Inspection on 23/06/05 for Hylton Bank (28)

This inspection was carried out on 23rd 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

Hylton Bank (28) 15/12/08

Hylton Bank (28) 18/03/08

Hylton Bank (28) 03/10/06

Hylton Bank (28) 17/01/06

Hylton Bank (28) 01/02/05

Hylton Bank (28) 13/10/04

Hylton Bank (28) 24/02/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 28 Hylton Bank South Hylton Sunderland Tyne and Wear SR4 0LL Lead Inspector Sam Doku Unannounced 23 June 2005 9:00am 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. 28 Hylton Bank B52 B02 S15740 28 Hylton Bank V219466 23 Jun 2005 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 28 Hylton Bank Address South Hylton Sunderland SR4 0LL 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) 0191 534 1185 0191 534 2137 Northgate & Prudhoe NHS Trust Mr Gary Bridgewater Care home only 8 Category(ies) of LD Learning disability (8) registration, with number of places 28 Hylton Bank B52 B02 S15740 28 Hylton Bank V219466 23 Jun 2005 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 1 February 2005 Brief Description of the Service: 28 Hylton Bank is a care home for eight people who have a learning disability and who have autism or behaviours associated with an ASD (Autistic Spectrum Disorder). Cheviot Housing Association owns the building and Northgate and Prudhoe Trust lease the property and delivers the service.The service accommodates male and female service users between the ages of 18 and 55 years. At present there are 8 men and women living at the home all who have varying abilities. All have difficulty in understanding their environment or communicating their needs. Consequently all of the people living at Hylton Bank have the potential of exhibiting challenging behaviours. There are 8 bedrooms and each service user occupies a single room, which complies with the National Minimum Standards.The design of the house with a North and South side gives the appearance of two separate houses, each accommodating 4 people. An area, which includes the activity room, the laundry and staff sleep over room, connects the 2 sides.Service users have access to all parts of the house with the exception of other people’s bedrooms unless invited.It is the aim of the home to develop activities, including daily life skills that are designed to reduce anxiety while creating personal security for the individual. 28 Hylton Bank B52 B02 S15740 28 Hylton Bank V219466 23 Jun 2005 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection commenced at 9.0 a.m. and lasted for 3 hours 30 minutes. At the time of arrival two service users were on their way out and the rest were getting ready to commence their planned activities for the day. The inspection process involved spent in trying to talk to service users, sitting in the lounge and observing staff interaction with the service users, discussions with the manager and care staff, tour of the house, examination of health and safety records and service users personal file including care plans. Verbal communication with the service users was difficult as those who the inspector met with had communication difficulties. The inspector was, however, able to determine from their demeanour and body language that they were comfortable and happy with the care that they receive. The Clinical Coordinator has been seconded to the home to introduce new recording systems, which include Activities Time Table, De-escalation Care Plans, Personal Health Action Plan and Picture Boards. What the service does well: The home delivers a high quality service to the service users. The care practices in the home allow the service users to be supported in exercising choices and making independent decisions. The staff are highly motivated and offer a service that is consistent with the identified wishes of the service users. The service users have very active and fulfilling lifestyles. There is evidence of service users engaging in a wide range of social and recreational activities of their choice. Staff are at the forefront at promoting community links with the home. There is excellent professional support from the Health Trust in ensuring that the social, psychological and healthcare needs of the service users are met. This is shown by the secondment of a Clinical Coordinator to the home to help facilitate new care programmes, which would be beneficial to the service users. 28 Hylton Bank B52 B02 S15740 28 Hylton Bank V219466 23 Jun 2005 Stage 4.doc Version 1.30 Page 6 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. 28 Hylton Bank B52 B02 S15740 28 Hylton Bank V219466 23 Jun 2005 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 28 Hylton Bank B52 B02 S15740 28 Hylton Bank V219466 23 Jun 2005 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) 2, 4, 5. The home has suitable arrangements in place to obtain detailed assessments from care managers and carry out their own assessment of needs before admission of arranged. This ensures that the care provided is appropriate to the needs of the individual. The process of admission to the home is managed in a way that offers maximum benefit to a prospective service user in settling into their new home. EVIDENCE: There have been no new admissions to the home for some considerable time. However, the manager described the home’s current admissions procedure, which would include receiving full and detailed assessment from the responsible social worker. He also stated that the home would also carry out their own assessment to ensure that the needs of the prospective service user could be met. In his description of the admission procedure, the manager stated that a prospective service user would be invited to visit the home and to use that opportunity to meet the staff and other service users. He also spoke about introductory visits to the home over an agreed period of time to allow the prospective service user to become familiar with the people that they would be living with and to their new environment. 28 Hylton Bank B52 B02 S15740 28 Hylton Bank V219466 23 Jun 2005 Stage 4.doc Version 1.30 Page 9 Two service users files were examined and these contained details of assessments carried out to identify their care needs, and care plans being formulated to address those needs. There was evidence of regular reviews and evaluation of care plans. This is to ensure that the care provided for the service users are relevant to their current needs. There was evidence of service users being supported to take part in the formulation of their care plans, thus providing them with the opportunity to be involved in decisions about their care. In this way the individuals wishes could be established and provisions made in the ensuing care plan to meet those needs. 28 Hylton Bank B52 B02 S15740 28 Hylton Bank V219466 23 Jun 2005 Stage 4.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 9. Appropriate support and encouragement is provided to enable service users to be involved in the planning and review of their care. This provides the opportunity for the service users to exercise their rights to be consulted with in decisions about their lives. EVIDENCE: Two service users personal files were examined. The care plans address care needs such as personal care, social care, healthcare and educational opportunities. Record of reviews indicated that service users have contributed to their care plans. Their views are reflected in the personal care plans. The home has written policies in place to ensure that service users are able to exercise their rights, and that they are sufficiently supported by staff or advocates to do so. Records of review meetings demonstrate that service users’ views are sought about the care they receive and that they are encouraged and supported to achieve their potential. Contained in the service users’ files are individual risk assessments, which have been carried out by the staff. The risk assessments cover areas such as 28 Hylton Bank B52 B02 S15740 28 Hylton Bank V219466 23 Jun 2005 Stage 4.doc Version 1.30 Page 11 transport journeys, eating out, kitchen safety, shopping trips, pub visits, and bus journeys. The process ensures the safety and wellbeing of the of each service user, both within the home and outside the home, while at the same time enabling them to lead independent life as much as possible. 28 Hylton Bank B52 B02 S15740 28 Hylton Bank V219466 23 Jun 2005 Stage 4.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 16, 17. There are suitable arrangements in place to ensure that the service users participate in all aspects of daily living activities including involvement in their personal care and in social and recreational activities. There is strong awareness amongst the staff group to support the service users in making decisions for themselves, thus promoting their independence and right to make choices. EVIDENCE: The service users are supported to access college courses and other social and recreational activities. Some of the service users continue to use the local college. The staff described the varied social activities that service users are engaged in and the opportunities for access to all community facilities where appropriate. These include regular visits to local pubs, cinema, restaurants, shops, exercise/sport, relaxed times, videos, drawing and visits to other places of interest and entertainment. Details of how service users enjoyed these services were documented in the daily activities books. 28 Hylton Bank B52 B02 S15740 28 Hylton Bank V219466 23 Jun 2005 Stage 4.doc Version 1.30 Page 13 Practices observed during this inspection showed that staff always respect the privacy of the service users and would often knock bedroom door or seek the individual’s permission before entering their room. One service user has a key to his room to ensure privacy for him. Staff confirmed that personal mail is given to the individuals unopened and staff provide support to the individuals in dealing their mails. Each service users has “Individual Structured Day Programme” where they are encouraged by staff to undertake a number of household chores including doing the laundry and cleaning their rooms. Some service users are able to assist with washing up and are supported to prepare snacks for themselves. Such practices enable those service users to maintain a level of independence and interest. Staff continue to empower service users in their day-to-day decision making. For example, the manager confirmed that two service users were supported to take part in the last general and local elections, thus allowing them to exercise their civic rights. Staff continue to involve service users in the drawing up of the weekly menus and also take part in the weekly shopping for the home. Service users were offered choice of meals and were encouraged by staff to maintain some level of independence regarding meals. There was documentary evidence in the care plans showing that service users dietary needs were being met. Service users are frequently offered the opportunity to go out for meals, and there was documentary evidence to support this. The service user plans are reviewed annually but this had not been carried out for this year, which was due in May 2005. This needs to be done if the recorded care needs are to be regarded as current and relevant. 28 Hylton Bank B52 B02 S15740 28 Hylton Bank V219466 23 Jun 2005 Stage 4.doc Version 1.30 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19. The staff in the home demonstrated high degree of professionalism in the conduct of their duties. They engage in practices which promote the service users’ healthcare needs, privacy, dignity and independence. EVIDENCE: Care plans and risk assessments clearly identify specific care needs and the care programme is the result of consultation with relatives, other professionals and service users where appropriate. Records show that agreed care plans are followed by all staff and these were reviewed regularly to ensure that care provided is current and relevant to the service user. Services users were supported to attend GP service and other health related appointments such as out patient appointments, district nursing support, appointments with dentists, opticians, chiropodists and speech therapy. These were recorded in the individual life plans and in daily report books. Service users have access to psychiatric and behaviour psychology services to ensure their psychological and emotional wellbeing are addressed. Service users files indicate regular access to such specialist medical services. 28 Hylton Bank B52 B02 S15740 28 Hylton Bank V219466 23 Jun 2005 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, 23. Policies, procedures and practices within the home ensure that the service users are protected from all forms of abuse. EVIDENCE: There has been no recorded complaint or concerns raised by any service user in the past year. One service user spoken with indicated that they have no concerns about the home and feel comfortable being there. The home has a written complaint procedure, which is part of the Northgate and Prudhoe NHS Trust complaint procedure. Summary of the complaint procedure is included in the Statement of Purpose/Service User Guide and copies are made available to all the service users. However, the written procedures still refer to Social Services Inspection Unit instead of the Commission for Social Care Inspection. There is also a Trust “Whistle Blowing” policy in place and copies of these procedures are available in the home. The staff who were spoken with confirmed that they have received training in the City of Sunderland Local Authority’s MAPPVA (Multi Agency Panel for the Protection of Vulnerable Adults) procedures and on whistle blowing policies. 28 Hylton Bank B52 B02 S15740 28 Hylton Bank V219466 23 Jun 2005 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, 25, 30. The Trust provides a homely, safe and comfortable accommodation for the service users. EVIDENCE: The home is designed to meet the needs of people with a wide range of physical disabilities. The corridors and doorways are wide enough to allow easy access and comfortable movement of people. All rooms are single occupancy. The generous room sizes allow individual service users to furnish their rooms with personal items while leaving sufficient spaces for movement within their rooms. The home continues to maintain good standard of hygiene. On the day of the inspection the home was clean and maintained to a good standard. Antibacterial hand washing facilities were available in the toilets. The kitchen, lounge and bedrooms were all noted to be clean and in good order. Laundry machines have programme facilities to meet disinfecting standards, thus ensuring good control of infection practices. The radiator in one of the lounges was damaged with sharp edges exposed. This should be boxed in to prevent accidental injury to service users. 28 Hylton Bank B52 B02 S15740 28 Hylton Bank V219466 23 Jun 2005 Stage 4.doc Version 1.30 Page 17 There are policies and procedures in place regarding safe handling and disposal of clinical waste, dealing spillage, the provision of protective clothing and hand washing. 28 Hylton Bank B52 B02 S15740 28 Hylton Bank V219466 23 Jun 2005 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) 32, 33, 35, 36. The needs of the service users are met by competent and qualified staff who receive appropriate training and supervision to enable them to undertake their duties for the benefit of the service users. EVIDENCE: The Trust has a comprehensive induction plan for all newly appointed staff. Two new care staff were spoken with and they confirmed the arrangements for their induction and future training. The manager confirmed that all new staff are provided with an induction programme and later followed by LADAF training. All staff have been provided with statutory training and other training such as anger management and autism awareness. A number of staff were spoken with during the inspection. They all confirmed that they have been issued with individual job description and terms and conditions of employment. The staff confirmed that they have all received copies of the General Social Care Council code of conduct. In discussions with one recently appointed staff member, she described the recruitment and selection process and this was in line with the Trust’s written policies. She confirmed that references were taken by the Trust and CRB enhanced check was done for her before she commenced work. It was evident from 28 Hylton Bank B52 B02 S15740 28 Hylton Bank V219466 23 Jun 2005 Stage 4.doc Version 1.30 Page 19 discussions with staff and the manager that the Trust follows it strict recruitment guidelines and in so doing ensures that the service users are safeguarded from any form of abuse. 28 Hylton Bank B52 B02 S15740 28 Hylton Bank V219466 23 Jun 2005 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) 38, 39, 40, 41, 42. The manager offers good leadership, ensuring that the staff receive proper direction, consequently the service users receive a consistent and high standard of care which enhances their health, safety and welfare. EVIDENCE: The manager is a trained nurse and has NVQ level 4 in management. He has considerable experience working in the healthcare setting and in managing a care home. Such training and experience has been beneficial to the service and the service users. The staff who were spoken with indicated that the manager runs the service for the benefit of the service users and has positive relations with the staff. The Trust has produced detailed Health and Safety policies and copies of these were made available for inspection. These cover policy areas such as fire prevention and Care of Substances Hazardous to Health (COSHH). The 28 Hylton Bank B52 B02 S15740 28 Hylton Bank V219466 23 Jun 2005 Stage 4.doc Version 1.30 Page 21 manager stated that all staff have had training in food hygiene, fire precaution and first aid. All portable appliances have been tested. A record is maintained of monthly water temperature tests in the home. There is evidence of regular servicing of fire equipment, gas and electrical appliances. All the servicing records that were examined were up to date. These included fire fighting equipments, water treatment, electrical installation and gas servicing. Up to date servicing and maintenance of these services and equipments ensure a safe environment for the service users and the staff who work there. 28 Hylton Bank B52 B02 S15740 28 Hylton Bank V219466 23 Jun 2005 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 x 3 x 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 x 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 28 Hylton Bank Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x 3 3 x 3 x x B52 B02 S15740 28 Hylton Bank V219466 23 Jun 2005 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 damage to radiator in the lounge must be repaired or boxed-in to prevent accidental injury to service users. Timescale for action 1 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 12 23 Good Practice Recommendations The service user support plans should be reviewed annually as per the homes policy on reviews. The statement of purpose and service user guide should be reviewed to include name of Commission for Social Care Inspection and not social services inspection unit. 28 Hylton Bank B52 B02 S15740 28 Hylton Bank V219466 23 Jun 2005 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Baltic House Port of Tyne, Tyne Dock South Shields NE34 9PT 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 28 Hylton Bank B52 B02 S15740 28 Hylton Bank V219466 23 Jun 2005 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. 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