CARE HOME ADULTS 18-65
Handsworth Development 63-65 St Joseph`s Road Handsworth Sheffield South Yorkshire S13 9AU Lead Inspector
Janis Robinson Key Unannounced Inspection 11th June 2007 08:45 DS0000002967.V330806.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 DS0000002967.V330806.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. DS0000002967.V330806.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Handsworth Development Address 63-65 St Joseph`s Road Handsworth Sheffield South Yorkshire S13 9AU 0114 254 8291 0114 269 0381 none None Northern Counties Housing Association Ltd 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) Ms Diane Margaret Bentley Care Home 12 Category(ies) of Learning disability (12) registration, with number of places DS0000002967.V330806.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. This registration includes 8 places for people with an additional physical disability (PD). This registration also includes 8 places at 101, 103, 105, 107 Hall Road, Sheffield S13 9AH. This registration includes 3 places for people who are over 65 years can reside at the home. 24th February 2006 Date of last inspection Brief Description of the Service: Handsworth Development provides a service for 12 adults with learning and physical disabilities. Four people live at one bungalow, and two people live in each of the four adjoining bungalows nearby. The bungalows are all purpose built, and are situated in the Handsworth residential area of Sheffield, which has good access to public transport and shops. The bungalows are all easily accessible to wheelchair users, have single bedrooms and large landscaped gardens. Each bungalow has a car parking area. Fees range from £277.00 to £322.35 per week. A statement of purpose and service user guide, giving information about the home, are available to current and prospective residents and their representatives in suitable formats. DS0000002967.V330806.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced. A visit to the home took place over 6.5 hours on the 11th June 2007. The manager was spoken with about the organisation and running of the home. All of the staff on duty were spoken with, two support workers were formally interviewed, about aspects of their jobs. The majority of people living at the home communicated through body language and limited verbal means, so daily routines and interactions were observed. One person spoke with the inspector about their home. A proportion of records were checked, including; assessments, care plans, staff training and recruitment, complaints, and health and safety, to make sure they were up to date and contained relevant information. In addition to the visit, questionnaires were sent to a proportion of people living at the home, their representatives, staff and professional visitors so they could give their views of the home. Eighteen questionnaires were returned. Comments received from these are reflected throughout this report. What the service does well:
All of the comments received were positive. From questionnaires, people said ‘I like it here’, and ‘the staff are nice’. Relatives were happy with the care provided, and said ‘my (relatives) care is important to staff’, and ‘staff are caring and do a good job’. Health professionals said ‘provides a high quality of life for people with high levels of care needs’ and ‘staff are well trained and very aware of individual needs’. Staff said that they worked well together and were provided with good training and supervision. Each person was provided with a comprehensive care plan that covered all aspects of social, health and personal care needs, and the staff action required to meet them. Interactions observed between people and staff appeared respectful and caring. Staff displayed a sense of commitment to people living at the home, and their well-being. Staff were knowledgeable about individual care needs. People were supported to lead full lives as safely as possible, access to the local community, leisure interests and family and friends were supported to improve quality of life. Staff were provided with relevant training to improve their knowledge and skills, and keep residents safe.
DS0000002967.V330806.R01.S.doc Version 5.2 Page 6 A thorough recruitment procedure was in operation to make sure suitable staff were employed and people’s’ safety was upheld. All of the records checked were fully completed and up to date, to make sure relevant information was available and could be monitored. The home was well decorated and well maintained, to provide a pleasant place to live. What has improved since the last inspection? What they could do better:
Whilst all staff had been provided with in house training in safe medication administration, the majority of staff had also been provided with medication training from the homes pharmacist. It is recommended that all staff undertake the additional training, to make sure all staff are equally informed. Records of medication training needed to include full dates so that this could be monitored more efficiently. DS0000002967.V330806.R01.S.doc Version 5.2 Page 7 All staff reported that they were provided with regular supervision, for development and support. However, formal staff supervision did not always take place at the recommended frequency. The inspector acknowledges that informal supervision took place on a regular basis. Whilst staff had been provided with fire training at appropriate levels and attended a fire lecture that covered evacuation, some staff had not attended separate fire drill training. The inspector acknowledges that this training was covered within the fire lecture. However, it is important that all staff participate in all aspects of fire training, to refresh their skills. 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. DS0000002967.V330806.R01.S.doc Version 5.2 Page 8 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 DS0000002967.V330806.R01.S.doc Version 5.2 Page 9 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): 1, 2 and 5. People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A statement of purpose and service user guide was available to people to give them full information about the home. A needs assessment had been undertaken with each person prior to admission to make sure the home could meet all identified needs. Each person had been provided with a contract to inform them of their rights. EVIDENCE: A copy of the statement of purpose and service user guide was available at the home, which the inspector saw. It was well set out and contained a range of information to make sure people knew about the home. The guide used pictures and diagrams to assist peoples understanding. A video guide to the home was available to people so that everyone had access to information. The manager confirmed that each person living at the home had been provided with a service user guide so that they could keep the information with them. A needs assessment was carried out with people prior to admission, to make sure all relevant information was obtained and the home could meet these
DS0000002967.V330806.R01.S.doc Version 5.2 Page 10 needs. Copies of the assessments were in place in the two files checked. They identified individual health, social and personal care needs, and were reflected throughout care plans so that staff were informed of the actions required of them. The two files checked also contained contracts (licence agreements) that had been undertaken with each person so that they were fully informed of their rights. DS0000002967.V330806.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): 6, 7 and 9. People who use this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person had a comprehensive care plan to inform staff of all their needs, interests and aspirations. People were supported to make decisions to respect their opinions. Risks had been identified to keep people safe. EVIDENCE: The inspector examined two care plans. These were comprehensively detailed and covered all aspects of social, personal and health care. Parts of the plan had been written in the first person so that the reader was clear that people’s agreement and involvement had been sought in writing the plan. Parts of the plan included diagrams, photographs and pictures to assist people’s understanding. The plans included information on goals and aspirations so
DS0000002967.V330806.R01.S.doc Version 5.2 Page 12 that these could be acknowledged. The plans clearly reflected people’s methods of communication so that staff could understand and respond to individuals who could not communicate verbally. The staff action required to meet identified needs was clear and specific so that staff knew what to do. The plans were reviewed regularly, some over and above the required frequency, to reflect the potentially changing needs of the individual. In addition to the written plan, key workers had produced ‘Key Worker Commitments’ for the people they supported. These were in the form of posters, pictures, books or albums. They set out key worker responsibilities in line with individual needs. For example, one person had a poster designed around trains, reflecting their interest, each carriage contained a statement from the key worker about what they would do, and how they would do it, support contact with family, social outings etc. Another key worker had produced an album that contained photographs explaining their commitment to the person they supported. These were seen on display in people’s bedrooms. This is to be commended as it gives people information about their lives in a way that they can understand, and is of interest to them. People were supported to make decisions, staff were observed to communicate with people throughout the day, and peoples opinions were sought so they could make choices. Individual risk assessments covering moving and handling, safety in and out of the home and other areas, had been undertaken and were recorded in plans to support people to lead full lives as safely as possible. The risk assessments were up to date and had been reviewed so that staff had relevant information provided to them. DS0000002967.V330806.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): 12, 13, 14, 15, 16 and 17. People who use this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were supported to follow their interests, take part in activities and maintain contact with their family so that they had a good quality of life. A healthy diet was provided to respect preferences and maintain peoples health. EVIDENCE: The care plans seen contained specific detail on all interests, hobbies and contact outside of the home so that staff could make sure these were maintained. People’s interests were reflected in their rooms and in the activities they participated in, for example, bowling, visiting pubs, shopping, day trips and holidays. Three people had recently returned from a holiday in Majorca, one person was packing to go on holiday at the weekend.
DS0000002967.V330806.R01.S.doc Version 5.2 Page 14 In recent months, as part of staff development, staff had undertaken an exercise looking at communication. Teams of staff had identified, sourced and supported a new activity for people to benefit from that reflected their hobbies, for example one person had a sailing trip organised, another person had a makeover and photograph. This had led to further, and ongoing, leisure opportunities for people. The majority of people had some contact with family or friends. Staff confirmed that there was an open visiting policy so that relatives were always welcome. The care plans seen gave details of all family contact. In questionnaires returned, relatives said that they were always kept informed by staff at the home, and were happy with the care provided. Care plans detailed people’s dietary needs and preferences so that these could be met. Some people needed a soft diet in line with their health needs, which was provided to them. Staff gave people a choice of what to eat by asking or showing photographs. Some people chose to go food shopping with staff as they enjoyed this activity. Since the last inspection nutritional assessments had been undertaken for all people to give detailed information to staff about all dietary needs, and to identify any potential needs. The records of food provided showed that people enjoyed a varied diet. There were plentiful stocks of food available, to offer people choice. As part of staff induction and staff development, the manager had introduced cooking tasks for staff, to make sure they had the skills needed to give people the food they liked. DS0000002967.V330806.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): 18, 19 and 20. People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People’s personal, health and medication needs were identified and met in a way that respected preferences and kept them safe. EVIDENCE: The care plans seen gave specific detail on personal care needs, and the staff action required to ensure these needs were met. Specialist equipment was provided to make sure peoples needs could be met safely. The plans contained a statement on the preferred gender of carer, so that this could be respected. Contact with health care professionals was supported, to maintain health. Records seen evidenced that people had regular contact with dentists, chiropodists, opticians and GP, as necessary. Staff were knowledgeable about people’s individual health needs and care plans contained advice and guidance on specific medical conditions for information. DS0000002967.V330806.R01.S.doc Version 5.2 Page 16 A medication policy was in place and all staff had undertaken in-house medication administration training so that they were aware of safe procedures to follow. In addition, the majority of staff had been provided with training from the homes Pharmacist, to refresh their knowledge. Remaining staff would be provided with this training as part of the rolling programme in operation. All medication was stored securely to minimise risk. Medication administration records were up to date and fully completed, to keep people safe. DS0000002967.V330806.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): 22 and 23. People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The polices and procedures in place protected people from abuse and ensured any concerns were listened to and taken seriously. EVIDENCE: A complaints policy was in place to ensure all complaints and concerns were taken seriously and responded to. People had been provided with a copy of the complaints procedure, in the service user guide, in an appropriate format to make it easier to understand. No complaints had been received. An adult protection policy was in place to inform staff and keep people safe. The staff interviewed knew of the procedure to follow if an allegation was made. It appeared from training records seen that the majority of staff had been provided with formal training in adult protection, and remaining staff had been nominated and were awaiting places. However, the manager confirmed that all staff had been provided with the training. A letter was sent to the CSCI to confirm this. Staff had access to relevant policies and procedures on adult protection, to make sure they were aware of the procedures to follow if they suspected abuse. The staff interviewed knew what to do if an allegation was made, to keep people safe. DS0000002967.V330806.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): 24, 25, 27, 28, 29 and 30. People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People lived in a homely, comfortable and safe environment, which met their needs and lifestyles. EVIDENCE: The inspector carried out a tour of the majority of the environment. All communal areas were clean and appeared comfortable. Pictures and ornaments were provided to create a homely feel. People’s bedrooms were highly individual to reflect their tastes and interests. At the time of this inspection all bathrooms were being refurbished with up to date specialist equipment to meet peoples personal support needs. Staff were provided with gloves and aprons to follow hygiene procedures. DS0000002967.V330806.R01.S.doc Version 5.2 Page 19 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): 32, 34, 35 and 36. People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected by a robust recruitment practice and comprehensive training programme. EVIDENCE: A programme of NVQ training was in place, to improve staff knowledge and skills. Of the 23 care staff, 65 had achieved NVQ levels 2 or 3 in care. In addition, a member of staff had qualified as an NVQ assessor to assist and improve training. This is over and above required levels of trained staff and is to be commended. A thorough recruitment policy was in operation to keep people safe. Two staff files were checked, they contained all of the required documentation, including proof of identity, two written references and details of previous employment. Criminal Records Bureau (CRB) checks had been undertaken with all staff to uphold safe procedures and protect people. DS0000002967.V330806.R01.S.doc Version 5.2 Page 20 A rolling programme of staff training was in operation to develop and maintain staff skills. Staff had been provided with induction and foundation training. Two staff had qualified as key trainers and developed a leaflet and DVD on safe moving and handling techniques. Individual training records were kept, and a matrix of staff training had been undertaken, to assist in monitoring. All staff said that they received regular supervision, on a formal and informal basis, for development and support. Whilst a plan and timetable for supervisions was seen that evidenced there was a programme in place, the records checked indicated that staff supervision did not take place at the recommended frequency of six times each year. DS0000002967.V330806.R01.S.doc Version 5.2 Page 21 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): 37, 39, 41 and 42. People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager’s leadership style benefited people living at the home and staff. Written policies and procedures were available to staff for information and guidance. The quality assurance system sought people’s views as part of monitoring and development. People’s welfare was promoted by the health and safety policies and procedures. DS0000002967.V330806.R01.S.doc Version 5.2 Page 22 EVIDENCE: People said that the manager was approachable and supportive. Everyone felt listened to. Regular staff meetings took place so that staff had the opportunity to voice their opinions. The manager appeared well organised and all records were maintained up to date so that relevant information was always available. A quality assurance system was in operation, to obtain and act on people’s views. Annual questionnaires were sent out to gather information from relatives, health professionals and people living at the home. The results of these were audited and kept in the office so that they were available to any interested parties. Monthly monitoring visits were undertaken by a company manager to make sure the home was running smoothly. A range of policies and procedures were available to staff so that they had access to information and guidance. Some policies had not been reviewed for some years, it is recommended that this be undertaken to check that information is up to date. A health and safety system was in operation to keep people safe. Equipment was checked and serviced to make sure it was in full working order. Weekly fire alarm checks were undertaken and regular fire drills and lectures took place, to ensure staff had the skills needed to respond in an emergency. Whilst some staff had not participated in fire drill training within agreed timescales, they had been provided with a lecture on fire procedures that covered evacuation. DS0000002967.V330806.R01.S.doc Version 5.2 Page 23 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 3 2 3 3 X 4 X 5 3 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 3 25 3 26 X 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X 3 3 X DS0000002967.V330806.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 YA36 Regulation 18 Requirement Appropriate levels of supervision must be provided to staff to uphold safe procedures. (Previous timescale of 20/04/06 not met) 2 YA42 13 In addition to fire lectures that cover evacuation, all staff must participate in a practice drill within required timescales to make sure their knowledge is maintained. 01/08/07 Timescale for action 31/08/07 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 YA41 Good Practice Recommendations Policies and procedures should be reviewed to make sure they contain up to date information. DS0000002967.V330806.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR 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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