Inspection on 31/08/05 for Hough Top

This inspection was carried out on 31st August 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Hough Top 04/01/07

Hough Top 26/04/05

Hough Top 11/01/05

Hough Top 13/05/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood Hall

Muston Road (70)

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

CARE HOME ADULTS 18-65 Hough Top 7 Hough Top LEEDS LS13 4QW Lead Inspector Chris Levi Unannounced 31 August 2005 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 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 Stationary 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. Hough Top J52 1468 Hough Top V174599 310805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Hough Top Address 7 Hough Top LEEDS LS13 4QW Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0113 204 0155 0113 204 0155 TACT Mrs Hilda Margaret Hurran Care Home 4 Category(ies) of Learning Diability (4) registration, with number of places Hough Top J52 1468 Hough Top V174599 310805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 26 April 2005 Brief Description of the Service: The home is located in the residential area of Swinnow in Leeds not far from Pudsey. It is within easy walking distance of a local parade of shops that includes a post office. Service users use these facilities on a regular basis. The home has a car that is well utilised to transport service users to appointments and trips out. A regular bus service is available to travel into the city centre or further afield.Personal care is provided for up to four service users who have learning disabilities. All are currently below the age of 65 years. Nursing care is not provided and the home is supported by local health care services.Accommodation is domestic in style. The home is situated in a quiet street in a residential area. The home is located on two floors and service user bedrooms are situated on the ground floor. They are all single rooms, comfortable and well decorated in the personal style of the individual. There are large enclosed gardens to the rear of the house with a small patio area. Hough Top J52 1468 Hough Top V174599 310805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced. It started at 9.15am finishing at 2.30pm. The person in charge of the home was Mrs J Hargreaves, acting manager of Hough Top. The morning was spent observing and interacting with the four male service users are under the age of 65 years, and have profound learning disabilities. The four have lived together at Hough Top for many years, following their discharge from a long stay hospital in Leeds. In the afternoon when service users were out at various external venues, a number of documents were inspected. These included plans of care for service users, management of medication, records of meetings for both staff and service users, and staff recruitment. A number of maintenance and health and safety documentation were also looked at. Some areas of the premises were visited. Information about the inspection findings was given to Mrs Hargreaves at the end of the inspection. Requirements and recommendations identified during the inspection can be found at the back of the report. What the service does well: This continues to be a well run home that provides good standards of support to the service users. The acting manager promotes a person centred approach to the service users and supports staff to focus their efforts to ensure the service users lead fulfilling lives. TACT, the organisation providing the services, offers staff regular training to enable staff to maintain high standards of care practice. Staff confirmed there was a positive teamwork approach. This was observed during the inspection, where examples of flexible use of staff skills benefited the service users. Hough Top J52 1468 Hough Top V174599 310805 Stage 4.doc Version 1.40 Page 6 Written risk assessments were of a high standard. They provide staff with relevant information when supporting service users in activities where risk had been identified. The continued involvement of external health professionals to provide advice and training for staff is well established. This ensures staff are updated with new strategies to develop the abilities and well being of the service users. 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. Hough Top J52 1468 Hough Top V174599 310805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Hough Top J52 1468 Hough Top V174599 310805 Stage 4.doc Version 1.40 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 standard(s) 1,2,5. People who use the service are able to access information about whether or not they wish to live in the home. Effective systems are in place to assess service user needs before admission to the home. Service users representatives have signed written contracts with TACT identifying the terms and conditions of a service users stay at the home. EVIDENCE: The home has written information about services provided at Hough Top. It is in a picture format as well as written text. Some amendments are needed to bring it up to date. This will assist any new service users who are unable to read to make a decision about moving to the home. Service users next of kin have signed individual written contracts since the last inspection visit. This document identifies their rights and responsibilities whilst living at Hough Top TACT, has a procedure for admission. This includes a number of informal visits and detailed assessments. However, no new service user has been admitted to the home since1996, when the current service users moved in from a long stay hospital in Leeds. Hough Top J52 1468 Hough Top V174599 310805 Stage 4.doc Version 1.40 Page 9 Hough Top J52 1468 Hough Top V174599 310805 Stage 4.doc Version 1.40 Page 10 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 standard(s) 6,7,8,9,10. Service users are provided with opportunities to make decisions about the way they live their lives, taking into consideration risks, choice and benefit to the individual. This promotes individuality, involvement, and fulfilment for each service user. Staff are aware of their responsibility relating to confidentiality of service user information. EVIDENCE: Detailed plans of care are in place to support each service user. One looked at had a new person centred planning journal. This was a very comprehensive book identifying all the areas of the service users life. The things he liked, disliked, and aspirations for the future. The service users meet with key workers for monthly meetings to agree any changes to plans of care and review the success of new activities. There was evidence of a service user representing the home at an external forum in Leeds to discuss the quality of the services provided. Hough Top J52 1468 Hough Top V174599 310805 Stage 4.doc Version 1.40 Page 11 Individual meetings are held monthly between service user and staff from the home. This provides opportunities to review and change any support offered to the service user. Service users have very limited ability to speak. However staff were observed understanding and responding to the needs of the individual service users. One service user has no next of kin. It is recommended that a external advocate is provided to ensure the best interests of the service user. Staff undertake training in Makaton a signing system of communication. Also there was evidence of extensive use of pictures to help the service users make decisions about their life. Staff have excellent evidence of assessing risks for service users in their daily living and social activities. Each service user has written risk assessments, to enable staff to assist where a risk is identified. A care plan and risk assessment was seen for a service user at risk of choking whilst eating. It would benefit from more detail regarding the first aid instructions. During induction staff are trained to understand the importance of confidentiality. Evidence of this was seen in a written statement signed by staff, a TACT policy and the storage of service user information when not in use. Hough Top J52 1468 Hough Top V174599 310805 Stage 4.doc Version 1.40 Page 12 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 standard(s) 12,13,14,16,17. Individual service users spend their day in the way they choose. They each appear to have busy lives, assisted by staff, who offer opportunities to support individual services users in identified social activities both in the home and the community. Food served at the home is balanced and nutritious and enjoyed by the service users. EVIDENCE: Each service user has a detailed written plan for agreed activities both social and domestic. They are very comprehensive in range and chosen by the service user relating to their special interests. One service users continues with dog walking at a local dog’s home. He has also chosen to try bike riding at a venue in Leeds. Service users have annual holidays accompanied by a support worker. Hough Top J52 1468 Hough Top V174599 310805 Stage 4.doc Version 1.40 Page 13 Service users days are structured, busy, and achievable as the home has its own transport and a number of staff drive the vehicle to a variety of external venues. Staff assess on a regular basis the success of activities in place for service users. Notes of this assessment were seen. Support staff, with the assistance of one service user, continue to purchase food from the supermarket to prepare meals at the home. There was evidence of visits by a dietician, and other external health professionals, for one service user who has difficulty with swallowing. A plan of care and risk assessment was seen. This provides information to staff about consistency, amount, and type of food suitable for the service user without compromising nutritional value. Hough Top J52 1468 Hough Top V174599 310805 Stage 4.doc Version 1.40 Page 14 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 standard(s) 18,19,20. Service users plans provide good information to ensure their health and wellbeing needs are met. Improvement in the safe administration of medication by staff to service users continues. EVIDENCE: The care plans looked at contained relevant, detailed information about the personal and health care needs of the individual service user. There was evidence of detailed plans of care enabling staff to provide appropriate assistance to the personal care needs of the service users. Those looked at included, bathing, sleeping, assistance when taking medication. In addition, evidence was seen that the health needs of the service users are appropriately identified and met. Visits to health centres, opticians, chiropodists and dentists were clearly recorded. During the inspection a health professional from Leeds Mental Heath Trust visited two service users to observe their behaviour and provide staff with ideas on intensive interaction techniques. Hough Top J52 1468 Hough Top V174599 310805 Stage 4.doc Version 1.40 Page 15 No service user is able to self medicate. Staff have implemented the previous requirement regarding safe storage of medication keys, and the use of the Medication administration records. This has resulted in minimal medication errors since the last inspection. A member of staff was observed administering and recording medication in a safe way to a service user. Hough Top J52 1468 Hough Top V174599 310805 Stage 4.doc Version 1.40 Page 16 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 standard(s) 22,23. Systems are in place to protect service users from abuse, and encourage their relatives to make complaints on behalf of the service users. EVIDENCE: The complaints procedure is displayed in the hallway. It is relevant and up to date. No complaint has been recorded since the last inspection. The home has a written procedure on what to do in the event of an allegation of abuse. It was clear and easy to follow. A support worker confirmed an understanding of whistle blowing and had attended training in recognising adult abuse. Hough Top J52 1468 Hough Top V174599 310805 Stage 4.doc Version 1.40 Page 17 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 standard(s) 24,25,28,30. Service users are provided with a safe and homely environment where individual service users can move freely about the house. Equipment is in place to enable staff to call for help in an emergency. EVIDENCE: The environment is homely. The lounge and dining room is furnished in a modern style with access to the well-used garden where a support worker was involved with a service user in growing vegetables. Some of the internal decorations were showing signs of wear and tear and would benefit from redecoration. The front door has a coded entry system to prevent service users leaving the home unaccompanied. A member of staff is responsible for ensuring fire safety checks and training for staff. Written records were seen that checks on fire safety equipment, hot water, and emergency lighting is regularly undertaken by staff. Hough Top J52 1468 Hough Top V174599 310805 Stage 4.doc Version 1.40 Page 18 Service users bedrooms are situated on the ground floor. They are for single occupancy but do not have en suite facilities. The building is owned and managed by a housing association who have responsibilities for building refurbishment and repair. Since the last inspection, the manager has introduced pager alarms to be worn by staff, to enable them to call for assistance in an emergency situation. Staff are responsible for all the cleaning tasks within the home and there was evidence that they try to involve the service users. It was noted during a tour of the building that the home was not as clean as it could be, and would benefit from a more thorough cleaning. Staff have received training on infection control and safe use of chemicals. The home was free from odour. The laundry was very hot due to the continuous use of the tumble dryer. It was noted that the central heating boiler cover was damaged. This might result in a health and safety hazard. Hough Top J52 1468 Hough Top V174599 310805 Stage 4.doc Version 1.40 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,34,35,36. The staff team at Hough Top are well trained and supported to provide very good levels of support to service users. The procedures for the recruitment of staff are robust, and offer protection for people living in the home. EVIDENCE: Staff were clear about their roles and responsibilities throughout the shift. One support worker said, “ We work well as a team and support each other”. Staff continue to put the needs of the service users first. Two members of staff said they had opportunities to discuss training needs in one to one supervision sessions, and staff meetings held monthly. Evidence of this documentation was seen. Staff have recently participated in their annual appraisal. Two support workers said they found the appraisals helpful, as they were an opportunity to look at what they had achieved and personal development plans for the coming year. Two staff files were looked at. Both provided evidence of robust recruitment practices. Each held identification of applicant, completed application forms, interview notes, a copy of the contract of employment. No new staff Hough Top J52 1468 Hough Top V174599 310805 Stage 4.doc Version 1.40 Page 20 commence employment before two references and a satisfactory CRB are received. This is good practice. The staff files are held in a secure cabinet to which the acting manager has access. Additional information held in the files includes copies of certificates of training, one to one supervision notes, and management of sickness absence. This was evidence of good management of confidential documentation. Hough Top J52 1468 Hough Top V174599 310805 Stage 4.doc Version 1.40 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,39,41,42. This is a well run home, where the acting manager demonstrates skills that ensure staff focus on the needs of the service users to provide a person centred approach. The home has a comprehensive range of policies and procedures relevant to the service, and a quality monitoring system. EVIDENCE: Mrs Hargreaves has been acting manager at the home for almost a year. She has experience of working with service users with learning disabilities and is currently studying for NVQ level 4 in care and a diploma in learning disabilities at a local university. A comprehensive folder of policies and procedures provide staff with clear guidance about what to do, and how to do it. A number of these were looked at and appeared up to date and relevant. An operations manager line manages the acting manager, providing supervision and monthly visits to the home. Hough Top J52 1468 Hough Top V174599 310805 Stage 4.doc Version 1.40 Page 22 Some of the information gathered at these meetings is used as part of the quality-monitoring programme. All staff undertake health and safety checks around the home. Evidence of these checks was seen. Accidents and incidents are correctly recorded and stored. Hough Top J52 1468 Hough Top V174599 310805 Stage 4.doc Version 1.40 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 x x 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 x x 3 x 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 x 3 3 Standard No 31 32 33 34 35 36 Score 3 3 x 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Hough Top Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 x 3 3 x J52 1468 Hough Top V174599 310805 Stage 4.doc Version 1.40 Page 24 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. Standard 24 Regulation 13 Requirement The central heating boiler must be made safe. Timescale for action 30th October 2005 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. 3. Refer to Standard 7 24 30 Good Practice Recommendations An external advocate should be provided for the service user without family. Some communal areas in the home should be redecorated. Cleanliness should be improved. Hough Top J52 1468 Hough Top V174599 310805 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Aire House Town Street Rodley LEEDS, LS13 1HP 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 Hough Top J52 1468 Hough Top V174599 310805 Stage 4.doc Version 1.40 Page 26 - 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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