CARE HOME ADULTS 18-65
Ivy Dene 20-22 Doncaster Road Ferrybridge Knottingley WF11 8NT Lead Inspector
Tony Railton 24
TH Unannounced Inspection February 2006 14.30 Ivy Dene DS0000037871.V284362.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 Ivy Dene DS0000037871.V284362.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. Ivy Dene DS0000037871.V284362.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Ivy Dene Address 20-22 Doncaster Road Ferrybridge Knottingley WF11 8NT 01977 671499 01977 672370 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) Ivy Cottage (Ackton) Limited Mrs Margaret Rose Eyre Care Home 14 Category(ies) of Learning disability (13), Physical disability (1) registration, with number of places Ivy Dene DS0000037871.V284362.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 30th August 2005 Brief Description of the Service: Ivy Dene continues to provide accommodation and personal care and support to up to fourteen people who have a learning disability, one of whom may also have a physical disability. The home also provides a semi - independent living unit for some service users who are learning to live independently with a view to moving into their own homes. The care provided is underpinned by ordinary living principles and residents are encouraged and supported to take advantage or ordinary community based leisure and healthcare services. All accommodation provided is single, however there is an expectation that residents will share the lounges, dining room, bathing and washing facilities. Having said this some of the bedrooms on the first floor have recently been provided with showers. The home is particularly designed to support and care for people who’s behaviours may challenge ordinary community based services. The design, decoration and furniture provided for the home reflects the nature of the work they do and care is taken to make the environment as homely and safe as possible. The home is situated close to the centre of Ferry Bridge where there are shops including a post office, pharmacy, fish and chip shop, public houses and community centre. There is car parking to the front of the home and there is a main bus route nearby. The home is quite close to the A1, M1 AND M62 link roads and the centre of Pontefract is only a few minutes journey from the home. Ivy Dene DS0000037871.V284362.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was a very positive and enjoyable unannounced inspection when there was the opportunity to meet and speak with nearly everyone living in the home. There was also the opportunity to speak to the senior manager for the organisation, the deputy manager and support workers. There was also the opportunity to look at staff selection and recruitment and training records. The staff development and training programme was also seen along with master copies of planned mandatory and related learning disability training for support workers. Some residents’ case files were also seen and included assessments, care plans, reviews, medical and daily records. The inspector would like to take the opportunity to thank residents, support workers, assistant manager and senior manager for their warm welcome, hospitality and patience throughout the inspection. The inspector would particularly like to thank those residents who chose to show the inspector their rooms and personal possessions. This was a very positive and enjoyable inspection. It was noted that the home continues to meet all statutory requirements and almost all good practice recommendations. What the service does well:
Throughout the inspection it was clear that residents liked living in the home and liked the people caring for them. Discussion with residents showed that they liked their own rooms, the way they were decorated and their possessions. One resident enjoyed showing the inspector his compact disc player and in particular spending some time together listening to the music he likes. Another resident said that she likes her room and enjoyed showing the inspector her favourite possessions. The inspector was particularly impressed with the positive attitude of support workers towards residents and the positive relationships there appeared top be fostered. Clearly when residents are well, such as the day of the inspection, there is a relaxed and homely atmosphere, reminiscent of that of an extended family. Providing this relaxed and positive environment is a credit to the manager and her staff team and is to be commended. There was evidence that residents are encouraged and supported to take advantage of ordinary community based leisure and healthcare services and that they have a positive community presence. The staff team are again to be commended for their efforts in making sure that residents live as ordinary a life as possible. The inspector acknowledges that this can at times be difficult. Ivy Dene DS0000037871.V284362.R01.S.doc Version 5.1 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. Ivy Dene DS0000037871.V284362.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 Ivy Dene DS0000037871.V284362.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 Residents care and support needs are assessed before they are admitted to the home. EVIDENCE: Examination of a sample of residents case files including assessments show that most residents already have an Integrated Care Management Programme Assessment before they are considered for placement in the home. Discussion with the Senior Manager indicated that the assessment process is extensive and everyone has to be sure that the home is appropriate and can meet individual residents needs before they are admitted. Ivy Dene DS0000037871.V284362.R01.S.doc Version 5.1 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): 6,7,8, 9 and 10 Residents are consulted at every opportunity for their opinion on the running of the home and their assessed and changing needs are reflected in their care plans. Risk assessments are also completed to protect residents who are encouraged to live an ordinary lifestyle as possible. EVIDENCE: Discussion with residents and examination of their case files including assessments, care plans, reviews, medical and daily records show that their care and support needs are identified and planed for. Residents records and in particular risk assessments show that steps are taken to minimise any risks to residents who are encouraged and supported to live as ordinary a life as possible. One resident said that he is due to “leave the home” and move into “a house of his own”. There was evidence that living at Ivy Dene had been a positive experience for him and he said that he would “miss living here”. The quality assurance questionnaires and reports show that residents are satisfied that their care needs are met. Residents’ care plans and reviews show that they are fully involved in their care and have a say in what happens to them. The minutes of the residents meetings show that everyone has the opportunity to comment on the running of the home. A notice on the notice board showed that there are open meetings planned with the providers
Ivy Dene DS0000037871.V284362.R01.S.doc Version 5.1 Page 10 representative to discuss any issues about the home or quality of the support provided. This good practice is to be commended. However, the daily records would benefit from the use of descriptive words to reflect and show residents choices, preferences, likes and dislikes on a day to day basis. Discussion with care staff and examination of new staff records including contract and induction training show that there are policies and procedures in place to ensure that information about residents is handled appropriately and that their confidences are kept. Ivy Dene DS0000037871.V284362.R01.S.doc Version 5.1 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 the following standard(s): 12,13,14,15,16 and 17. Residents are provided with opportunities for personal development and to take art in age, peer and culturally appropriate activities. They are part of their local community and are supported to take full advantage of ordinary community based leisure services. Positive relationships with relatives are openly encouraged an residents are offered a healthy diet and enjoy their meals and mealtimes. EVIDENCE: Through discussion with residents, assistant manager, care staff and examination of residents’ records including care plans, assessments and reviews it was found that everyone is supported to live as ordinary a lifestyle as possible. Discussion with one resident shows that he goes to the local newsagent for his papers and magazines. Another said that he goes home on a regular basis to spend time with his parents. The daily records show that residents are encouraged and supported to take full advantage of all ordinary community based leisure services. Ivy Dene DS0000037871.V284362.R01.S.doc Version 5.1 Page 12 Discussion with support workers indicated that this sometimes can be difficult given the nature of some residents conditions and their associated behaviours. The inspector commends the manager and her staff team for their efforts in ensuring that residents’ rights are upheld and that a positive community presence is promoted. On the day of the inspection positive relationships were observed between residents and support workers and in particular around one meal time when great care was been taken to explain the menu and the alternatives provided. This good practice is to be commended. Residents’ assessments, care plans also identified residents’ likes dislikes and preferences regarding choice of meals and meal times. It was also noted that residents appetite is monitored and that they are weighed on a regular basis. Ivy Dene DS0000037871.V284362.R01.S.doc Version 5.1 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 the following standard(s): 18 and 19 Residents receive personal support in a way they prefer and require and their healthcare and emotional needs are met. EVIDENCE: Discussion with residents, the senior manager, assistant manager and examination of residents records show that they are encouraged and supported to use ordinary community based healthcare services. However, some residents are still supported by hospital based consultants and there is also advice available from the specialist social workers if required. The quality assurance monitoring questionnaires and reviews show that residents , their relatives and other stakeholders are satisfied that residents are getting the care and support they need and require. Ivy Dene DS0000037871.V284362.R01.S.doc Version 5.1 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 support workers are confident that their views, concerns and comments will be listened to and acted upon. Residents are safeguarded and protected from self harm and abuse by the policies , procedures and practices governing adult abuse. EVIDENCE: Discussion with residents, support workers, senior manager and assistant manager show that the home listens to what people say and takes action to make sure things are right. The home has not received any complaints since the last inspection. Staff induction training records show that staff receive training in adult abuse and protection as part of their induction. It was also noted that the home has its own adult abuse and protection policy and procedure, however, this is used in conjunction with Wakefield Social Services and Health Multidisciplinary Adult Abuse and Protection Policy and Procedure. The senior manager said that they have a number of different local authority adult abuse and protection policies and procedures as residents are placed from all over the country. One support worker said that there is plenty of opportunity to bring your concerns to the manager, as there are regular staff meetings and supervision sessions. She went on to say that the manager has an open door and will always listen to what you have to say. Ivy Dene DS0000037871.V284362.R01.S.doc Version 5.1 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): 24,26,28 and 30 Residents have their own bedrooms as they want and the shared spaces compliment and supplement their own rooms. EVIDENCE: Discussion with residents’ show that they like living in the home. One resident said that he will be “sorry to go” as he has enjoyed living at Ivy Dene he went on to explain that he would be taking his own furniture with him when he moves into his own house. Another resident who volunteered to show the inspector her bedroom was very pleased with her possessions and enjoyed showing them to the inspector. Another was very proud of his bedroom and in particular his Compact Disc Player and together we listened to some of his music. All the bedrooms seen appeared to be well decorated and maintained. Two new shower rooms were seen on the upper floor which presented well and made good use of the space available. The lounges and the conservatory appeared to be well maintained. On the day of the inspection most residents appeared to congregate in the dining room or the activities room next door. Everyone appeared to be comfortable and relaxed and there was a homely environment created. All parts of the home were clean.
Ivy Dene DS0000037871.V284362.R01.S.doc Version 5.1 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): 32,34 and 35 Residents are supported by competent and qualified staff team, residents are also protected by the staff selection and recruitment policies and practices. EVIDENCE: Discussion with the senior manager, new support worker and examination of staff records show that residents are safeguarded and protected by the staff recruitment and selection processes. They show that CRB and POVA (Protection of Vulnerable Adults List) checks are carried out before staff are employed. Records also show that new staff receive induction training which reflects national training organisation specification. On the day of the inspection the new support worker said that she had undertaken induction training, however, some of this was not signed off or dated to say it had been completed. The master staff training records of both proposed and completed training show that all staff receive mandatory training such as First Aid, Moving and Handling, Food Hygiene and Infection Control. They also show that 50 of support workers have a National Vocational Qualification Level 2 or above. The senior manager went on to say that there are currently nine workers enrolled on NVQ training. Training records also show that staff receive training on Epilepsy, Makaton (a form of signing ), Autism and Adult Protection. The new Skills for Care Induction Training was discussed with the Senior Manager who was aware of the changes due to take place in September this year.
Ivy Dene DS0000037871.V284362.R01.S.doc Version 5.1 Page 17 After speaking to support workers the inspector was impressed with their enthusiasm and positive attitude towards residents. Ivy Dene DS0000037871.V284362.R01.S.doc Version 5.1 Page 18 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 and 42 Residents’ benefit from living in a well run home where they know their views will be listened to and influence what happens in the home. Residents’ and support workers welfare is safeguarded and protected by the homes policies and practices regarding health and safety. EVIDENCE: Discussion with the senior manager and examination of the residents quality assurance questionnaires and quality assurance reports, show that residents views on the way the home runs are sought and acted upon. Examination of the minutes of residents meetings, their reviews and planned open meetings show that residents have the opportunity to comment on the running of the home and the quality of support provided. Throughout the inspection there was a relaxed, open and inclusive management style which is to be commended. Discussion with the senior manager, assistant manager and examination of the staff training matrix and master training and development plans show that support workers receive mandatory health and safety training. Ivy Dene DS0000037871.V284362.R01.S.doc Version 5.1 Page 19 Records also show that there are health and safety protocols within the home to ensure a safe environment. Ivy Dene DS0000037871.V284362.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 X 28 3 29 X 30 x STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X 3 X 3 X X 3 X Ivy Dene DS0000037871.V284362.R01.S.doc Version 5.1 Page 21 N/A Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement On the day of the inspection there was no failure to meet statutory requirements noted. Timescale for action 24/02/06 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 YA7 Good Practice Recommendations Other evidence was available to show that residents do make decisions about their lives, however, the daily records would benefit from the use of descriptive words to show and reflect residents choices and preferences, likes and dislikes. This becomes particularly important when introducing the person centred approach documentation as it helps demonstrate that the service users are ‘driving’ what happens to them on a daily basis. Ivy Dene DS0000037871.V284362.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB 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 Ivy Dene DS0000037871.V284362.R01.S.doc Version 5.1 Page 23 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
