Inspection on 15/11/06 for Hardriding House

This inspection was carried out on 15th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hardriding House 11/01/06

Hardriding House 21/09/05

Hardriding House 04/03/05

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

CARE HOME ADULTS 18-65 Hardriding House Bardon Mill Hexham Northumberland NE47 7ET Lead Inspector Mary Blake Key Unannounced Inspection 15 and 29th November 2006 09:30 th Hardriding House DS0000061948.V295229.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 Hardriding House DS0000061948.V295229.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. Hardriding House DS0000061948.V295229.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hardriding House Address Bardon Mill Hexham Northumberland NE47 7ET 01434 344330 01434 344330 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) Hardriding House Limited Mrs Angela Rose Hanking Care Home 19 Category(ies) of Learning disability (17), Learning disability over registration, with number 65 years of age (2) of places Hardriding House DS0000061948.V295229.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th January 2006 Brief Description of the Service: Hardriding House provides care to nineteen adults with learning disabilities. Care is provided from a large, traditional building, which has been modernised but at the same time retains many original features, which adds to the character. Annexes comprising a bungalow, a house and three flats adjoin the property, which provides accommodation as well as the main house. The home is situated in a rural area and is located within a farm. It enjoys magnificent views of the surrounding countryside. Local facilities are accessible by public transport and car and a small village is within walking distance. The fees are £370 per week. The service user guide and last inspection report were available within the entrance hall. Hardriding House DS0000061948.V295229.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced, the first of the year and took place over two day. Residents care records, staff records and additional statutory records were examined. Case tracking was undertaken, this involved following the care of individual residents. During the visit the inspector spoke with the manager, proprietor, three care staff, one ancillary staff. Over the two days all of the residents spoke with the inspector in private. 18 resident and 6 relative questionnaires were received prior to the site visit; residents were supported to complete these by relatives, advocates, supporting professionals and staff. These were very positive. What the service does well: Residents and staff explained the admission process; this usually includes a visit from the manager. This helps new residents identify their own needs and enables staff to meet their needs during their stay. The service gives good support to enable individuals to make decisions and participate in the running of the home. The service gives good support to enable individuals to maintain and develop personal and family relationships and provides support to help deal with bereavement and change. Residents described good relationships with the staff and said they were all polite and helpful. Staff were friendly and relaxed and showed a good understanding of residents needs. Individual care plans have continued to improve. Staff were more involved in planning and evaluating care and the plans this helps staff give residents the care they need. The management overviews these plans and this helps to provide a consistent staff approach. Residents are fully involved with their care plans where able. Meals are varied, well balanced and nicely presented offering good choice and nutritious food at all meals. All of the residents spoken to were pleased with the quality and choice available. The home is staffed with a skilled and consistent staff team giving security to residents. Staff recruitment and training records were clear and concise and contained all relevant information. The vetting process helps protect residents. The staff have a good understanding of residents individual needs and the residents were very complimentary about the staff. Hardriding House DS0000061948.V295229.R01.S.doc Version 5.2 Page 6 The management/senior care staff supervises staff and this gives an overview of staffs ability to provide satisfactory care for residents. Residents live in a home, which is well run and managed. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Hardriding House DS0000061948.V295229.R01.S.doc Version 5.2 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 Hardriding House DS0000061948.V295229.R01.S.doc Version 5.2 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): 2,3,4 Quality in the area is good. This judgement has been made using Residents have theirs need fully assessed by care staff before admission to the home but this is not always sufficiently documented. Residents have a gradual introduction and opportunity to visit the home. EVIDENCE: Pre-admission assessments are undertaken and reflect the needs of the residents. Generally care plans had good information to ensure that the home can meet the needs of the prospective resident but this had not been sufficiently recorded for the last admission. The Manager is involved in the decisions and in the majority of instances visits the residents herself prior to their admission. Residents and staff spoke of visiting the home prior to admission “was brought to have a look” “ I came for tea before I moved in” “happy to come here” “given all information” and that this was useful to reduce anxiety and make the settling in process easier. Hardriding House DS0000061948.V295229.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 & 9 Quality in this area is good. This judgement has been made Residents make decisions and are consulted and participate in all aspects of life within the home. Residents are supported to taken risks as part of their independence. EVIDENCE: On examination of a sample of service users plans these were found to be comprehensive care plan that assists them to become as independent as possible. The Registered Manager had ensured that all recorded information is reviewed and summarised on a monthly basis but this was not consistent and some care plans contained outdated information making the recent information difficult to find. The residents have had the opportunity to participate in the selection of staff. Regular residents meetings are held. The home and organisation has good systems to enable residents to share their views and they continue to look at ways of involving residents and improving individualised services. Residents commented “Angela helps me choose” “I can go to bed when I want to” “I can have a drink whenever I want to” Hardriding House DS0000061948.V295229.R01.S.doc Version 5.2 Page 10 Risk assessments were in place and had generally been reviewed and updated. An individual risk assessment (details discussed with Registered Manager) need to be reviewed in order to provide risk assessment for activities within and outside of the home. The manager had undertaken refresher training in risk assessments and a further review of residents risk assessments was taking place. Hardriding House DS0000061948.V295229.R01.S.doc Version 5.2 Page 11 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): 12,13,14,15,16 & 17 Quality in this area is excellent. This judgement Residents have good opportunities for personal development, are part of the local community and are able to take part in appropriate educational, training, work, social and leisure activities. Residents are supported to have appropriate family and personal relationships Resident’s rights are respected and responsibilities recognised in their daily lives. Residents are offered healthy diet and a relaxed and social mealtime. EVIDENCE: The philosophy of the home is for residents to learn skills and be given support to become as independent as possible. “I like living here” “I like helping by making the beds” “I help with dishes, Hoover and polishing” “ I like it here” Hardriding House DS0000061948.V295229.R01.S.doc Version 5.2 Page 12 Residents have the opportunity to increase their social network and staff support residents to maintain existing friendships and social relationships. Residents have opportunities to participate and learn in a range of settings attending College and training centres. They have opportunities for personal development both in the home and through involvement in a range of community based activities. Personal centred plans indicated that most residents access community facilities during the day either full or part time. Some attend college courses, work places and adult training centres, in order to gain work experience or a therapeutic or educational benefit. Relatives and residents commented, “He participates in a voluntary capacity in a learning environment” “I am happy living here” “I like going to work”. Residents have the opportunity to use community facilities for leisure activities e.g. cinema, pub, meals, shopping etc. They are offered the opportunity to experience new activities and leisure pursuits as well as supported where necessary to continue with hobbies and interests. For example cooking, music and dancing were undertaken. “I like to play dominoes and dance when we have music time” “I enjoy the weekends as they are” The residents have regular outings, holidays at local and national venues. Staff assists and encourage residents to maintain family links and previous friendships, respecting the individual resident’s wishes. Many residents spend weekends at the family home. “I go to my mum and dads at weekends” In discussion with the residents, manager and staff they confirmed their involvement and choice in relation to visitors. Opportunities to meet people who do not have a disability were available and reviewed within the individual plan was social and relationship opportunities It was observed staff respecting privacy by seeking permission prior to entering individual rooms and interacting well with residents. Residents were observed to move freely around the home and were able to spend time alone. Residents commented on the quality and choice of food available. Fresh fruit was available and residents were observed having coffee in a relaxed and social setting. Residents are able to prepare light meals in the kitchen. Hardriding House DS0000061948.V295229.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 21 Quality in this area was good. This judgement has been Residents receive personal support the way they prefer and require. Residents physical and emotional health needs are met. Ageing, illness and death of residents are handled with respect. EVIDENCE: Residents, who require personal support, are given this in a way that protects their dignity and maximises their independence. It was evident that residents’ individual health needs are identified and residents are supported to access community health services such as general practitioner, district nurse, dentist, and optician. All residents have an annual health check. Physiotherapist, psychiatric, psychologist and learning support team provide specialist health support. Preventative health care is also supported with some attendance at well woman and well man clinics as required. Hardriding House DS0000061948.V295229.R01.S.doc Version 5.2 Page 14 Staff training has been undertaken to provide awareness and additional support for health related needs. The changing needs of residents and the death of a resident has been well managed over the past year; staff have provided additional support and accessed appropriate aids/adaptations as necessary. There are currently no residents who have any moving and transferring needs. Staff have dealt sensitively with the recent bereavement and have provided support to all residents and families. Hardriding House DS0000061948.V295229.R01.S.doc Version 5.2 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 the following standard(s): 22 & 23 Quality in this area is good. This judgement has been made Residents feel their views are listened to and acted upon. Residents are protected from abuse, neglect and self-harm EVIDENCE: There have been no recorded complaints. A complaint procedure is in place. Residents and families spoken to over the inspection year stated that they felt confident that their views would be listened to and acted upon if necessary. “I can talk to all the staff” “if I’m not happy I’ll tell the staff” “if I was very angry at someone I would tell Angela” “I would speak to K or G” “ I can speak to any of the staff”. Staff have undertaken the one day training on the Protection of Vulnerable Adults. The manager/deputy have undertaken the two day course in the Management of suspected abuse. There have been no allegations or cause for concern within the home. Issues to provide support and protection to individuals in and outside of the home are being reviewed by a multidisciplinary team. Hardriding House DS0000061948.V295229.R01.S.doc Version 5.2 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 the following standard(s): 24 & 30 Quality in this area is good. This judgement has been made Residents live in a homely, clean, comfortable and safe environment. EVIDENCE: . The inspection of the building indicated that the premises appeared safe, comfortable, bright and airy, clean and free from odours and generally of a good standard. Recent major refurbishments throughout the buildings were evident with residents commenting upon these improvements. Hardriding House DS0000061948.V295229.R01.S.doc Version 5.2 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 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): 32,34,35 & 36 Quality in this area is good. This judgement has been The manager ensures there are adequate numbers of staff on duty that have appropriate skills and experience to care for the residents. The recruitment processes in place protect residents. External and internal training takes place providing residents with a skilled, consistent staff team. EVIDENCE: Staffing rotas showed that there are enough staff are on duty to meet the necessary staffing levels. Staff undertake mandatory training, National Vocational Qualifications in Care and other training. This was clarified from the sample of records inspected and discussions with staff. The training programme and records are currently under review Staff said that they are undertaking or had completed National Vocational Qualification in Care level 2 (NVQ) or over and the home has an induction and training programme for all staff working in the home. Due to staff changes the home does not meet the 50 target for NVQ but plans are in place for new staff to undertake this training. Staff spoke knowledgably about the individual needs of residents. Hardriding House DS0000061948.V295229.R01.S.doc Version 5.2 Page 18 Residents and relatives wrote and spoke positively about staff “staff are very understanding at all times” “like all the staff” “if I am sad, the staff listen to me” “service provided is very good” “perfect care and attention better than I could do myself” “if he registers unhappiness the staff know how to react” Staff supervision and recruitment files were examined and were satisfactory. Hardriding House DS0000061948.V295229.R01.S.doc Version 5.2 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 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 & 42 Quality in this area is good. This judgement has been made Resident’s benefit from a well run home with a manager who has developed an open and inclusive atmosphere. Residents’ health, safety and welfare are protected. EVIDENCE: On observations of staff and residents it was evident that they felt confident with the openness and approachability of the Registered Manager. The Registered Manager is qualified and experienced and communicates a clear sense of direction and leadership. The Registered Manager is currently undertaking quality assurance involving working with residents, advocates and staff to obtain their views on the service provided. Regular meetings had been held for residents, relatives and staff. Hardriding House DS0000061948.V295229.R01.S.doc Version 5.2 Page 20 Quality assurance systems are currently under review. Monthly proprietor visits are undertaken with good written reports and any issues addressed. Accidents are recorded effectively with accident analyses being completed and risk preventions being undertaken to safeguard residents. The system for checking resident’s monies was satisfactory. The records examined were secure, up to date and in good order. Health and safety systems are well organised, the building is safe and the management and staff spoke knowledgeably about maintaining and promoting the welfare of the residents. Fire testing and maintenance is undertaken at the given timescales. Hardriding House DS0000061948.V295229.R01.S.doc Version 5.2 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 Standard No Score 1 X 2 3 3 2 4 3 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 4 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 X 3 X X 3 X Hardriding House DS0000061948.V295229.R01.S.doc Version 5.2 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 Standard YA3 YA6 YA9 Regulation 14 (1) 15 (2) 4 (b)(c) Requirement The Registered Manager must complete preadmission documentation for all residents The Registered Manager must update all service user plans The Registered Manager must provide updated risk assessments for all residents as necessary. Timescale for action 31/01/07 31/01/07 31/01/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Hardriding House DS0000061948.V295229.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Cramlington Area Office 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 Hardriding House DS0000061948.V295229.R01.S.doc Version 5.2 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!