Inspection on 29/11/05 for Isabella Court

This inspection was carried out on 29th November 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Isabella Court 16/05/07

Isabella Court 25/07/05

Isabella Court 13/10/04

Isabella Court 29/06/04

Similar services:

Whitwood House

Whitwood Hall

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

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

CARE HOME ADULTS 18-65 Isabella Court 72a Westgate Pickering North Yorkshire YO18 8AU Lead Inspector David Blackburn Unannounced Inspection 29th November 2005 10:00 Isabella Court DS0000007833.V261185.R01.S.doc Version 5.0 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 Isabella Court DS0000007833.V261185.R01.S.doc Version 5.0 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. Isabella Court DS0000007833.V261185.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Isabella Court Address 72a Westgate Pickering North Yorkshire YO18 8AU 01751 475787 01751 477116 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) The Wilf Ward Family Trust Mr Paul Spencer Holbrook Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Isabella Court DS0000007833.V261185.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered for 10 residents with Learning Disabilities some or all of whom may have Physical Disabilities 25th July 2005 Date of last inspection Brief Description of the Service: Isabella Court is a purpose built centre situated on the outskirts of Pickering. The site offers three facilities: Isabella Court itself giving respite care to a maximum of six guests at any one time, a day care centre within this building and Woodside, an adapted property, offering permanent accommodation to four residents. The total accommodation gives sufficient communal space for the people in the home together with kitchens, laundries and offices. There are sufficient toilets and bathrooms in each location. Isabella Court and Woodside cater for adults with a learning disability and associated health and behavioural problems including some challenging behaviour. The staff seek to provide a holistic regime offering personal care, help, advice and guidance with daily living skills and activities, a catering service, a laundry service and domestic and cleaning services. All services are offered with input from service users where possible. Activities are offered both on and off site. Residents are registered with local general medical practitioners. The doctors arrange access to other more specialist health services. The home has close links with the Community Resource Team for people with a learning disability who provide advice, guidance and access to specialist services. The properties are owned by the Wilf Ward Family Trust, a registered charity, who also provide the care input. Isabella Court DS0000007833.V261185.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection upon which this report is based was the second to be undertaken in the inspection year April 2005 to March 2006. It was carried out over five hours including preparation time. The focus was on those key standards not assessed at the first inspection in July 2005 together with those parts of other standards that were subject to a requirement or recommendation. Those accommodated in Woodside are known as residents while those on respite care in Isabella Court are titled guests. Some care plans were examined together with some policies and procedures. Only the communal areas of the premises were seen. Discussions were entered into with the staff on duty. Some residents and guests were spoken with though their ability to communicate was very limited. Their feedback was mainly one-word answers, gestures or facial expressions. Observation throughout the inspection showed a very good rapport between residents and staff on both sites. What the service does well: The residents and guests remained at the centre of all activity in the home. Their needs were given priority and all tasks, routines and duties carried out focused without exception on them. Residents and guests enjoyed a varied menu that met their individual preferences and dietary requirements. Residents and guests were offered personal care and health care in a manner that met their requirements and promoted their overall wellbeing. Residents and guests were assured of protection from harm through good policies and procedures designed to safeguard them. Staff had a good understanding of adult protection issues that further promoted residents’ safety. Residents and guests continued to live in a homely environment. Residents and guests could feel confident their needs would be met by a competent, able, motivated and well-trained staff group. The registered provider’s recruitment and selection procedure was designed to further protect residents and guests from harm. The home was well managed and provided an environment in which residents and guests could feel safe and secure. Isabella Court DS0000007833.V261185.R01.S.doc Version 5.0 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. Isabella Court DS0000007833.V261185.R01.S.doc Version 5.0 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 Isabella Court DS0000007833.V261185.R01.S.doc Version 5.0 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): 0 None of these standards was assessed. EVIDENCE: Isabella Court DS0000007833.V261185.R01.S.doc Version 5.0 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 the following standard(s): 9. Thorough assessments must be completed on all aspects of daily living if residents and guests are not to be placed at risk. EVIDENCE: Two residents case files were examined in Woodside with specific reference to the completion of risk assessments. It was found that comprehensive and detailed risk assessments were undertaken on behalf of each resident in relation to activities outside the home, for example transport, swimming and horse riding. Risk assessments had also been carried out on a number of general activities in the home, for example use of laundry and kitchen equipment. However close scrutiny of the care plans showed little information on some aspects of daily living where an element of risk could be present, for example bathing and showering. It is essential that assessments are carried out for all activities of daily living to ensure that should a risk be present staff are aware of the actions to be taken to minimise or eliminate that risk. Isabella Court DS0000007833.V261185.R01.S.doc Version 5.0 Page 10 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): 16 and 17. Routines in the home were flexible and promoted residents’ and guests’ independence, choice and freedom of movement. The meals in the home were good offering choice and variety and catering for special dietary needs. EVIDENCE: Routines, rules and regulations appeared to be few within both buildings. Those in place were designed for the safety and overall welfare of resident and guest. Those care plans seen showed each resident’s personal preferences and choices in a number of areas of daily living. Staff worked hard to ensure these choices were met wherever possible. Despite the residents’ and guests’ many and very differing needs staff were seen to promote and maintain individual choice and maximise independence. Staff were observed to interact with residents and guests throughout the inspection. They were well able to recognise, understand and respond appropriately to every word, gesture or facial expression. Isabella Court DS0000007833.V261185.R01.S.doc Version 5.0 Page 11 Staff in the respite unit showed a great depth of knowledge about the many people in their care. Over 50 guests were accommodated throughout the year, some for one or two days, others for longer periods. Staff were able to relate to them, understood their needs and how they were to be met. Each site took responsibility for its own catering arrangements. In Woodside the support staff on duty were expected to undertake catering duties. Menus devised by the staff were firmly and clearly based on the likes, dislikes, preferences and choices of the residents. New items were added to the menu and if liked became a permanent addition; if not liked were deleted. Menus were changed to reflect the seasons. Different choices were offered, for example a number of cereals was available at breakfast and these were regularly changed to ensure residents continued to be offered a variety. In Isabella Court catering duties were undertaken by one of the two cooks. The menus were again devised around the recorded likes and dislikes of the guests. Specific requirements could be met, for example vegetarian choice and low fat diets. A list was kept in the kitchen of each guest’s particular dietary needs. One meal was observed in Isabella Court. The food was well presented and pleasantly served. Staff joined the guests for the meal. Assistance was provided quietly and unobtrusively. Encouragement was given in a gentle and non-judgemental manner. The whole meal was conducted in a dignified way and appeared to be enjoyed by each guest. Isabella Court DS0000007833.V261185.R01.S.doc Version 5.0 Page 12 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): 18. 19 and 20. Residents and guests received personal support that promoted and maintained their privacy and dignity. The health needs of residents and guests, including any medication requirements, were well met with evidence of good multidisciplinary working taking place. EVIDENCE: The pre-admission assessment and initial care plan detailed the care needs and the manner in which these were to be met. Subsequent re-assessments and care plan reviews had shown any revisions to needs and how they should be addressed. Observation clearly demonstrated staff were diligent and alert to the signals, whether word, sound, movement or gesture, made by each resident or guest. Not only were they able to “read” these signs but also responded quickly and appropriately. In Woodside the residents’ health needs were recorded on their case files. All were registered with a local general medical practitioner. There was clear evidence on the files of the involvement of specialist health professionals including occupational therapists, physiotherapists, district nurses and members of the Community Learning Disability Team. All residents received a yearly medical check-up. Isabella Court DS0000007833.V261185.R01.S.doc Version 5.0 Page 13 In Isabella Court on-going health care would be provided by practitioners in the area from which the guest had been admitted. Specific health care requirements that needed to be addressed while on respite care were recorded in their files. The local general medical practice in the town could be accessed in an emergency for any guest. A medication policy and procedure was seen. In Isabella Court proper procedures were followed for the receipt, storage, administration, recording and return of medication. Some of these procedures were observed and seen to be followed. In Woodside adjustments had been made to the medication system to alleviate the need to secondary dispense. Medication was now given from the original packaging or bottle. Staff had undertaken an in-house medication training course. The registered manager said he had identified an external training course in medication at a local college. He was hoping that permission would be given for staff to attend. All staff who administer medicines should undergo a period of external medication training. Isabella Court DS0000007833.V261185.R01.S.doc Version 5.0 Page 14 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): 22 and 23. Residents and guests were assured their concerns would be acted upon through a relevant complaints procedure. They were protected from harm by staff’s clear understanding of adult protection policies and procedures. EVIDENCE: A complaints procedure was available in written and pictorial form. It detailed how to complain, to whom and gave timescales for response. It showed the name and address of the current regulatory authority. An “abuse” policy and procedure was seen. It was written with specific reference to dealing with disclosures concerning people with disabilities. Staff confirmed training in adult protection was given at induction and when undergoing LDAF training (Learning Disability Award Framework). The registered manager said staff undertaking National Vocational Qualifications in care had to complete a compulsory unit on adult protection issues. The registered manager had a copy of the original multi-agency agreement on adult protection. He was advised to obtain a copy of the revised protocol, discuss this with staff and then implement its’ recommendations. Isabella Court DS0000007833.V261185.R01.S.doc Version 5.0 Page 15 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. Residents were able to live in a homely and comfortable environment. EVIDENCE: All parts of the premises remained in good condition internally and externally. Proper attention was given to general upkeep with re-decoration, refurbishment and re-carpeting carried out as necessary. Such work was in hand to the communal areas in Woodside. Those parts of the premises seen were clean, tidy and odour free. Appropriate systems were in place for the laundering of bedding, linen, towels and personal clothing. Proper attention was given to matters of hygiene and infection control. Isabella Court DS0000007833.V261185.R01.S.doc Version 5.0 Page 16 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): 31, 32 and 34. Residents and guests were well supported by a properly recruited, competent, motivated and trained staff team. EVIDENCE: Woodside had a complement of 12 support staff including an assistant manager. This post was vacant though being advertised. Isabella Court had 14 support staff together with the registered manager and catering staff. A gardener was also employed. Job descriptions were available for all posts. Staff had also received a copy of the General Social Care Council’s Code of Practice. Of the 26 support workers 15 had achieved a National Vocational Qualification in care to at least level 2 with 7 having achieved the award to level 3. Others continued work towards this award. The registered manager followed the recruitment and selection policies and procedures of the registered provider. They detailed the arrangements for the recruitment, selection, interview and appointment of staff. The necessary clearances, for example references and enhanced disclosures from the Criminal Records Bureau, had been obtained. Isabella Court DS0000007833.V261185.R01.S.doc Version 5.0 Page 17 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): 37, 39, 41 and 42. The home was well managed with good consultation systems that indicated residents’, guests’, relatives’ and other visitors’ views were actively sought and acted upon. Residents’ and guests’ health and safety was protected. EVIDENCE: The registered manager was a Registered Mental Nurse (RMN) and held a current Nursing and Midwifery Council registration. He had been appointed to the home in June 2005 following over 14 years in care environments including the last six years as assistant manager in a home for people with serious brain injury. He was undertaking the Registered Managers (Adults) NVQ 4 award. The registered manager spoke of his intention to undertake a thorough and comprehensive re-assessment of the overall service being offered by the staff at the home. He was to re-issue the written survey carried out earlier in the year although in a shorter form and asking not only for comments on present performance but suggestions and ideas for expanding the service. Isabella Court DS0000007833.V261185.R01.S.doc Version 5.0 Page 18 The registered manager was to undertake a presentation to senior managers on what he saw as the future role(s) of the home. In discussion with him it was evident that he wished to be pro-active in his approach and challenging in his thinking about the present and future service. He was keen to ensure a dynamic, positive, forward thinking and responsive service geared to individual needs and not one that just appeared reactive and stationary. The staff currently made follow-up calls to families when respite guests returned home. The record of these calls and the response given was seen. Those records seen were being maintained in an appropriate manner. Staff files had been seen earlier in the year at the registered provider’s headquarters. They were found to be satisfactory. Proper attention was being given to matters of health and safety. Staff confirmed attendance on a number of courses including manual handling, first aid and food hygiene. A number of safety reports and certificates were examined. They were found to be up-to-date and relevant. Isabella Court DS0000007833.V261185.R01.S.doc Version 5.0 Page 19 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 X X X X Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 X 3 X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Isabella Court Score 3 3 2 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X 3 3 X DS0000007833.V261185.R01.S.doc Version 5.0 Page 20 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 YA9 Regulation 13(4)(c) Requirement Risk assessments must be completed where required and where applicable for all activities of daily living including those related to personal care. Timescale for action 31/12/05 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 YA20 YA23 Good Practice Recommendations All staff who administer medicines should receive accredited medication training. The registered manager should obtain a copy of the revised multi-agency protocol on adult protection, discuss this with staff and implement its recommendations. Isabella Court DS0000007833.V261185.R01.S.doc Version 5.0 Page 21 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 Isabella Court DS0000007833.V261185.R01.S.doc Version 5.0 Page 22 - 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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