CARE HOME ADULTS 18-65
Helmsley Road Short Break Service 27-33 Helmsley Road Rainworth Nottingham Nottinghamshire NG21 0DQ Lead Inspector
Dee Shelvey Unannounced Inspection 28th September 2005 10:15 Helmsley Road Short Break Service DS0000036300.V251735.R01.S.doc Version 5.0 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 Helmsley Road Short Break Service DS0000036300.V251735.R01.S.doc Version 5.0 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. Helmsley Road Short Break Service DS0000036300.V251735.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Helmsley Road Short Break Service Address 27-33 Helmsley Road Rainworth Nottingham Nottinghamshire NG21 0DQ 0115 9823 823 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) Nottinghamshire County Council Sarah Robinson Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Helmsley Road Short Break Service DS0000036300.V251735.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. That two named existing long-term service users may remain at the home 11th November 2004 Date of last inspection Brief Description of the Service:
Helmsley Road consists of four purpose built bungalows three of which provide accommodation, in single rooms, for up to twelve younger adults who have learning difficulties. One is used as an administration centre and also houses the central kitchen and laundry. The service is part of Nottinghamshire County Council’s short-breaks provision. Located in Rainworth close to shops, pubs, post office and other amenities the bungalows are easily accessed by service users. There is car parking available for 12 cars and each bungalow has a separate front garden. The rear gardens had not been separated and service users spoken to preferred this layout. A variation of registration has been agreed in respect of two named long-stay service-users who remain resident in one of the bungalows for an indefinite period. Helmsley Road Short Break Service DS0000036300.V251735.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over a period of four and a half hours. It consisted of reading policy documents, records, and discussions with staff and service users. A tour of bungalows 27,29 and 31 took place. A complete refurbishment of all bungalows had just been completed and unfortunately some documents, usually kept in the manager’s office, were still packed in boxes awaiting the return of the manager. The senior members of staff on duty were most helpful but the homes records will be covered in greater detail in future inspections. What the service does well: What has improved since the last inspection? Helmsley Road Short Break Service DS0000036300.V251735.R01.S.doc Version 5.0 Page 6 The requirements set following the last inspection had been addressed. Service users, following risk assessments, now have keys to their rooms. In addition service users spiritual needs had been considered in the assessment process and their wishes recorded. All confidential records were securely stored in locked cabinets or locked offices and only accessible to appropriate people. The required information on employees had been gathered and placed on file. Staff had received fire safety awareness training and evacuation drills had taken place. The files seen were evidence of a general improvement in record keeping. Staff were noting all significant events during a service users stay so as to provide monitoring of care plans. 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. Helmsley Road Short Break Service DS0000036300.V251735.R01.S.doc Version 5.0 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 Helmsley Road Short Break Service DS0000036300.V251735.R01.S.doc Version 5.0 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): 1 and 5 Service users received sufficient information about the home to make a decision about having a short stay there. The service user would know what services to expect, what accommodation they would have, and what cost would be incurred. EVIDENCE: To enable service users to understand the information about the home it is provided in plain English and pictorial form. The terms and conditions are also supplied in pictorial form and sent out with every booking form ensuring that all service users know what is to be provided during their stay. Helmsley Road Short Break Service DS0000036300.V251735.R01.S.doc Version 5.0 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): 6,8 and 9. Service users needs were met enabling them to continue with their usual routines or treating the stay as a holiday. Their views on the standards of service received are actively sought. No restrictions are placed on service user activity and they are encouraged to maintain as much control over their own lives as possible. EVIDENCE: Service users assessments were compiled by the community learning disability team in conjunction with the service user and their family. Those seen were comprehensive and covered every aspect of need. Where risks were identified assessments had been carried out. The plans drawn up by the home had built in review dates but on the two examined there was no evidence that this had taken place. The staff spoken with gave assurances that service users were involved in the care planning process but the plans seen carried no evidence of this. On the day of inspection service users were observed taking part in various activities, going to the shops and receiving visitors. They were in charge of their own routines and staff were giving appropriate assistance. Helmsley Road Short Break Service DS0000036300.V251735.R01.S.doc Version 5.0 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): 11,12,14,16 and 17. Service users were actively encouraged to be as independent as possible whilst at the home and given access to a wide range of activities. The service users were treated with respect and were expected to treat others in a like manner. A varied menu of nutritious meals was offered. EVIDENCE: Service users were seen to use the local amenities e.g. shops and would be assisted to develop other daily living skills. If necessary the home would enable people to visit places of worship and such needs were included in assessments. A range of leisure activities were available to service users varying from indoor games to visiting the swimming baths. The terms and conditions set out the service users responsibilities and rights so that everyone knew what was expected of them. Service users were seen to be treated with respect. The menus examined contained a range of appropriate dishes. The cook demonstrated an understanding of the need to consult with service users and to offer choice. Helmsley Road Short Break Service DS0000036300.V251735.R01.S.doc Version 5.0 Page 11 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): None of these standards were assessed on this occasion. At the last inspection all these standards were assessed as being met. EVIDENCE: Helmsley Road Short Break Service DS0000036300.V251735.R01.S.doc Version 5.0 Page 12 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 and 23 The home makes every effort to seek the views of service users and to offer protection to the vulnerable. EVIDENCE: The complaints procedure was available in pictorial form and contained all the information set out in the national minimum standards. Staff received training on recognising signs of abuse and were familiar with the Nottingham County Councils protection of vulnerable adults policy. Staff meet regularly with service users and encourage them to express opinions on the home. This helps to create a climate where service users are confident in speaking to staff. Service users spoken with knew their “special” member of staff. Helmsley Road Short Break Service DS0000036300.V251735.R01.S.doc Version 5.0 Page 13 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): All of these standards were assessed. The bungalows had undergone a complete refurbishment and offered a high standard of accommodation in a safe and comfortable environment. EVIDENCE: The service users rooms were fitted with locks as were all bathing and toilet facilities ensuring the privacy of residents at all times. Each bungalow had a bathroom, shower and separate toilet facilities. Service users had access to a well-equipped kitchenette in each bungalow. The bungalows had been furnished in a domestic style but had also been provided with specialist equipment to meet the needs of service users. Two service users gave conducted tours of their rooms and expressed complete satisfaction with the accommodation. Helmsley Road Short Break Service DS0000036300.V251735.R01.S.doc Version 5.0 Page 14 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): 32,34,35and 36. Service users have the assistance of a competent group of staff that get appropriate training to enable them to carry out their duties. Nottingham County Council operates a robust recruitment procedure offering protection to vulnerable service users. Once employed staff are properly supervised and their work is appraised annually. EVIDENCE: Three personal files were examined and found to contain all the statutory information required on employees. This included two satisfactory references and evidence of checks through the criminal records bureaux. Prior to commencing work all new employees complete the Learning Disability Awards Framework. This takes three months and covers all core training including moving and handling, first aid, and food hygiene. Once they commence work staff are encourage to take up further training. Currently eight members of staff are undertaking NVQs. Training records contain evidence of related courses being available to staff. Staff appraisals take place yearly and each member of staff receives supervision at least six times per year. Helmsley Road Short Break Service DS0000036300.V251735.R01.S.doc Version 5.0 Page 15 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): 40,41 and 42. The home had satisfactory policies and procedures which if followed would safeguard the heath, safety and welfare of service users. EVIDENCE: The home operates under a set of policies and procedures drawn up by Nottingham County Council. These cover all areas of activity within a home including health and safety. These documents were still packed in boxes and could not be examined. Individual members of staff had delegated responsibilities for ensuring that policies were reviewed, updated and followed. Those staff members present demonstrated an understanding of infection control, electrical appliance checks and fire safety awareness. Fire safety records were seen and were up to date. All equipment checks had been carried out at appropriate intervals. Fire drills were carried out at approximately six monthly intervals. Helmsley Road Short Break Service DS0000036300.V251735.R01.S.doc Version 5.0 Page 16 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 3 X X X 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X 3 3 X Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 X 14 3 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Helmsley Road Short Break Service Score X X X X Standard No 37 38 39 40 41 42 43 Score X X X 3 3 3 X DS0000036300.V251735.R01.S.doc Version 5.0 Page 17 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 YA6 Regulation 15.1 15.2(c) Requirement Timescale for action 28/09/05 2 YA6 15.2(b) Ensure that the care plan contains evidence of service-user and family involvement. (Timescales of 30/08/04 and 31/12/04 not met) Ensure that service-user care 28/09/05 plans are reviewed on a regular basis (timescales of 30/08/04 and 31/12/04 not met) 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 YA42 Good Practice Recommendations To make a record of all attendees at fire drills. Helmsley Road Short Break Service DS0000036300.V251735.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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