Inspection on 08/03/06 for Hudson Street

This inspection was carried out on 8th March 2006.

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 29/06/05

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 Mr M. A. Tomlinson Unannounced Inspection 8th March 2006 09:45 Hudson Street DS0000061659.V285299.R01.S.doc Version 5.1 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 Hudson Street DS0000061659.V285299.R01.S.doc Version 5.1 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. Hudson Street DS0000061659.V285299.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hudson Street Address 24 Hudson Street Whitby North Yorkshire YO21 3EP 01947 603367 01947 600199 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) Milewood Healthcare Limited Mrs Alison Graham Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Hudson Street DS0000061659.V285299.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service Users must be fully ambulant and require minimal physical care. 12th January 2005 Date of last inspection 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, it will be provided by the community healthcare services. Hudson Street DS0000061659.V285299.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second of two statutory inspections to be undertaken by the Commission for Social Care Inspection during this inspectoral year. The inspection was unannounced. In the absence of the Registered Manager, the inspection was conducted with the assistance and cooperation of the deputy manager. The inspection primarily focussed on the requirements and recommendations made during the previous inspection and on those ‘key’ National Minimum Standards not assessed on that occasion. This report should, therefore, be read in conjunction with the report of the inspection undertaken on 29th June 2005. Discussions were held with a number of service users and those staff on duty at the time of the inspection. Several statutory records were examined. An inspection was undertaken of the premises including, with their permission, the service users’ bedrooms. On the completion of the inspection, feedback was provided for the deputy manager. What the service does well: What has improved since the last inspection? The Requirements and Recommendations identified during the previous inspection have been addressed. Improvements have been made to the physical standard of the property. The expertise and professionalism of the staff has improved and several have taken responsibility for undertaking additional tasks. Hudson Street DS0000061659.V285299.R01.S.doc Version 5.1 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 DS0000061659.V285299.R01.S.doc Version 5.1 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 Hudson Street DS0000061659.V285299.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The pre-admission assessments made on prospective service users provide sufficient information to enable the home’s management to make a considered decision as to the appropriateness of the planned placement. EVIDENCE: The service users’ care records contained recorded evidence that preadmission assessments had been undertaken on prospective service users. These were in addition to any assessment provided by the placing authority and provided adequate information on which a considered decision could be made regarding the appropriateness of the pending placement. It was evident that these assessments had been undertaken with the direct involvement of the service user concerned. In addition to the prospective service user’s health and social needs, the assessments also identified the person’s abilities. Considerable emphasis was placed on the compatibility of the prospective service user with the existing service user group. Prospective service users were therefore encouraged to visit the home several times, and if possible stay overnight, before a final decision was made regarding their admission. This was apparent during the day of the inspection when a prospective service user was visiting along with a representative of his placing authority. It was apparent that the permanent service users were fully aware of prospective placements and that their views and opinions had been sought. Any possible restrictions to a service user, such as not going out unaccompanied, was the Hudson Street DS0000061659.V285299.R01.S.doc Version 5.1 Page 9 subject of a written risk assessment and an ‘agreement’ with that person. The staff had access to the assessments. The staff also displayed confidence in dealing with health and social care professionals. Hudson Street DS0000061659.V285299.R01.S.doc Version 5.1 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 the following standard(s): 6 The service users are provided with appropriate care plans that provide the staff with sufficient information by which they are able to meet the service users’ needs. EVIDENCE: All of the service users had a care plan developed and implemented by the home. These were in addition to care plans provided by a placing authority. The service users had signed their care plans in agreement. From discussions with them it was apparent that they were aware of the content of their care plan and were in agreement with its contents. There was recorded evidence that the care plans had been regularly reviewed and amended as necessary. It was apparent that the needs of several of the service users had changed in a positive way since their admission into the home. The care records provided evidence that the service users continued to be provided with good support from health and social care professionals. On the day of the inspection, two care managers were visiting the home. Both made positive comments regarding the service provided by the home and the efforts of the staff to enable the service users to live meaningful lifestyles. It was evident from discussions with the staff that they endeavoured to be pro-active in addressing Hudson Street DS0000061659.V285299.R01.S.doc Version 5.1 Page 11 behavioural problems displayed by service users and apparently made maximum use of the external professional support available to the service users. In order to provide a degree of continuity for the service users, each service user had been allocated two ‘key workers’ one of which was a senior member of staff. The key workers had direct involvement in the monitoring and reviewing of the service users’ care plans. Hudson Street DS0000061659.V285299.R01.S.doc Version 5.1 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 the following standard(s): 15 and 16 The service users are encouraged to remain in contact with their families so that their relatives have first hand knowledge of their progress or problems. EVIDENCE: It was apparent from discussions with the service users that they had been encouraged to remain in contact with their families. It was also evident from the records that a variety of family members regularly visited the home and were able to take the respective service user out. Where family members were unable to visit, the staff stated that they were willing to take the service user to see them. It was evident that the home’s staff endeavoured to provide the service users’ families with support, keep them informed and, where possible, involve them in the activities of the home. Several of the service users attended external facilities and it was apparent that they had made friends at these placements. It was observed that the service users interacted with each other reasonably well and had established a close but professional relationship with the staff. Hudson Street DS0000061659.V285299.R01.S.doc Version 5.1 Page 13 It was observed that the staff gave the service users appropriate respect and spoke to them in a mature and adult manner. Any limitations or restrictions to a service user’s life was formalised in a written ‘agreement’ between the service user and the home. Before a restriction was implemented it was discussed with the service user concerned. It was evident that these restrictions were regularly reviewed. For example, on the day of the inspection one service user was not attending a social event due to their recent poor behaviour in the home. The service users were in agreement with this approach, as it appeared to teach them to take responsibility for their actions. It was evident that the need to impose such restrictions on a service user had generally lessened following their admission into the home. The staff provided examples of how service users had improved their social and domestic skills. Hudson Street DS0000061659.V285299.R01.S.doc Version 5.1 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 the following standard(s): None EVIDENCE: These standards were not fully assessed on this occasion. Hudson Street DS0000061659.V285299.R01.S.doc Version 5.1 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 the following standard(s): None EVIDENCE: These standards were not fully assessed on this occasion. Hudson Street DS0000061659.V285299.R01.S.doc Version 5.1 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 the following standard(s): 24 and 30 The service users are provided with an environment that meets their needs. EVIDENCE: The home continued to present as an informal and friendly environment in which the service users were able to live meaningful and reasonably normal lifestyles. The communal rooms were clean and tidy. Since the previous inspection new carpets had been fitted in the main entrance hall, the stairway and the corridors. The Operations Manager, who was visiting at the time of the inspection, provided their assurance that the frontage of the property is to be re-decorated and that it is the intention to provide the service users with an ‘undercover’ area in the rear yard in which they could smoke. This smoking area will be accessed via. the dining room. The manager is to obtain approval of the Environmental Health, Building Control and Fire Departments for this proposed modification to the premises. At present access to the rear yard is through the admin/manager’s office, which consequently provided little privacy for the staff. The office appeared somewhat chaotic and noisy, for at any one time there were between six and ten people in the office the majority having separate conversations. It was evident that this was frustrating for visiting professionals in particular. In general the dining room Hudson Street DS0000061659.V285299.R01.S.doc Version 5.1 Page 17 was used if privacy was required. With the permission of the service users, the majority of the bedrooms were inspected. It was evident that the service users took considerable pride in the appearance of their rooms. The rooms were decorated to a reasonable standard and had been personalised by the service users. Hudson Street DS0000061659.V285299.R01.S.doc Version 5.1 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34 The service users are protected by a robust staff recruitment and selection procedure. EVIDENCE: The deputy manager provided evidence that all prospective staff had been appropriately vetted. This included obtaining at least two written references and the completion of a CRB/POVA check before a prospective staff member commenced employment in the home. Three staff records were inspected. The service users said that they were made aware of any prospective staff and that their views and opinions were sought on the appropriateness of the proposed staff member. The enthusiasm of the staff was very evident and it was commendable that in the absence of the registered manager the staff were able to assist with the inspection in a professional and competent manner. It was evident that the staff operated as a team by supporting each other. It was apparent that the manager had delegated appropriate tasks to the staff that were commensurate with the level of the experience and competence. For example, one member of staff had responsibility for overseeing health and safety issues and another, who had a nursing qualification, was responsible for monitoring the administration procedure for the service users’ medication. A visiting health professional expressed surprise and pleasure as to how the staff had developed professionally in a relatively short period of time. Hudson Street DS0000061659.V285299.R01.S.doc Version 5.1 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39, 41 and 42 The apparent frequent use of physical restraint on service users needs to be detailed and fully justified in the records to ensure that there is no misunderstanding regarding its use. EVIDENCE: The home was subjected to regular internal and external audits as part of the quality assurance process. The Operations Manager confirmed that the process was being further developed so that any weaknesses in the home’s procedures and practices would be quickly identified and acted upon. It was evident that the views of the service users, with regard to the service provided, were actively sought particularly during service users’ meetings. Examples were given where service users had identified poor staff practices and evidence provided that this had promptly been addressed. Health and safety checks, including fire safety checks, had been regularly undertaken and recorded. The gas and electrical system had been serviced Hudson Street DS0000061659.V285299.R01.S.doc Version 5.1 Page 20 and a safety certificate issued to the home. Risk assessments were in the process of being reviewed. The use of restraint was discussed at length with the deputy manager. Whilst it was evident from the records that the use of restraint was a last resort and only involved minimum force, such as conducting a service user out of a room, this was not always evident from the Regulation 37 Notification records provided for the CSCI. Hudson Street DS0000061659.V285299.R01.S.doc Version 5.1 Page 21 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 X 23 X ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X X X X 3 X 2 3 X Hudson Street DS0000061659.V285299.R01.S.doc Version 5.1 Page 22 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. 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. Refer to Standard YA24 Good Practice Recommendations Advice should be sought from the Fire, Building Control and Environmental Health Departments regarding the proposed modifications to the dining area and the rear yard. Action should be taken to provide the management and staff with increased levels of privacy when using the office. The records relating to the use of physical restraint, including those covered by Regulation 37, should be in such details as to justify the use of restraint. 2. 3. YA24 YA41 Hudson Street DS0000061659.V285299.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Hudson Street DS0000061659.V285299.R01.S.doc Version 5.1 Page 24 - 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. 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