Inspection on 29/11/05 for High Street (80) - Resource Centre - NYCC

This inspection was carried out on 29th November 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 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

High Street (80) - Resource... 01/08/07

High Street (80) - Resource... 10/08/06

High Street (80) - Resource... 21/03/06

High Street (80) - Resource... 13/01/05

High Street (80) - Resource... 13/07/04

High Street (80) - Resource... 22/03/04

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

CARE HOME ADULTS 18-65 High Street (80) - Resource Centre - NYCC Resource Centre 80 High Street Starbeck Harrogate North Yorkshire HG2 7LW Lead Inspector Mrs Irene Ward Unannounced Inspection 29th November 2005 10:00 High Street (80) - Resource Centre - NYCC DS0000034427.V265057.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 Street (80) - Resource Centre - NYCC DS0000034427.V265057.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 Street (80) - Resource Centre - NYCC DS0000034427.V265057.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service High Street (80) - Resource Centre - NYCC Address 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) Resource Centre 80 High Street Starbeck Harrogate North Yorkshire HG2 7LW 01423 883301 01423 881498 North Yorkshire County Council Mrs Julia Heather Glenny Care Home 8 Category(ies) of Learning disability (8), Learning disability over registration, with number 65 years of age (8) of places High Street (80) - Resource Centre - NYCC DS0000034427.V265057.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service Users up to 8 (LD) and up to 8 (LD(E)) up to a maximum of 8 Service Users 13th January 2005 Date of last inspection Brief Description of the Service: The Resource Centre, 80 High Street is registered to provide residential care for up to 8 adults aged between 18 and 65 years with a learning disability and up to 8 adults aged 65 years and above with a learning disability. The maximum number of places available at any given time is 8. The registered provider is North Yorkshire County Council. The home offers placements exclusively to service users and their families who require respite care. The accommodation is set on the ground floor and is located in a building that also houses the Community Resource Team offices and rooms accessed by other community groups. The home is situated approximately 2 miles from Harrogate town centre. There are good local amenities within 20 minutes walk in Starbeck. High Street (80) - Resource Centre - NYCC DS0000034427.V265057.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over four and a half hours and was an unannounced inspection, which commenced at 10.00 am with a follow up visit at 16.00 hrs to speak with service users. A tour of the respite unit was carried out in the morning with a senior staff member and a number of records were inspected. Two service users and staff on duty were spoken to. What the service does well: What has improved since the last inspection? What they could do better: The environment requires some attention as some areas have been damaged and some of the furnishings are now worn. The requirements made at the last inspection are still outstanding and should be addressed. Staffing hours are above the minimum required. However the unit’s management should consider and look towards making improvements in this area by employing a cook and domestic staff. Management should also implement further training in the Protection of Vulnerable Adults. Attention should also be given to Care Plans in that they must be more detailed for staff when providing personal care to service users. High Street (80) - Resource Centre - NYCC DS0000034427.V265057.R01.S.doc Version 5.0 Page 6 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 Street (80) - Resource Centre - NYCC DS0000034427.V265057.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 Street (80) - Resource Centre - NYCC DS0000034427.V265057.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): 2 and 4 Comprehensive assessments are carried out prior to any provision of service is offered. EVIDENCE: The care management team prior to a service user being offered a respite service carry out comprehensive assessments. All referrals to the unit would include a care management plan including emergencies. Prospective service users are offered a visit to the unit and stop for tea prior to coming to stay for respite. Usually service users have 3-4 tea visits, which then leads to arrangements being made for a one-night stop at the unit. High Street (80) - Resource Centre - NYCC DS0000034427.V265057.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 and 9 Service users can be confident that their needs can be met through the clear planning system in place that provides staff with the necessary information. EVIDENCE: There are comprehensive care plans in place. Three service users care plans were inspected which outlined in detail their care needs. However one service users care plan stated that the service user was able to bathe himself once in the bath. The information was unclear as to whether he required assistance in getting both in and out of the bath and how this was to be achieved. In discussion held with senior staff it was agreed that this information requires to more specific in detail to ensure that all staff were following clear instructions when meeting the care needs of service users. Service users care plans are regularly reviewed and up dated. Risk assessments have been completed and are held with service users care plans. Staff were observed enabling service users to be as independent as possible and were also available to assist where necessary. High Street (80) - Resource Centre - NYCC DS0000034427.V265057.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): 12,13,15,16 and 17 Service users rights are respected, promoted and supported by the staff team. EVIDENCE: Service users are encouraged and supported to maintain established links in the community. There is a daily activities programme in place and service users are supported to attend various activities including training, day services and meaningful occupation. The unit does not employ a cook or domestic staff, as all staff are involved in the preparation of meals. The recommendation made at the last inspection was that this should be reviewed as this impacts on the ability of staff to supervise service users at critical times of the day. Service users stated that the food at the unit is “very good” and that they are able to have choices at each mealtime. There is a four week rolling menu that is adapted to service users preferences. High Street (80) - Resource Centre - NYCC DS0000034427.V265057.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): 18, 19 and 20 Service users health care needs are well met. EVIDENCE: Service users were observed receiving support from staff when they needed it. Although service users are encouraged to undertake as many tasks independently if they are able to. For those service users who are able to self-medicate a locked box is provided in their own room. However for those service users who are unable to selfmedicate the unit has a medication system in place and procedures are followed accordingly. Medication was stored securely and medication records were accurately maintained. There are currently no service users that require controlled drugs. All staff who administer medication have recently undergone the Safe Handling of Medication training. High Street (80) - Resource Centre - NYCC DS0000034427.V265057.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 Service users are confident that the manager or staff at the unit will deal with their complaints/ concerns. EVIDENCE: North Yorkshire County Council’s policies and procedures regarding complaints is in place. There have been no complaints received by the unit or the Commission For Social Care Inspection. The leaflet “ How to Complain” is given to all service users or their relative or their representative. Two service users stated that if they were worried about anything they would speak with staff or the registered manager. North Yorkshire County Council’s policy and procedure regarding abuse is in place. In discussions held with senior staff Adult Abuse is covered in induction training and in NVQ training. New procedures have been implemented, however staff were unclear as to what those procedures were and what course of action they needed to take when a service user disclosed any form of abuse. Staff should be briefed to any new procedures that protect service users from abuse. The management of the unit may wish to look towards implementing additional adult abuse training to ensure that staff are clear as what actions are required to be taken if a service user discloses that they have been abused. High Street (80) - Resource Centre - NYCC DS0000034427.V265057.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): 24,25 and 30 The unit provides a comfortable environment that is clean but requires some attention to repairs and re-decoration in some areas. EVIDENCE: The unit is purpose built and has all rooms on the ground floor. There are eight bedrooms in total. The unoccupied rooms are not personalised, as it is a respite unit. There is a lounge and dining area, which has been painted by the staff in January of this year. Staff have also painted one bedroom which has also had a new carpet fitted. In discussions held with staff it would seem that they have carried out painting the unit as they felt let down by North Yorkshire County Council and felt “ashamed” of the décor and what families may think about the unit. There has been major wheelchair damage caused to all of the doors and some of the corridors in the unit. There was also damage to the walls in the purple room that require repairs. There was also a kitchen cupboard door that was missing and has been for sometime that needs to be replaced. The small kitchen has had the hot water turned off as there is no regulator and service users may scald themselves. Therefore this kitchen is no longer used for any independent living skills that the unit may want to support service users with. All areas inspected were clean and free of any odours. Service users who want to access the back garden can only do so with great High Street (80) - Resource Centre - NYCC DS0000034427.V265057.R01.S.doc Version 5.0 Page 14 difficulty. This was discussed with senior staff and currently there is a water leak in the garden, which has made this area muddy. However when possible a ramp from the patio area outside the lounge would improve the situation for service users when they want to sit out in the garden. This was a requirement made at the last inspection and is still outstanding. High Street (80) - Resource Centre - NYCC DS0000034427.V265057.R01.S.doc Version 5.0 Page 15 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): 32,33,34 and 35 Service users are protected by North Yorkshire County Councils recruitment procedures. EVIDENCE: Four staff files were inspected. All files held completed application forms, two references and health questionnaires. CRB checks have been obtained although the CRB Disclosures are held centrally at County Hall. The unit is currently obtaining summaries of CRB Disclosures as previously all staff files were held with the Human Resources department. The staff rota was inspected and showed that there was three staff on duty in the afternoon. There is one sleeping in staff and one waking night on duty each night. The unit currently provides 452.5 hours for the total staffing hours for the unit. This is above the minimum staffing hours required. However in discussions held with staff it was highlighted that on occasion the shortage of staff does impact on the service, such as the lack of activities and at mealtimes when service users are requiring assistance. A recommendation was made at the last inspection for management to look towards reviewing current staffing arrangements as they have a negative impact on staff ability to supervise service users at critical times of the day. High Street (80) - Resource Centre - NYCC DS0000034427.V265057.R01.S.doc Version 5.0 Page 16 Staff training is ongoing and available such as fire training, first aid, basic food health and hygiene, mental health awareness, breakaway restraint, dementia and so on. The unit meets the 50 of staff holding NVQ qualifications as 11 staff have NVQ level 3. The registered manager holds NVQ Level 4 and has completed the Registered Managers Award. High Street (80) - Resource Centre - NYCC DS0000034427.V265057.R01.S.doc Version 5.0 Page 17 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 and 42 Service users health, safety and welfare is promoted and protected. EVIDENCE: The unit does seek the views of service users about the service they receive. Throughout the day from discussions held with service users and staff and through observation, 80 High Street continues to be managed well with a committed staff team. Although there is a few issues regarding the environment that need to be addressed. A number of health and safety records were inspected all of which were up to date and most were accurately maintained. However the accident book was inspected and was not maintained in line with the requirements of the Data Protection Act. High Street (80) - Resource Centre - NYCC DS0000034427.V265057.R01.S.doc Version 5.0 Page 18 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 X 3 X 3 X Standard No 22 23 Score 3 1 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 1 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 1 3 X X X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 3 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 1 X High Street (80) - Resource Centre - NYCC DS0000034427.V265057.R01.S.doc Version 5.0 Page 19 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 YA6 YA23 Regulation 15(1) 13(6) Requirement Service users care plans must be specific in detail for staff when providing personal care. Staff must be familiar with North Yorkshire County Council procedures that are in place regarding Adult Abuse and further training in this area is required. The following areas require attention; The damaged doors and corridors. Damage to the walls in the purple room. The kitchen cupboard door must be replaced. A ramp should be installed to permit access to the grassed area of the gardens. Wheelchair access to all parts of the building should be improved. The accident book must be maintained in line with the requirements of Data Protection. Timescale for action 28/02/06 29/11/05 3 YA24 23 28/02/06 4 5 6 YA24 YA24 YA42 23 23 17(2) 30/07/04 30/09/04 29/11/05 High Street (80) - Resource Centre - NYCC DS0000034427.V265057.R01.S.doc Version 5.0 Page 20 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 YA33 Good Practice Recommendations The absence of a cook and domestic staff should be reviewed in light of staff comments that the current arrangements have a negative impact on their ability to supervise service users at critical times of the day. High Street (80) - Resource Centre - NYCC DS0000034427.V265057.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 Street (80) - Resource Centre - NYCC DS0000034427.V265057.R01.S.doc Version 5.0 Page 22 - 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. 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