Inspection on 21/06/07 for Howbeck Close 2

This inspection was carried out on 21st June 2007.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Howbeck Close 2 22/01/06

Howbeck Close 2 09/05/05

Howbeck Close 2 18/01/05

Howbeck Close 2 03/08/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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

CARE HOME ADULTS 18-65 Howbeck Close 2 1 - 2 Howbeck Close, Off Howbeck Drive Edlington Doncaster DN12 1RE Lead Inspector Andrea Leverett Key Unannounced Inspection 21st June 2007 10:00 Howbeck Close 2 DS0000007991.V329270.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Howbeck Close 2 DS0000007991.V329270.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Howbeck Close 2 DS0000007991.V329270.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Howbeck Close 2 Address 1 - 2 Howbeck Close, Off Howbeck Drive Edlington Doncaster DN12 1RE 01709 865755 01709 862714 NONE None South Yorkshire Housing Association 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) ** Post Vacant *** Care Home 14 Category(ies) of Learning disability (14), Learning disability over registration, with number 65 years of age (14) of places Howbeck Close 2 DS0000007991.V329270.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd January 2006 Brief Description of the Service: 1/2 Howbeck Close provides care for up to fourteen adult service users with learning disabilities. Eight service users can be accommodated at No 1 Howbeck Close and a further six at No 2. Both propertied are purpose built bungalows with the space, facilities and equipment to accommodate people with associated physical disabilities including wheelchair users. The home has an adapted minibus enabling access to the wider community. The accommodation is located in Edlington about four miles form Doncaster. Edlington has local facilities such as shops, library, health centres and a weekly market close by. The majority of service users attend a range of day care provision that includes social education during the working week. Annual holidays, regular outings and social events take place. The service is provided by a partnership between South Yorkshire Housing Association and Doncaster Healthcare Trust, referred to SYHA and DHT in the report. SYHA own and operate the service with DHT providing the staff. All service users have a Licence agreement with SYHA. This partnership provides and operates three other such schemes in the Doncaster area. Current Scale of charges start at £355.19 to £845.49 Howbeck Close 2 DS0000007991.V329270.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection took place on the 21st of June 2007. Service users were interacted with and observed during the site visit and 5 staff and the manager were spoken with. Due to the nature of the service, it is difficult to reliably incorporate accurate reflections of the service users in the report. Some judgements about quality of life and choices were taken from direct observation on the day followed by discussion with support staff and evidencing records held at the home. Feedback from staff, professional and service users questionnaires have also been reflected in this report. The inspector concluded that the service users receive a good quality service at Howbeck close with particularly good access to specialist health services. Several requirements have been made in regards to social and recreational needs and recommendations to monitor staffing levels to ensure consistent access to activities. What the service does well: Risk assessments covered all key areas such as Moving and handling, eating and drinking, medication and behaviour. The documents gave good detailed information in order to support service users safely and in keeping with their needs. The Home is currently in the process of supporting a new service user to move into the Home and discussion with the manager showed that the Home is undertaking extensive assessments in partnership with health professionals before the service user will move in. The Home supports service users with a range of communication systems to promote choice and interaction. Communication systems included computers, communication passports, makaton and signs and symbols. It was also clear that this work was undertaken with the support of speech therapists. It was evident that relationships with families were supported by the service and feedback from professional questionnaires indicated that staff work in partnership with families to make decisions in the best interest of service users. Howbeck Close 2 DS0000007991.V329270.R01.S.doc Version 5.2 Page 6 Evidence seen on the day and feedback from professional questionnaires suggests that the Home is proactive in accessing specialist health services on behalf of service users. It was clear that the Home worked closely with speech therapists, occupational therapists and the back care co coordinator to develop appropriate health care plans for 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. The summary of this inspection report can be made available in other formats on request. Howbeck Close 2 DS0000007991.V329270.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Howbeck Close 2 DS0000007991.V329270.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2, Service users experience good quality outcomes in this area. On the whole prospective service users can be confident that their individual aspirations and needs will be assessed, but more could be done to explore service users aspirations and needs in terms of social activities. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three service users assessments were inspected as part of the case tracking process. Assessments included detailed pen pictures, communication passports, Health and Social care needs and likes and dislikes. Risk assessments covered all key areas such as Moving and handling, eating and drinking, medication and behaviour. The documents gave good detailed information in order to support service users safely and in keeping with their needs. The Home is currently in the process of supporting a new service user to move into the Home and discussion with the manager showed that the Home is undertaking extensive assessments in partnership with health professionals before the service user will move in. Their bedroom was in the process of being decorated and overhead hoist tracking and other mobility aids were being put in place in preparation for the move. Howbeck Close 2 DS0000007991.V329270.R01.S.doc Version 5.2 Page 9 It was noted that service users assessments did not give as much consideration to service users social and recreational needs and aspirations and a requirement has been made that this is done. Howbeck Close 2 DS0000007991.V329270.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9,10 Service users experience good quality outcomes in this area. On the whole service users can be confidant that they’re assessed and changing needs and personal goals are reflected in their individual plans but more could be done to ensure that service users social and recreational needs are planned for. The Home works hard to ensure that appropriate communication systems are in place to support service users to make decisions about their lives. Service users are supported to take risks as part of an independent life style. More could be done to ensure that personal information about service users is handled appropriately and ensure that their confidentiality is not compromised. This judgement has been made using available evidence including a visit to this service. Howbeck Close 2 DS0000007991.V329270.R01.S.doc Version 5.2 Page 11 EVIDENCE: Three service user care plans and assessments were inspected. Care plans were detailed and reflected their assessed needs. Detailed risk assessments were also in place that promoted service users safety and quality of life. These documents were reviewed regularly with input from health professionals such as speech therapists, physiotherapists and back care co coordinator. It was noted that care plans did not fully reflect service users wishes and needs in terms of social and recreational activities and more could be done to evidence that activities undertaken are in keeping with service users wishes. The Home supports service users with a range of communication systems to promote choice and interaction. Communication systems included computers, communication passports, makaton and signs and symbols. It was also clear that this work was undertaken with the support of speech therapists. Although generally information about service users was kept confidential, in an attempt to ensure staff have up to date information about service users some information was posted on service users bedroom walls and the homes kitchen. This practise was discussed with the manager and a requirement has been made that the Home look at more appropriate ways of ensuring information and guidance to staff is available at the point of need. Howbeck Close 2 DS0000007991.V329270.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Service users experience good quality outcomes in this area. Service users benefit from having the opportunity for personal development and enjoy leisure activities in their local community and holidays. However more could be done to evidence that activities undertaken are in keeping with their needs and aspirations. Service users are supported to maintain contact with family and friends. Service users choices regarding food are respected and they benefit from a balanced diet, using a range of vegetables and freshly prepared meals. This judgement has been made using available evidence including a visit to this service. Howbeck Close 2 DS0000007991.V329270.R01.S.doc Version 5.2 Page 13 EVIDENCE: Service users attend day services several days a week and in addition have access to their local community. There was evidence that trips to concerts, cafés and day trips were undertaken. In addition service users get the opportunity to go on holidays. The service users benefit from the Home having two specially adapted vehicles to support access to the community and take service users to day services. As stated previously it was not evident in service users assessments and care plans that activities and leisure activities were in line with service users wishes and more could be done to develop social and leisure activity care plans based on assessed needs and aspirations. It was evident that relationships with families were supported by the service and feedback from professional questionnaires indicated that staff work in partnership with families to make decisions in the best interest of service users. An inspection of the home’s kitchen, food storage areas and the home’s menus was undertaken and it was evident that a balanced diet was provided. Detailed eating and drinking programs were in place and it was evident that these had been developed with input from speech therapists. The Home takes time and effort to ensure that food prepared to particular consistencies are nicely presented and in keeping with good practice. Feedback from professionals suggested that the Home does not always have enough staff to support service users on a 1:1 basis in line with their needs. It is acknowledged that staffing levels have improved since the new manager came into post and separate sittings for meal times have been implemented to try and resolve this issue. It is recommended that support for service users with eating continue to be monitored. Professional comments included: “They involve service users families in decision making were possible.” “ I feel meal times may be rushed and not enough time given to individuals for social communication, which could impact on emotional and psychological wellbeing.” Howbeck Close 2 DS0000007991.V329270.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Service users experience excellent quality outcomes in this area. The Home ensures that service users receive personal support in a way that they prefer and require and their physical and emotional health needs are met. The Home ensures that service users benefit from a safe medication administration system. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Discussion with the manager and records viewed revealed that information was available to ensure that staff were able to meet service users personal needs and that this was being acted upon. Information was also available regarding service users preferred routines and observation on the day indicated that these were adhered to. Howbeck Close 2 DS0000007991.V329270.R01.S.doc Version 5.2 Page 15 Evidence seen on the day and feedback from professional questionnaires suggests that the Home is proactive in accessing specialist health services on behalf of service users. It was clear that the Home worked closely with speech therapists, occupational therapists and the back care co coordinator to develop appropriate health care plans for service users. An inspection of the homes’ administration and medication procedures was undertaken. Records inspected indicated that appropriate record keeping was being maintained and that medication was being stored appropriately. Discussion with staff and records seen also evidenced that all staff that administer medication are appropriately trained to do so. Howbeck Close 2 DS0000007991.V329270.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Service users experience good quality outcomes in this area. Home has robust systems and staff training to protect service users from abuse and promote their right to complain. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Discussion with staff and records seen on the day of the site visit showed that the Home had an appropriate complaints system and communication systems for service user to promote their right to raise concerns and make complaints. Evidence was seen of the Home responding proactively when complaints are made. Discussion with staff and training records seen also showed that staff had the skills and training to protect service users from abuse. Howbeck Close 2 DS0000007991.V329270.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Service users experience excellent quality outcomes in this area. Service users benefit from living in a comfortable and safe environment with a range of mobility aids to meet their needs. Service users benefit from living in a clean Home, which is odour free. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the premises was undertaken. The Home is purpose built and provides a spacious environment to accommodate service users wheelchairs and mobility aids. The Home is furnished and decorated to a good standard and was clean and free from offensive odours. The Home has overhead hoist tracking systems in bathrooms and some bedrooms. In addition the Home has mobile hoists and a range of mobility aids that are appropriate to service users needs and are well maintained. Howbeck Close 2 DS0000007991.V329270.R01.S.doc Version 5.2 Page 18 Information taken from the homes pre inspection questionnaire and observation on the day showed that facilities were maintained and services appropriately and good fire and evacuation procedures are in place. Howbeck Close 2 DS0000007991.V329270.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 & 35 Service users experience good quality outcomes in this area. On the whole service users benefit from being supported by a sufficient number of staff to meet their personal care needs but staffing levels may not always be sufficient to provide social activities on a consistent basis. Service users are protected by the homes policies and procedures for recruiting staff. Service users can be confident that the staff team are trained to meet their needs. This judgement has been made using available evidence including a visit to this service. Howbeck Close 2 DS0000007991.V329270.R01.S.doc Version 5.2 Page 20 EVIDENCE: Observation on the day of the site visit and feedback from staff and records seen showed that on the whole staffing levels were sufficient to meet service users basic care needs. However although staffing levels have been improved since the last inspection feedback from staff and professionals suggest that the Home does not always have enough staff to support service users with activities on a consistent basis. Activity records were not being kept to evidence the consistency of activities. Requirements have been made regarding this. Staff recruitment records are not held in the Home and are kept in the organisations central offices. Consequently the inspector did not view original recruitment documentation on this occasion. Instead the manager prepared information for the inspector to evidence this standard and forwarded this information after the site visit had been undertaken. Information provided by the manager showed that appropriate recruitment procedures were being followed and included written references, application forms and Criminal Record Bureau checks. In addition discussion with staff on the day of the site visit confirmed that these practices and checks had been undertaken prior the commencing employment. Training records seen and discussion with staff showed that training was given a high priority in the service. Staff have undertaken appropriate mandatory training and service specific training to meet service users needs including moving and handling, food hygiene, Induction, basic life support, first aid, adult abuse, medication administration, communication workshops and makaton training. It was also evidenced that over 50 of staff have obtained NVQ level 2 or above and the Home has a rolling programme of NVQ training in place. Howbeck Close 2 DS0000007991.V329270.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Service users experience good quality outcomes in this area. Service users benefit from a competent and experienced manager, who ensures a well run and accountable management of the service. The service works hard to ensure the Home is run in their best interests and their health and welfare are protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The new manager is in the process of applying to be the registered manager of the Home. They are a qualified learning disability nurse and have a qualification in health and social services management. Howbeck Close 2 DS0000007991.V329270.R01.S.doc Version 5.2 Page 22 Feedback from staff and health professionals evidenced that the new manager has overseen considerable improvements to the running of the Home. Staffing levels, moving and handling practices, eating and drinking support and care planning have been improved. Observation on the day, records viewed and discussion with staff evidenced that the manager delivered an effective service and had an in-depth understanding of service users needs. Staff spoke highly of them and felt that they were approachable and inclusive in their management style. Records showed that the Homes practices are monitored appropriately. Regular supervisions and staff meetings are undertaken and regular service user reviews are undertaken. Observation and information taken from the homes pre inspection questionnaire showed that the Home was maintained appropriately risk assessments were in place to ensure the safety and wellbeing of service users. Howbeck Close 2 DS0000007991.V329270.R01.S.doc Version 5.2 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 4 2 LIFESTYLES Standard No Score 11 X 12 2 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 3 X 3 X X 4 X Howbeck Close 2 DS0000007991.V329270.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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 YA2 & YA6 Regulation 14 &15 Requirement Timescale for action 20/08/07 2. YA10 17 3 YA12 12 The Home must ensure that service users assessments give consideration to service users social and recreational needs and aspirations and that this information is reflected in care plans. The Home must review the 20/08/07 practice of displaying service users personal information and find ways to share information more discreetly and effectively. The Home must ensure that 20/08/07 activities undertaken are in keeping with their needs and aspirations. 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 It is recommended that staffing levels continue to be monitored to ensure that appropriate support for eating and drinking and facilitating activities can be consistently DS0000007991.V329270.R01.S.doc Version 5.2 Page 25 Howbeck Close 2 provided. Howbeck Close 2 DS0000007991.V329270.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Sheffield Area Office Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Howbeck Close 2 DS0000007991.V329270.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!