Inspection on 08/08/07 for Mencap In Kirklees

This inspection was carried out on 8th August 2007.

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

Mencap In Kirklees 05/08/09

Mencap In Kirklees 24/08/06

Mencap In Kirklees 18/01/06

Mencap In Kirklees 24/08/05

Mencap In Kirklees 20/01/05

Mencap In Kirklees 19/10/04

Mencap In Kirklees 17/02/04

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 Huddersfield Mencap 5 100 Pennine Crescent Salendine Nook Huddersfield West Yorkshire HD3 3TP Lead Inspector Bronwynn Bennett Unannounced Inspection 8th August 10:10 Huddersfield Mencap 5 DS0000026345.V343888.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 Huddersfield Mencap 5 DS0000026345.V343888.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. Huddersfield Mencap 5 DS0000026345.V343888.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Huddersfield Mencap 5 Address 100 Pennine Crescent Salendine Nook Huddersfield West Yorkshire HD3 3TP 01484 348961 01484 340822 gill-leverton@huddersfield-mencap.org.uk 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) Huddersfield Mencap Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Huddersfield Mencap 5 DS0000026345.V343888.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th August 2006 Brief Description of the Service: 100 Pennine Crescent is a care home providing personal care and accommodation for eight younger adults with learning disabilities. It is owned by Huddersfield Mencap, a charity working locally in the field of learning disabilities. The home is situated in Salendine Nook near Huddersfield with good transport facilities and some local amenities. It is a two storey detached building with an attached bungalow, adjacent to some similar properties provided with warden services. All the home’s bedrooms are single, some of which are self contained. The home has adequate communal facilities. The home is surrounded by a grassed area. The registered provider informed the Commission for Social Care Inspection on 8th August 2007 that the fees range from £273.22 and £362.40. There are additional charges for hairdressing, newspapers and magazines, toiletries, trips and holidays. Information about the home and the services provided are available from the home in the Statement of Purpose and the Service User Guide. Huddersfield Mencap 5 DS0000026345.V343888.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection included an unannounced visit. The visit began at 10.10am and finished at 3.10 pm. During this visit the inspector spoke to two people living at Huddersfield Mencap 5, a member of staff and the manager. The inspector read records of people’s care and staff records, looked at how medicines are given and looked at the accommodation available in the home. There were eight people living at the home on the day of this visit. Before this visit the Commission for Social Care Inspection sent out questionnaires. Eight questionnaires were sent to people living at the home and everyone responded. Five questionnaires were received from relatives. Prior to this visit the manager gave the CSCI information about illnesses, accidents and incidents and how the home is managed. The inspector would like to thank everyone for their assistance during this inspection process. What the service does well: There is a homely environment where people are supported to be independent and be part of the local community. People who live at the home and the staff enjoy good working relationships. Individuals who responded to the survey said the staff “always” treats them well. Many positive comments were received from people living at the home that took part in the survey. One person said “This is a lovely home” Friends and relatives were also asked to take part in the survey, one commented, “I find the care home very friendly, and are always made to feel welcome there”. Another said “I would like to say a big thank you to all the staff for all their care”. People are supported to make decisions in their lives. Huddersfield Mencap 5 DS0000026345.V343888.R01.S.doc Version 5.2 Page 6 People are involved in their ongoing plan of care. These records are person centred and reflect choices made by individuals as part of their lifestyle. 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. Huddersfield Mencap 5 DS0000026345.V343888.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 Huddersfield Mencap 5 DS0000026345.V343888.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 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individual’s needs and aspirations are assessed prior to their admission into the care home. EVIDENCE: There have been no new admissions to the home since the last visit by the CSCI. The admission process was discussed with the manager who advised that no person would be admitted to the home without a full assessment carried out by social services and short visits in order to meet people. Individual assessments were seen in the care records and demonstrated the home was able to meet people’s needs. Individuals who responded to the survey said they received enough information about the care home before deciding to live there. Huddersfield Mencap 5 DS0000026345.V343888.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9. People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individual’s assessed, personal needs and goals are recorded; as is the support required by the person to make decisions and take risks as part of an independent lifestyle. EVIDENCE: A relative who responded to the survey regarding the care of their loved one said “They give good quality home life and care which I fully appreciate”. People spoken to during this visit said they were happy living at the home. There is a relaxed atmosphere in the home and staff interact well with people who live there. Two people said they liked the staff and they had a key worker. Two care records were looked at. The care plans are generally good and are person centred and reflect how people wish to be cared for and their care Huddersfield Mencap 5 DS0000026345.V343888.R01.S.doc Version 5.2 Page 10 needs. Individuals are involved in the formulation and review of their care plan. This is good practice. The way care records are reviewed was discussed during this visit. To record “No changes” when reviewing care plans is not sufficient. The review should include checking that the care plan is working, show any changes to the care being provided, or if a care need has been met. The manager agreed to take action in this matter. Individuals were observed making decisions independently, and with information and assistance from the staff during this visit. For example, managing their finances. There are risk assessments in place for each individual to support people to take risks as part of an independent lifestyle. Huddersfield Mencap 5 DS0000026345.V343888.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17. People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to be part of the local community and take part in appropriate activities. Individuals are supported to maintain relationships with family and friends, and the rights of people are respected with their choice and independence being promoted. EVIDENCE: People who responded to the survey said they are able to make decisions about what they do each day. One person commented, “ I can decide where I want to go”. During this visit people were choosing how to spend their day. One person had chosen to go out independently and was supported by the staff to plan their day. Huddersfield Mencap 5 DS0000026345.V343888.R01.S.doc Version 5.2 Page 12 One person said they liked to go out with the staff and enjoyed visiting the local pub. Everyone has a care plan considering each individual’s education and employment options and some people are working as gardeners and being part of an “odd jobs” scheme set up by Mencap. People are supported to maintain relationships with family and friends. Some individuals enjoy short visits away from the home to stay with relatives. Individuals spoken to during this visit said they enjoy going out to the local clubs, shopping, cinema, days out and holidays. People continue to have their right to privacy respected such as being given personal mail unopened, a key to their room and having the right to decide whether to spend time alone of in the company of others. There is a varied menu offered to people and the staff spoken to said people are supported to choose a healthy meal option. On the day of this visit people living in the home had chosen to go out for lunch. Individuals spoken to during this visit said they enjoyed the meals provided at the home, and they are supported to plan menus and go shopping. Huddersfield Mencap 5 DS0000026345.V343888.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20. People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive personal support in the way they prefer and generally their health care needs are being met. The medication policies and procedures sufficiently protect people living at the home. EVIDENCE: People who responded to the survey said the staff listen and act on what they say. The personal preferences for how people wish to be cared for were seen recorded in the care records looked at. One individual spoken with said that staff supports them in their preferred way. Two care records looked at during this visit contained a healthcare plan. People are supported to access NHS appointments and facilities. Individuals have their weight monitored on a monthly basis. However, greater care is required to ensure prompt action is taken where there are significant weight gains or a Huddersfield Mencap 5 DS0000026345.V343888.R01.S.doc Version 5.2 Page 14 weight loss. This was discussed with the manager, who will make sure staff follow up significant changes to people’s weight. The medication and medication records looked at for two people were correct. Huddersfield Mencap 5 DS0000026345.V343888.R01.S.doc Version 5.2 Page 15 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 and 23. People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home, their relatives and advocates are confident their views are listened to and acted upon. People are protected from abuse. EVIDENCE: There is a policy and procedure for dealing with complaints in a suitable format for people displayed in the home. There have been no complaints made to the home since the last visit by the CSCI. One individual spoken to during this visit said they knew who to talk to if they had a concern or wished to complain. Everyone who responded to the survey said they knew who to speak to if they were not happy and how to make a complaint. The financial records, receipts and money for two people were checked and were correct. One individual was seen being appropriately supported by staff to manage their own finances. Huddersfield Mencap 5 DS0000026345.V343888.R01.S.doc Version 5.2 Page 16 The staff spoken to during this visit had a good understanding of the necessary actions that must be taken following any allegations of abuse. The staff team has completed safeguarding (adult protection) training. Huddersfield Mencap 5 DS0000026345.V343888.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 and 30. People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean, hygienic and generally well maintained. EVIDENCE: Everyone who responded to the survey said the home is generally fresh and clean. One individual commented, “I like to clean my room”. On the day of this visit the home was clean and odour free. The organisation has taken action since the last visit by the CSCI and fitted radiator covers in all areas of the home. The rooms seen during this visit had been personalised by the individual. Redecoration of the home will be completed within the coming weeks. The manager said that new floor covering would then be fitted to the kitchen and bathroom. Consideration should be given to installing a hand wash sink to the Huddersfield Mencap 5 DS0000026345.V343888.R01.S.doc Version 5.2 Page 18 first floor toilet to promote good hygiene standards and infection control measures. There have been no improvements made to the laundry facilities since the last visit by the CSCI. The floor covering in this area is a potential tripping hazard and should be replaced. Huddersfield Mencap 5 DS0000026345.V343888.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): 32,34 and 35. People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Overall a competent staff team supports people living at the home. People are protected by the organisations recruitment policy and procedure. EVIDENCE: Everyone who responded to the survey said the staff “always “ treats them well. Individuals and staff were seen interacting well and enjoying each other’s company during this visit. All new staff receive induction training. The staff records showed that staff have completed mandatory training such as safe movement and handling, safeguarding (Adult Protection), infection control, or this training is planned. The manager is planning staff training sessions relating to the potential health care conditions of people, such as nutrition and dietary needs. Huddersfield Mencap 5 DS0000026345.V343888.R01.S.doc Version 5.2 Page 20 Three out of five staff working at the home have achieved NVQ (National Vocational Qualification) level 2 or above in care. This is good practice and should continue for all staff. The employment records for two staff were looked at. Not all the required written references were available in the home. However, this information is kept at Mencap head office. One reference was seen. The organisation has taken action and informed the CSCI that staff records kept in the home have written references. Huddersfield Mencap 5 DS0000026345.V343888.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 and 42. People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from a home that is well run and operates in their best interests. The health, safety and welfare of everyone is generally promoted and protected. EVIDENCE: The organisation has employed a new manager since that last visit by the CSCI. Ms Barbara Matula commenced working at the home in July 2007. The responsible individual should ensure an application is made to the CSCI to register Ms Matula to comply with the requirements of the Care Standards Act 2000. Huddersfield Mencap 5 DS0000026345.V343888.R01.S.doc Version 5.2 Page 22 The home has a quality monitoring system in place. The quality assurance report was made available to the inspector and the results of this quality audit were positive. People spoken to during this visit said they are supported to air their views and there are residents’ meetings held on a monthly basis. There were many positive comments in the surveys received by the CSCI such as, “I would like to say a big thank you to all the staff for all their care” and “They give good quality home life which I fully appreciate”. Another responded that they were happy for their loved one to live at the home. The fire records were looked and showed that there are weekly checks of the home’s fire alarm system and emergency lighting. Not all the staff have completed the required fire safety training. However, this training is imminent. The organisation must ensure that all staff receives fire training at six monthly intervals. The manager agreed to ensure this was arranged. The home has regular fire drills; evidence of these was seen in the records kept in the home. Not all staff have received mandatory training such as safe movement and handling, infection control and safeguarding (Adult Protection). The CSCI was given the dates planned for this training. Huddersfield Mencap 5 DS0000026345.V343888.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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 X 3 X 3 X X 3 X Huddersfield Mencap 5 DS0000026345.V343888.R01.S.doc Version 5.2 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. Standard Regulation Requirement Timescale for action 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 YA19 YA24 Good Practice Recommendations Greater care should be taken to ensure where an individual has a significant weight loss or weight gain guidance is sought from the relevant professional. A hand washbasin should be fitted to the identified toilet in order to promote good hygiene standards and infection control. The responsible individual should ensure an application is made to the CSCI to register the home’s manager to comply with the requirements of the Care Standards Act 2000. To ensure safe working practice all staff should undertake six monthly updates in fire training. 3. YA37 4. YA42 Huddersfield Mencap 5 DS0000026345.V343888.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Brighouse Area Team First Floor St Pauls House 23 Park Square Leeds LS1 2ND 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. 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