Inspection on 14/09/05 for High Cross House

This inspection was carried out on 14th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

High Cross House 23/02/09

High Cross House 29/01/07

High Cross House 23/01/06

High Cross House 01/03/05

High Cross House 09/12/04

High Cross House 20/11/03

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Polesworth Group Friary Road

Polesworth Group Pooley Heights

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Polesworth Group 70 Long Street

Breme

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Polesworth Group 68 Long Street

10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 High Cross House 93 Blurton Road Heron Cross Stoke-on-Trent Staffordshire ST3 2BS Lead Inspector Sue Jordan Unannounced Inspection 14th September 2005 10:30 High Cross House DS0000008236.V249474.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 High Cross House DS0000008236.V249474.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. High Cross House DS0000008236.V249474.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service High Cross House Address 93 Blurton Road Heron Cross Stoke-on-Trent Staffordshire ST3 2BS 01782 596629 01782 596629 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) Strathmore Care Services Ms Barbara Ann MacBryde Care Home 9 Category(ies) of Learning disability (9) registration, with number of places High Cross House DS0000008236.V249474.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 01/03/05 Brief Description of the Service: High Cross is a detached property in a residential area of Blurton, Stoke–on– Trent. The home is managed by Strathmore Care Services. The property is a large house, which is in keeping with other properties in the immediate area. High Cross is within walking distance from shops and other local amenities, which include a mini market, hairdressers, and a dentist. A bus stop is located close to the home. The home provides accommodation for up to nine service users who have a degree of learning disability. Service users are helped to find full or part time local employment and in appropriate cases to attend the local college. The accommodation briefly consists of nine individual bedrooms, which are situated on the ground and first floor, two bathrooms, three WCs, a kitchen, laundry, office and communal dining room and lounge. The home provides staffing support to three service users in the organisations semi-independent facility situated 200 yards away. High Cross House DS0000008236.V249474.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over five hours and the methodologies used were lunch with some of the residents at Highcross, discussion with three staff members and informal discussions with five of the residents. A tour of Highcross was made with the support of one of the residents. The care records for three residents, fire documentation and the complaints log were examined. What the service does well: What has improved since the last inspection? What they could do better: The manager was not present at this inspection therefore it was not possible to check all of the requirements previously made. Consequently some requirements have been carried over. These include the need for a maintenance plan, a whistle blowing policy, adequate recruitment procedures, High Cross House DS0000008236.V249474.R01.S.doc Version 5.0 Page 6 supervision and support for the manager, and service specific policies and procedures. These will be checked with the manager at an arranged additional visit. The Statement of Purpose and Service Users Guide have been developed and checked with the CSCI at previous inspections, however these documents were not available at this visit and the staff seemed to be unaware of their existence. These records should be current and available to all the staff and residents in the Home. The manager must ensure that the staff attend the required number of fire drills/training per year and given the independence and ability of the residents it is recommended that the Home re-commence fire drills for them also. 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. High Cross House DS0000008236.V249474.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 High Cross House DS0000008236.V249474.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, 2, 3, 5 Information regarding the Home must be available to the residents and staff to ensure that they are being provided with all of the facilities on offer. EVIDENCE: The Statement of Purpose and The Service Users’ were not available during this visit and the staff spoken to were not sure of their existence. Although it is known that they have been developed, they should be readily available to the staff and residents. As a result it was not possible to ascertain whether they have been reviewed and/or amended. There have been no new admissions into the Home, however copies of assessments were seen in the residents’ records. Evidence gathered during this and previous visits indicate that the Home is able to meet the needs of the current residents. Health monitoring is excellent and there is evidence of residents attending medical health appointments as required. The residents are all actively involved in the local community and are encouraged to be as independent as possible. There is a consistent staff team at the Home, who are experienced and trained to care for Adults with a Learning Disability. The staff were observed treating the residents with respect. Contracts were seen in the residents’ files. A statement of service has been added to the contract, which lists the facilities both included and not included in the fees. High Cross House DS0000008236.V249474.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, 7, 8, 9 Holistic care plans are in place, which are supported by written risk assessments. EVIDENCE: Three care records were examined. Plans are in place for various areas of the residents’ lives and risk assessments have now been undertaken to support all activities. The risk assessments are signed by the residents and the key worker. The entries on the care plans were made enthusiastically and regularly up until July/August 2005, however there seems to have been a recent decrease in the information recorded. This may be as a result of the holiday period, but it is recommended that the staff continue to record the action taken to help the residents meet their goals and aspirations. In-house evaluation of the care plans was taking place on a monthly basis, however those seen had not been evaluated since July 2005. Those care plans seen have been formally reviewed with the care management team within the last twelve months. The residents participate in some of the decision making in the Home within the forum of ‘house meetings’. They are also involved in their care planning and reviews. There is no evidence that the residents are involved in developing High Cross House DS0000008236.V249474.R01.S.doc Version 5.0 Page 10 or understanding the Home’s policies and procedures and as mentioned previously they should be aware of the Statement of Purpose and Service Users’ Guide. Financial agreements are made with each individual resident, which are dependent on ability. Some of the residents self medicate. High Cross House DS0000008236.V249474.R01.S.doc Version 5.0 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): 11, 12, 13, 14, 15, 16, 17 The residents enjoy a very active and extremely varied lifestyle, integrating into the local community. EVIDENCE: The residents of Highcross and 134 Blurton Road enjoy a varied and busy life. Each has an activity plan, which shows the numerous events they attend. These include college courses, sports activities, drama workshops and work placements. Alongside this the residents spend time with their families. On the day of the inspection three of the residents were at home. They were involved in doing their domestic tasks. Another resident spent the afternoon shopping for clothes with a member of staff. The residents are encouraged to be as independent as possible and most access the local community alone. They use public transport and local facilities. Two of the residents of 134 Blurton Road have been supported by an independent agency to find employment, some of which is voluntary and another paid. The third is meeting with the agency in the hope of also finding suitable employment. The residents maintain close contact with their families, spending regular weekends with their parents. Families are welcomed into the Home and there High Cross House DS0000008236.V249474.R01.S.doc Version 5.0 Page 12 is a strong support group, which meets to raise funds for activities. Many of the activities have been sponsored by local organisations. The residents have keys to their bedrooms but chose in a residents’ meeting not to have a front door key. The residents said that they are going to Majorca on holiday at the end of September 2005. The residents are involved in planning their own meals and during this visit; three prepared their own lunch with minimal support. Some of the residents have been trying to eat more healthily and therefore fresh fruit is readily available. High Cross House DS0000008236.V249474.R01.S.doc Version 5.0 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, 20 The residents have access to physical and mental health care and the results well recorded. EVIDENCE: Personal support needs are recorded in the care plans. Each resident has a key worker and discussions with some of the residents indicated that they understood the role of this person. Each resident has their own individual style. The health of the residents is well monitored and all medical appointments are recorded. Appropriate attendance at dentists, opticians and general practitioners was noted. The medication systems were not thoroughly examined at this visit, although the staff did report that they are undertaking the distance learning-Safe Handling of Medicines course. High Cross House DS0000008236.V249474.R01.S.doc Version 5.0 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): 22, 23 The residents are made aware of how to complain and can demonstrate this, however a whistle blowing policy must be developed to further ensure service user protection. EVIDENCE: A complaint was made to the CSCI in May 2005. The manager was informed and an appropriate investigation undertaken, which is recorded. The CSCI was satisfied with the outcome. There is a complaints procedure on the notice board. One of the residents described how she would make a complaint and to whom. The staff reported that they had received training in Adult Protection Procedures from the manager. The manager has obtained a copy of the Department of Health’s ‘No Secrets’ document, which explains the whistle blowing process, however there was no evidence during this inspection that the organisation has developed their own policy. When asked the staff on duty pointed to a list of contact names and numbers, which the organisation claim is for whistle blowing purposes. This however does not constitute an actual policy and procedure. The residents sign financial agreements and have been provided with a list of the facilities included in the fees. High Cross House DS0000008236.V249474.R01.S.doc Version 5.0 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, 26, 30 Highcross provides comfortable accommodation for its residents, although the home should have a planned maintenance and renewal programme for the fabric and decoration of the premises in order that this comfort be maintained. EVIDENCE: A tour of the accommodation was made with the support of one of the residents. Each of the residents has their own room and locks and keys are provided. The staff were asked whether any improvements had been made recently to the Home and they stated that none had. The carpets are due to be cleaned when the residents go on holiday and another is to be replaced. One of the residents said that they had been consulted when the dining room was decorated, although it is thought that this is some time ago. A statement of service has been completed, which stipulates what the resident may be expected to finance with regard to their bedroom re-decoration. The organisation is still required to provide the CSCI with a maintenance plan for the Home. Staff and residents work together to maintain the cleanliness of the Home. It was noticed that paper towels were not available in the kitchen, although the residents were encouraged to wash their hands before food preparation. High Cross House DS0000008236.V249474.R01.S.doc Version 5.0 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): 31, 33, 35, 36 The residents are supported by a consistent, trained and supervised team of staff. EVIDENCE: The manager was not present during this visit and therefore the staff files were not accessible. The staff on duty explained the training they had received and it would appear that mandatory training is delivered up to date, however they did feel that in-house training was less available since Craegmoor has become the organisational provider. Both of the staff members spoken to had achieved NVQ 2 and would like to progress to level 3. Both staff members said that they had now received the GSCC code of conduct. Three members of staff support the residents, who generally are very independent therefore this level of support is adequate. The staff from Highcross also support the residents of 134 Blurton Road and one of the residents explained the procedure for contacting staff and obtaining assistance. One member of staff sleeps in at each home. The recruitment files were not available therefore it was not possible to ascertain as to whether recruitment procedures have been strengthened as previously required. This requirement has therefore been carried over. High Cross House DS0000008236.V249474.R01.S.doc Version 5.0 Page 17 The staff reported that they are now being supervised by the manager and records kept. Regular team meetings are also held. Handover is held before each shift and important information recorded. All of the staff have their own notebooks, in which they record the requirements and appointments of the day. High Cross House DS0000008236.V249474.R01.S.doc Version 5.0 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, 40, 42 Thorough inspection of this section was not possible because the manager was not present, however the staff speak highly of the support given. EVIDENCE: The manager was not present at this visit therefore it was not possible to ask whether she is now being formally supervised. Two new policies and procedures were seen at this inspection, however the staff were not sure whether any more have been developed. A concern had been raised at previous inspections that the organisational policies and procedures do not relate to the service delivered at Highcross or 134 Blurton Road. It is recommended that the residents be involved in developing some of the policies and procedures. The fire safety records were examined; the fire risk assessment was out of date as these should be done annually. There have been no fire drills since the end of July 2005, although this was being done monthly. The manager is reminded that night staff must be involved in three monthly fire drills/training High Cross House DS0000008236.V249474.R01.S.doc Version 5.0 Page 19 and day staff six monthly. The Home was undertaking fire safety training for the residents up until November 2003. It is recommended that this be recommenced. It was not ascertained at this inspection whether the manager has contacted the fire department with regard to the personal furnishings and the need fire retention properties. High Cross House DS0000008236.V249474.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 3 X 3 Standard No 22 23 Score 3 1 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X 3 X X X 3 LIFESTYLES Standard No Score 11 3 12 3 13 4 14 3 15 4 16 3 17 Standard No 31 32 33 34 35 36 Score 3 X 3 1 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 High Cross House Score 3 3 X X Standard No 37 38 39 40 41 42 43 Score 2 3 X 1 X 2 x DS0000008236.V249474.R01.S.doc Version 5.0 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 2 Standard YA1 YA1 Regulation 4, 5, 6 Requirement The Statement of Purpose and Service Users’ Guide must be available to residents and staff. The Statement of Purpose and Service Users’ Guide must be kept under review and amended accordingly. A whistle blowing policy must be developed and accessible to staff. Previous Requirement. The home must have a planned maintenance and renewal programme for the fabric and decoration of the premises. Previous Requirement Staff files must contain all of the elements listed in Schedule 2 of The Care Homes Regulations. Previous Requirement. The manager must also receive professional support and supervision and annual appraisal. Previous Requirement. Timescale for action 01/11/05 01/11/05 3 YA23 13 (6), 17 01/11/05 4 YA24 23, 17 01/11/05 5 YA34 18, 19, 17, 13 Sch 2 01/11/05 6 YA37 9,10 01/11/05 High Cross House DS0000008236.V249474.R01.S.doc Version 5.0 Page 22 7 YA40 17, 12 Policies and procedures must be accessible to staff, which relate to and are specific to the service delivered at the Home. Previous Requirement. Staff must partake in fire drills/training at the appropriate frequencies. The manager must contact the Fire Safety Department with regard to personal furnishings and the need for fire retention properties. Previous Requirement 01/11/05 8 9 YA42 YA42 24 (4d, e) 23, 13 01/11/05 01/11/05 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 Refer to Standard YA6 YA40 Good Practice Recommendations It is recommended that the care plans continue to be evaluated monthly. It is recommended that the residents be involved in reviewing, developing and understanding the Home’s policies, procedures, Statement of Purpose and Service Users’ Guide. High Cross House DS0000008236.V249474.R01.S.doc Version 5.0 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 © 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 High Cross House DS0000008236.V249474.R01.S.doc Version 5.0 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. 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