Inspection on 29/06/05 for Hudson Street

This inspection was carried out on 29th June 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

Hudson Street 06/10/08

Hudson Street 24/10/06

Hudson Street 08/03/06

Hudson Street 12/01/05

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 Hudson Street 24 Hudson Street Whitby North Yorkshire YO21 3EP Lead Inspector M.A. Tomlinson Unannounced 29 June 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. Hudson Street v233293 j53-j04 s61659 hudson street v233293 290605 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Hudson Street Address 24 Hudson Street Whitby North Yorkshire YO21 3EP 01947 603367 01947 600199 alison.graham@milewood.co.uk Milewood Healthcare Ltd 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) Mrs Alison Graham Care home only 6 Category(ies) of LD Learning disability (6) registration, with number of places Hudson Street v233293 j53-j04 s61659 hudson street v233293 290605 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 12.01.05 Brief Description of the Service: 24 Hudson Street is a traditional middle terraced property located in a residential area of Whitby close to all of the main community facilities including the public transport network. On-street parking is readily available. The property was originally registered in October 2004 and has been extensively refurbished to provide accommodation for six (6) younger adults who have a learning disability. The service users (residents) are provided with single accommodation that is located on three upper floors. The care home does not have a passenger lift and consequently it is only considered suitable for service users who are fully ambulant. The communal space, consisting of a lounge, dining room and a kitchen, is located on the ground floor. There is an enclosed rear yard and a small front garden. The primary aim of 24 Hudson Street is to provide an environment in which the service users can learn, or re-learn, life skills with the aim of enabling them to become more independent. The majority of the service users have complex needs, including behavioural problems, and consequently the staffing level reflects this. Only minimal physical care is provided with emphasis being placed on support, guidance and social rehabilitation. The home does not provide nursing care. Should such care be required on a short-term basis, then it will be provided by the community healthcare services. Hudson Street v233293 j53-j04 s61659 hudson street v233293 290605 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first of two statutory inspections to be undertaken by the Commission for Social Care Inspection of 24 Hudson Street during this inspectoral year. The inspection took a total of five and a half hours including the preparation time. The registered manager was available throughout the inspection. All of the service users and staff were spoken to during the inspection along with the relatives of a service user and the members of a combined health and social care review team. A number of records were inspected. An inspection of the communal or shared rooms was carried out. An additional visit was made to the home in February 2005 in order to investigate a complaint. Some of the issues identified in the complaint were substantiated and were subsequently addressed by the registered person and the registered manager. What the service does well: What has improved since the last inspection? The registered manager had continued to develop policies, procedures and records that were for the benefit of the service users and the staff. Several visitors to the home remarked on the progress made by the service users over the last year. The staff had been provided with opportunities to participate in a range of training courses and several had achieved, or were in the process of achieving, a National Vocational Qualification. This had led to a better understanding of the service users’ needs and of the actions required to meet those needs. The issues identified during an investigation into a complaint earlier in the year had been addressed. Hudson Street v233293 j53-j04 s61659 hudson street v233293 290605 stage 4.doc Version 1.30 Page 6 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. Hudson Street v233293 j53-j04 s61659 hudson street v233293 290605 stage 4.doc Version 1.30 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 Hudson Street v233293 j53-j04 s61659 hudson street v233293 290605 stage 4.doc Version 1.30 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) 1,3,4 and 5 The service users receive clear information to enable them to make a considered choice about whether or not they might wish to live in the home. EVIDENCE: The registered provider and registered manager had developed a comprehensive Statement of Purpose and Service Users’ Guide. Following the recommendation made during the previous inspection, the service users had been provided with a copy of the Guide. A copy of the Statement was displayed in the entrance hall. The service users and a visiting relative confirmed that they had been fully informed of the service provided by the home prior to the service users admission in to the home. In some cases they had also been able to make a pre-admission visit. The service users had been provided with a ‘contract of residence’ by the home, which they, or their representative, had signed in agreement. These contracts were in addition to any contract provided by a service user’s placing agency. The conditions contained in the contract were clear and unambiguous. Hudson Street v233293 j53-j04 s61659 hudson street v233293 290605 stage 4.doc Version 1.30 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 standard(s) 7,8 and 9 The service users are encouraged to live active and meaningful lifestyles through good support from the staff. EVIDENCE: From discussions with, and observation of, the service users, it was evident that they were enabled to make decisions and that the staff respected their decisions. It was also observed that the possible consequences of such decisions were discussed with the service user concerned by the staff particularly if the service user could be at risk from that decision. One example of such a decision involved a service user who did not want to attend a review meeting (C.P.A.) on the day of the inspection. His stated reason for not attending was, “I didn’t like the questions being asked”. Due to their vulnerability, all of the service users had ‘agreed’ to be supervised when out of the home. These agreements were included with the service users’ care plans. Other agreements included restrictions on cigarettes and money. The service users understood the need for these restrictions. These restrictions were regularly reviewed. Hudson Street v233293 j53-j04 s61659 hudson street v233293 290605 stage 4.doc Version 1.30 Page 10 It was evident that the service users were directly involved in the daily domestic routines of the home and had access to all facilities, including the kitchen, without reference to the staff. They were expected to participate in cleaning routines particularly with regard to their bedrooms. One service user expressed considerable pride in the standard of cleanliness of their room. The service users expressed specific personal aims. For example one stated, “ I’m going on a computer course in Scarborough. I want to live in a supported living house with two or three others and I’m getting training for it.” Hudson Street v233293 j53-j04 s61659 hudson street v233293 290605 stage 4.doc Version 1.30 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14 and 17 The service users are encouraged to develop good links with the community that enables them to develop their life and social skills. EVIDENCE: It was evident that emphasis is placed on the service users’ personal development needs. Examples were provided by the staff to show the progress made by some of the service users. This progress was confirmed by health and social care professionals and a service user’s visiting relatives. Some of the comments made by these relatives included: “This is a brilliant place, she (service user) has improved no-end. The staff discuss things with her and explain the consequences. The staff never shout, they are patient and discuss things with her. She has an excellent social life. I am always kept informed and involved in her care plan and reviews. The staff give the residents respect – it works both ways. I’m delighted for her.” The service users confirmed that they had a varied social life that takes into account their needs and wishes. The records supported this. It was evident that maximum use was made of the local community facilities in order to Hudson Street v233293 j53-j04 s61659 hudson street v233293 290605 stage 4.doc Version 1.30 Page 12 integrate the service users into the community. The manager was in the process of liaising with a local charitable organisation with the intention of finding appropriate day placements for some of the service users. It apparent that the service users had made friends outside of the home and one said that she had a boy friend. The service users expressed satisfaction with the standard of meals provided. The menus indicated that the meals ensured a reasonable diet for the service users although the service users did say that they enjoyed eating out and ‘convenience or fast food’. They gave examples of this. The main meal of the day is generally taken in the evening with a snack type meal being eaten at lunchtime. According to the staff this arrangement took into account the service users’ social and educational activities. One service user expressed pride in the biscuits he had baked on the day of the inspection. Hudson Street v233293 j53-j04 s61659 hudson street v233293 290605 stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19 and 20 The service users’ support needs are well understood by the staff and are addressed in a manner that provides the service users with appropriate respect and guidance. This is evident from the positive relationships that have been established between the staff and the service users. EVIDENCE: It was evident that a good relationship had been established between the staff and the service users that was based on trust and mutual respect. The service users were of the view that the staff were there to help them and it was evident that the service users were not reticent in making their views and opinions known. The records of the service users’ meetings also confirmed this. It was observed that the staff endeavoured to pre-empt any potential behavioural problem displayed by a service user. They used a variety of techniques including discussing the problem with the service user concerned or using ‘diversionary’ techniques in order to diffuse the situation. Whilst physical restraint had been used on a few occasions, this had, according to the staff, been a last resort and involved the minimum of force. All of the staff had received training in restraint techniques. All incidents where restraint had been used had been recorded. Hudson Street v233293 j53-j04 s61659 hudson street v233293 290605 stage 4.doc Version 1.30 Page 14 The records confirmed that the services had good access to healthcare services and that there was good input from health and social care professionals. All of the service users had external support. None of the service users self-medicated. The home continued to use a monitored dosage system for the administration of the service users’ medication. The staff had been provided with appropriate training on the administration process and the safe handling of medication. The medication was appropriately secured and the senior member of staff on duty carried the key to the medication cabinet. The medication records were complete and up to date. Hudson Street v233293 j53-j04 s61659 hudson street v233293 290605 stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 The network of support provided for the service users is good and should guarantee that any issue or problem experienced by a service user is quickly identified and acted upon. EVIDENCE: An appropriate complaints procedure was in place. This was displayed in the entrance hall in pictorial form. All of the current service users had the ability to make a complaint either to the staff within the home or to their external care management. It was evident from discussions with the staff and an inspection of the records that the service users views were taken seriously by the staff and appropriate action taken. An example was provided where a service user had made serious allegations against another care home. These allegations were promptly reported to the appropriate agencies by the staff of Hudson Street. The staff had received training in adult protection and demonstrated their awareness of the associated procedures. The service users had access to an independent advocate. Hudson Street v233293 j53-j04 s61659 hudson street v233293 290605 stage 4.doc Version 1.30 Page 16 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) 24,28 and 30 Whilst there has been some improvement in the physical standards of the property, there remain some aspects that could provide a visitor to the home with a poor first impression. EVIDENCE: The home presented as informal, reasonably clean and homely. The records confirmed that the registered manager had taken appropriate action to ensure that the environment was safe for both service users and staff. The only exception to this was the amount of disused equipment, such as mattresses, and rubbish deposited in the rear yard. This was not only unsightly but could be a fire risk as the service users and staff smoked in that area. The service users’ bedrooms were not inspected on this occasion. The communal or shared space, that consisted of a lounge and dining room, was decorated and furnished to an acceptable standard. It was noted that the entrance hall carpet was stained and marked. According to the manager this was due to the fact that the shampooer was being repaired. It was also observed that the external paintwork at the front of the property was stained/flaking. Hudson Street v233293 j53-j04 s61659 hudson street v233293 290605 stage 4.doc Version 1.30 Page 17 Hudson Street v233293 j53-j04 s61659 hudson street v233293 290605 stage 4.doc Version 1.30 Page 18 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) 31,32,33 and 35 Staff morale presents as being good resulting in an enthusiastic and wellmotivated staff team that works positively with the service users to improve their quality of life. EVIDENCE: The staff roster confirmed that their had been no regression in terms of the staffing level since the previous inspection. The normal staff complement consisted during the day of 3 or 4 support workers, depending upon the needs of the service users at any particular time, plus the manager. Two staff were on duty during the night. All staff take turns in undertaking night duties. According to the staff, this relatively high level of staffing was necessary to take into account the complex needs of the service users and it enabled the service users to be appropriately supervised when out of the home. The staff team was supplemented through the involvement of social care staff. For example, a community worker was visiting her client on the day of the inspection and took him out into the local town. The records confirmed that the staff had been provided with an opportunity to participate in a number of courses on statutory subjects such as first aid, adult protection and restraint. Several of the staff had completed, or were in the process of completing, a National Vocational Qualification. A number of staff had undertaken the Learning Disability Award Framework training. They confirmed that they found Hudson Street v233293 j53-j04 s61659 hudson street v233293 290605 stage 4.doc Version 1.30 Page 19 it useful. The staff presented as enthusiastic and knowledgeable particularly with regard to the needs and abilities of the service users. A visiting Clinical Psychiatrist said that in his opinion the staff were ‘doing a good job’. A visiting relative of a service user highly commended the efforts of the staff to provide the service users with meaningful lifestyles. The home employed a ‘key worker’ system with each member of staff being allocated a service user. A ‘back-up’ key worker system was also in place to cover staff absences. Hudson Street v233293 j53-j04 s61659 hudson street v233293 290605 stage 4.doc Version 1.30 Page 20 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) 37,38,40,41 and 43 The manager has a clear development plan that she has communicated to the staff and the service users. Her vision is primarily for the benefit of the service users in order to promote and enhance their independence. EVIDENCE: The registered manager presented an open, inclusive and democratic style of management and had endeavoured to maximise the use of the staff’s assessed skills. It was evident that there was a good relationship between the manager and the staff and without exception the staff spoke highly of the manager’s skills and attitude. The manager demonstrated a good understanding of the aims of the home and of the actions she required the staff to take in order to achieve those aims. It was evident that she had considerable respect for the service users and that the home was primarily run for their benefit. The records, policies and procedures satisfied the National Minimum Standards and there was evidence that the manager and her staff team kept them under review. The accident and fire records were inspected. Records were also Hudson Street v233293 j53-j04 s61659 hudson street v233293 290605 stage 4.doc Version 1.30 Page 21 maintained of the temperature of the hot water accessible to the service users. Individual and general risk assessments had been developed including those required by the Fire and Rescue and Environmental Health Departments. Hudson Street v233293 j53-j04 s61659 hudson street v233293 290605 stage 4.doc Version 1.30 Page 22 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 x 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x 3 4 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 x x x 3 x 2 Standard No 11 12 13 14 15 16 17 3 3 3 3 x x 3 Standard No 31 32 33 34 35 36 Score 3 3 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Hudson Street Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 3 x 3 v233293 j53-j04 s61659 hudson street v233293 290605 stage 4.doc Version 1.30 Page 23 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(4)(a) Requirement The rubbish and equipment discarded in the rear yard is considered a risk to both staff and service users and must be removed. Timescale for action 1st August 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. Refer to Standard 24 30 Good Practice Recommendations A programme of external redecoration should be developed. Action should be taken to ensure that the entrance carpet remains clean. Hudson Street v233293 j53-j04 s61659 hudson street v233293 290605 stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 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 Hudson Street v233293 j53-j04 s61659 hudson street v233293 290605 stage 4.doc Version 1.30 Page 25 - 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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