed that he attended these meetings. Requirements and recommendations made by CSCI, and within the manager’s remit, have been complied with. Handley Drive DS0000028916.V280406.R01.S.doc Version 5.1 Page 20 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 x 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 x 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 x STAFFING Standard No Score 31 x 32 2 33 x 34 3 35 x 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score x 3 x x x LIFESTYLES Standard No Score 11 x 12 2 13 3 14 x 15 x 16 x 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 x x x 3 x 2 x x x x Handley Drive DS0000028916.V280406.R01.S.doc Version 5.1 Page 21 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. Standard YA12 Regulation 16(2)(m) Requirement Arrangements must be made to enable service users to engage in structured activities of their choice. Regular monitoring by a representative of Stoke City Council must take place. All service users to have a contract (previous timescale of 01/06/05 and 31/10/05 not met) A clear record of all medical and healthy intervention must be available within the home. All staff must have training in the management of challenging behaviour. Timescale for action 06/03/06 2. 3. YA39 YA1 26(1) 4(1)(c) 06/03/06 31/03/06 4. 5. YA18 YA32 17(1)(a) 18(1)(c) 06/03/06 24/04/06 Handley Drive DS0000028916.V280406.R01.S.doc Version 5.1 Page 22 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. 4 Refer to Standard YA6 YA7 YA42 YA32 Good Practice Recommendations All staff should have training in the proposed PCP system. The manager should seek to evidence that service users views are listened to and acted upon. An audit of which staff have a current first aid qualification should take place to ensure that there is a qualified member of staff on every shift. Staff should be enabled to complete NVQ qualifications. Handley Drive DS0000028916.V280406.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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