Inspection on 13/11/07 for Karline Care Home

This inspection was carried out on 13th November 2007.

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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Karline Care Home 24/01/07

Karline Care Home 25/01/06

Karline Care Home 07/11/05

Karline Care Home 16/02/05

Karline Care Home 24/06/04

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 Karline Care Home Karline Care Home 23 Dickens Street Spennymoor Durham DL16 6AZ Lead Inspector Ms Kathy Bell Unannounced Inspection 13th November 2007 2:30pm Karline Care Home DS0000007598.V351860.R01.S.doc Version 5.2 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 Karline Care Home DS0000007598.V351860.R01.S.doc Version 5.2 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. Karline Care Home DS0000007598.V351860.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Karline Care Home Address Karline Care Home 23 Dickens Street Spennymoor Durham DL16 6AZ 01388 420 863 P/F karensnowdon@aol.com 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) Miss Karen Snowdon Miss Karen Snowdon Care Home 3 Category(ies) of Learning disability (3), Learning disability over registration, with number 65 years of age (3) of places Karline Care Home DS0000007598.V351860.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th January 2007 Brief Description of the Service: Karline is registered to provide care (but not nursing care) for three adults with learning disabilities, over 18 years: the registration was varied to allow the home to accommodate a resident who was over 65 but all three current residents are under 65. The building is a semi-detached house, near the town centre of Spennymoor with a single bedroom for each resident and one for the owner/manager who is the main carer, and her partner. There is a good-sized lounge, dining room, kitchen, utility, bathroom/toilet and a separate toilet. A garden at the back of the house provides space for a number of family pets. Karline Care Home DS0000007598.V351860.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place during one afternoon in November 2007. During the inspection, the Inspector talked with the residents, the two staff and the manager/owner. She had received completed surveys from the residents (some were helped by staff to fill them in), two relatives and one care manager. She also spoke with a care manager after the inspection. The inspector looked at some records in the home and looked around the building. What the service does well: What has improved since the last inspection? The manager and care managers are working much more closely together now for the benefit of residents. They have agreed how much support each person needs and how they can be independent while staying safe. This is good because it means everyone is clear about what is expected and residents can be as independent as possible. There are more staff available so that the manager can have a life of her own, without this affecting the care of residents. Also, the husband of one of the staff acts as a volunteer. This means it is easier for her to take one or two residents out on social outings, for meals etc. There has been progress in renovating the house next door which will be used mainly by the manager and her partner but which already includes an office for Karline Care Home DS0000007598.V351860.R01.S.doc Version 5.2 Page 6 the home. The office should be a big improvement as it will help the manager keep her records properly. 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. The summary of this inspection report can be made available in other formats on request. Karline Care Home DS0000007598.V351860.R01.S.doc Version 5.2 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 Karline Care Home DS0000007598.V351860.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2. People who use the service experience good quality outcomes in this area. Residents were assessed before they were admitted to make sure the home would be able to meet their needs. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: All the residents were assessed by a care manager before they were admitted. The files contain copies of these assessments. The care managers have looked again at each residents needs recently, to make sure they are still being met. Karline Care Home DS0000007598.V351860.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 & 9. People who use the service experience good quality outcomes in this area. Each resident has a care plan which explains the help they need. Residents can make choices in their daily lives. The manager has agreed with care managers how to manage any risks in peoples lives, while respecting their wishes for independence. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: Care plans provided detailed information on the care each person needs. There were detailed descriptions, agreed with the care managers, about what each person could do independently and what they needed help with. There were also guidelines on what to do if someones behaviour was causing problems. Staff showed that they knew what to do and followed these guidelines. This home benefits from having only a few people working in it so they get to know each resident really well. Karline Care Home DS0000007598.V351860.R01.S.doc Version 5.2 Page 10 Each resident has a different programme of activities through the week. Some are more able than others to say what they want to do. One said in a survey that she can go out with a friend at the weekends, as long as she says when she will be back. One resident has a variety of day placements which suit her interests. The manager described how she gives a resident choice, either by using her knowledge of the TV programmes he likes or going through the channels until he decides what to watch. Other residents say what they want to eat and are involved in making meals. The small size of this home makes it easy to do this. In the surveys, residents said that they mostly can do what they wanted to do. During the inspection, they were going into the kitchen as they chose, helping themselves to fruit and, in one case preparing sandwiches for the next day. A resident did ask permission to put on a video but this was to go on the video in the lounge used by all three residents. So in this situation, it seems reasonable that the resident should check if this was ok for everyone. Care managers have agreed with the home a number of risk assessments, which look at how the home can avoid people coming to harm while helping them be as independent as possible. These consider whether people can be left alone, if they can manage their own medication and how to respond to any difficult behaviour. They also consider whether anything in the home could be a danger to people, such as hot water. But they should also consider whether one or two staff are needed to carry out some activities safely, such as taking a resident out. Karline Care Home DS0000007598.V351860.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15, 16 & 17. People who use the service experience good quality outcomes in this area. Residents take part in a range of leisure activities and use local community resources. They can maintain contact with their families and develop new relationships. The home is run so that people can make choices about how they live and spend their time. Residents are offered a reasonable choice of food and staff try and provide a healthy diet. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: Each resident goes to different day placements, arranged by care managers, according to their needs and interests. These include craft activities, woodwork and trying out new leisure interests. One resident only goes to a day centre two days a week. At home, he concentrates on the TV or video but daily records show that staff are managing to take him out more regularly, to the shops, for meals out etc. Karline Care Home DS0000007598.V351860.R01.S.doc Version 5.2 Page 12 Residents use local community facilities; pubs, the gym, shops. They go for days out, and had a trip to Blackpool at Easter. They also have social events in the home, one resident described a Halloween party which she had enjoyed. One resident regularly visits her family and has been able to keep going a friendship outside the home. Another relative said that his daughter is brought to see her parents now and again. Staff provide support and guidance about personal relationships. The home is run flexibly and residents can make choices about whether to sit in the lounge or watch TV in their bedrooms. Residents who are more able are closely involved with the choosing and preparation of food. Staff know what each person likes to eat and try and provide a healthy diet. But residents can also enjoy a take-away and the records showed that people could make their different choices at these times, one having fish and chips and another pizza, for example. One resident monitors her weight and staff try and provide guidance to help her control this. Residents can help themselves to fruit from the kitchen. Karline Care Home DS0000007598.V351860.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 18, 19 & 20. People who use the service experience good quality outcomes in this area. Residents receive the personal care they need and can maintain their independence wherever possible. The home makes sure that residents receive medical attention when they need it and staff keep good records. Staff handle medication safely. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The care plans provide enough detail to guide staff. This helps them provide as much care as people need while allowing them to be as independent as possible. The small size of the home helps staff to be consistent and flexible. Each residents care manager has been reassessing the care they need and referrals have been made to specialists like speech therapists and occupational therapists. The manager has done a full assessment of each residents healthcare needs. She is keeping very detailed records to help the doctors find out the cause of Karline Care Home DS0000007598.V351860.R01.S.doc Version 5.2 Page 14 one residents pains. Visits by community nurses are recorded as well. A care manager said that, I believe that care staff are vigilant in monitoring individuals health and wellbeing and in taking action when necessary. Individuals are encouraged to follow healthy diets, maintain hygiene etc . Regular visits made to GP surgery with service users, efforts are made to resolve health issues wherever possible, and support provided to attend appointments, treatment etc as necessary. Residents in this home do not take a lot of medication. Care managers and the home have looked at whether people could look after their own medication but decided this is not a safe idea. Records were not checked on this inspection but have been found to be satisfactory before. Karline Care Home DS0000007598.V351860.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 & 23. People who use the service experience good quality outcomes in this area. Residents and relatives know how to make a complaint. Residents are protected from abuse. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: Two relatives and the residents confirmed they knew how to make a complaint and they and the care manager said that the home has always responded appropriately if concerns were raised. One complaint has been made about the care of residents. This was investigated by care managers and they were satisfied that residents were not abused. However care managers have been concerned that it is difficult for one person to provide most of the care in a home while still having a normal social life. Another member of staff is now employed and the husband of the other staff member acts as a volunteer. This means that more people are available to support the manager in providing care. Satisfactory records are kept of personal allowances which the manager looks after and receipts are available for money spent. Durham County Councils financial protection team looks after residents finances. Criminal Records Bureau/Protection of Vulnerable Adults list checks have been done on new staff and on the husbands of staff members, who act as volunteers in the home. This helps the home make sure that there is nothing in someones background which would mean they were not safe to work with vulnerable adults. Karline Care Home DS0000007598.V351860.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 & 30. People who use the service experience good quality outcomes in this area. The home provides a comfortable place to live in a domestic house. It appears to be kept clean. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The home is decorated and furnished in a domestic way and the manager takes the safety precautions expected of a responsible householder. Each resident has their own room, and they arrange their rooms as they want to. There is a shared living room, a dining room and kitchen, shared with the owner and her partner. There is a bathroom upstairs and a downstairs toilet. Improvements have been made to the outside of the home, with a large paved area at the front and an extended garden, with decking and a summerhouse, at the back. The owner/manager has bought the house next door which she plans to turn into living space for herself and her partner. The houses have been connected Karline Care Home DS0000007598.V351860.R01.S.doc Version 5.2 Page 17 through a bedroom on the first floor. The new house has an office, which should help the manager work much more efficiently and keep her records in good order. At the moment, staff have to walk through one residents bedroom to get to the office. This is obviously unacceptable. But as soon as the manager and her partner move into the house next door, which will be very soon, this resident will move into the managers old room. Another resident who swapped rooms, said in the survey, I am pleased I have changed rooms. The home seemed clean on the day of inspection. In the surveys, residents said that the home is always or sometimes fresh and clean. It is always nice and tidy here. Karline Care Home DS0000007598.V351860.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 33, 34 & 35. People who use the service experience good quality outcomes in this area. Staff seem to have the personal qualities needed for this job and one of the two staff has achieved the recommended qualification for care workers. There is at least one person on duty when all the residents are in the building, and this seems enough to look after residents safely. Before new staff have started, the manager has checked they will be safe to work with vulnerable adults. Staff have had almost all the training they need to look after people safely. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: In the surveys, residents said that staff always treated them well. Relatives also praised the way residents were cared for. My daughter is cared for every way by all the staff. The National Minimum Standards for care homes recommended that 50 of the care staff achieve the National Vocational Qualification in care at level 2. One of the two staff has already achieved this. Also the manager has decided that people who live or spend time in the home, such as her partner and the husband of a member of staff who act as a volunteer, should also achieve qualifications. This is a good standard to aim Karline Care Home DS0000007598.V351860.R01.S.doc Version 5.2 Page 19 for as it helps make sure that everyone involved with residents has an understanding of how they should be cared for. Her partner has already achieved the NVQ in care. The staffing rota showed that there is always at least one person on duty. The new member of staff who started work several weeks ago is not yet working on her own but always works alongside the manager or the other member of staff. The manager still works most of the hours but on two evenings a week one of the staff works the evening shift. This is important because it allows the manager to have a social life without this affecting the care of residents. As well as paid staff, residents benefit from the time provided by the husband of one of the staff, who works as a volunteer. This has meant it is easier for staff to take two residents out, and staff can be more confident taking out a resident whose behaviour can be difficult. At night, the manager, or a member of staff if she is on holiday, sleeps in the home, but is available if residents need them. The manager has also made arrangements so that, in case of emergency, there is an established arrangement with a staffing agency to provide staff for the home. Only one person has started work since the last inspection. Records showed that the manager obtained references and carried out a Criminal Records Bureau/Protection of Vulnerable Adults list check, to make sure she would be a suitable person to work with vulnerable adults. The manager and one member of staff have had training in essential areas such as moving and handling, food hygiene, first aid, protection of vulnerable adults and fire safety. The new member of staff has had training in first aid and is working through workbooks on health and safety, fire safety, protection of vulnerable adults and infection control. She must also obtain a food hygiene certificate as soon as possible. Karline Care Home DS0000007598.V351860.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39 & 42. People who use the service experience good quality outcomes in this area. The manager has the skills, qualifications and experience to run the home but still needs to improve her record-keeping. She has not carried out surveys of residents and relatives views to find out what they think of the home. But she does get day-to-day feedback from residents about what they are happy or unhappy about. The home is a safe place to live. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The manager is a qualified nurse who has specialised in learning disabilities. She has achieved the NVQ 4 in management which is the recommended qualification for managers of care homes. She still has problems in keeping records well-organised and easy to find but having a proper office may help Karline Care Home DS0000007598.V351860.R01.S.doc Version 5.2 Page 21 her with this in the future. But the day-to-day records about peoples care are in order and available. She has considered a system which will help her and her staff keep the home running to the standards she expects. She has not tried to obtain the views of residents and relatives in a systematic way to make sure that she finds out what they think of the home. But she does receive day-to-day feedback from them. Equipment etc in the home is regularly serviced and the fire detection system is checked regularly. The checks required by food hygiene regulations are carried out. The manager has thought about how she can make sure residents are safe at night when she moves in to the house next door and has asked for advice from an occupational therapist. She has also had advice from the fire officer about fire precautions for two connected houses and put in the standard of fire door he recommended. Fire drills are not carried out and this must be done, to make sure that everyone is familiar with what to do if there is a fire. Care managers have looked at whether other things in the home, such as hot water or opening windows, could be a risk to people, and have agreed with the existing safeguards. Karline Care Home DS0000007598.V351860.R01.S.doc Version 5.2 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 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 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 X 3 X 2 X X 3 X Karline Care Home DS0000007598.V351860.R01.S.doc Version 5.2 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 YA35 Regulation 18 Requirement The new member of staff must receive food hygiene training as soon as possible. The manager must set up a system to make sure the care in the home meets the expectations of residents, relatives and care managers. Staff and residents must take part in a fire drill every six months (every three months for staff who do night duty). Timescale for action 31/01/08 2. YA9 YA39 24 28/02/08 3. YA42 23 31/12/07 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 YA9 Good Practice Recommendations For residents with behaviour problems, risk assessments should include information on whether one or two staff are needed to take them out. DS0000007598.V351860.R01.S.doc Version 5.2 Page 24 Karline Care Home Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Karline Care Home DS0000007598.V351860.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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