Inspection on 07/11/05 for Karline Care Home

This inspection was carried out on 7th 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Karline Care Home 13/11/07

Karline Care Home 24/01/07

Karline Care Home 25/01/06

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 7th November 2005 09:30 Karline Care Home DS0000007598.V262903.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 Karline Care Home DS0000007598.V262903.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. Karline Care Home DS0000007598.V262903.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Karline Care Home Address Karline Care Home 23 Dickens Street Spennymoor Durham DL16 6AZ 01388 810617 01388 420915 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.V262903.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th February 2005 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. 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.V262903.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place during one afternoon and all three residents returned to the home during the course of it. The inspector visited again two days later in order to meet the manager and discuss some matters with her. Some residents are not able to comment directly upon their care but one who can, continues to be satisfied with her placement in this home. What the service does well: What has improved since the last inspection? What they could do better: Detailed guidance on how to prevent challenging behaviour and how to respond if it occurs must be included in the care plan for one resident. The manager must work with a member of staff to develop her skills and understanding in this area. At times, the member of staff takes one resident back to her house. The manager must assess whether the health and safety of the resident are protected when this happens. The manager must develop a quality assurance system. She should record whether residents are able to look after their own medication and each year record that she has discussed with residents whether they want wash hand basins in their bedrooms. Wherever possible, residents should sign to confirm they have received their personal allowances or any other money handled for them. Karline Care Home DS0000007598.V262903.R01.S.doc Version 5.0 Page 6 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. Karline Care Home DS0000007598.V262903.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 Karline Care Home DS0000007598.V262903.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): 2 Residents have only been admitted following an assessment by a care manager to make sure that the home will be able to meet their needs. EVIDENCE: All the residents were assessed by a care manager before they were admitted. The files contain copies of these assessments. Karline Care Home DS0000007598.V262903.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): Care plans provided much detailed information on the care each person needs but did not give enough information on how to avoid and respond to behavioural problems. This is essential to make sure that staff behave in a consistent way and help residents avoid behaviour which limits the activities they can enjoy. EVIDENCE: Each resident has a care plan which explains the help they need. These cover most aspects of their lives, describing if they need help with personal care, if they can go out on their own etc. The care plans include any areas where peoples choices are restricted, for example going out without staff. The care plan for one resident did not include detailed guidance on how to avoid behavioural problems developing. Karline Care Home DS0000007598.V262903.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): 12, 13, 15 Residents have a varied lifestyle and can follow their individual interests. They use local community facilities such as shops and pubs. They can keep up and develop family links and friendships. EVIDENCE: Residents attend day placements arranged by care managers. One attends college for vocational training in an area she has chosen. One resident spends more time in the home and he is taken to activities and places he particularly enjoys, such as Hardwick Hall and the station. Residents have been able to maintain contact with their families and friends can visit the home freely. Karline Care Home DS0000007598.V262903.R01.S.doc Version 5.0 Page 11 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, 20 Residents receive the personal care they need and can maintain their independence wherever possible. However staff need more guidance in reducing behavioural problems. The home make sure that residents receive medical attention when they need it. The arrangements for handling medication appear safe. EVIDENCE: The care plans explained how much care each person needs and it is clear that, wherever possible, they are able to be independent. However they did not include guidance on reducing behavioural problems and discussion with the manager showed that work is needed to make sure that everyone working in the home acts in the same way. Records showed that the manager made sure residents received medical help when they needed it, had regular checks of long-term conditions and dental care etc. The manager and staff have had training in handling medication. Records are kept which show a safe system for looking after medication. None of the residents look after their own medication but the home has not yet recorded an explanation of why this is necessary which would be good practice. Karline Care Home DS0000007598.V262903.R01.S.doc Version 5.0 Page 12 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): EVIDENCE: Karline Care Home DS0000007598.V262903.R01.S.doc Version 5.0 Page 13 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, 30 The home provides a comfortable place to live in a domestic house. It appeared clean although constant care is needed to prevent the three cats who live in the house affecting hygiene. EVIDENCE: The home is decorated and furnished in a domestic way and the manager takes the safety precautions expected of a responsible householder. She described plans to renew the carpet in one room. One resident showed me how she has been able to decorate and furnish her bedroom in a way that reflects her particular interests. Three cats share the house with residents and the manager is aware of the care which is needed to prevent any hygiene problems. At times the number of staff takes one resident back to her house. The manager must check that his health and safety is protected when he visits there. Karline Care Home DS0000007598.V262903.R01.S.doc Version 5.0 Page 14 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, 25 There is one person on duty whenever residents are in the building which meets their needs. The manager has the necessary skills and knowledge and should provide staff with extra training in learning disabilities. EVIDENCE: The home is staffed at the moment only by the owner/manager , who lives in the home, and one employee. Between them they cover the times when residents are at home, with one on duty at a time. Two of the residents do not need help with their personal care and one goes out independently so this arrangement seems to meet their needs. The manager is a nurse specialising in learning disabilities and has updated her training as necessary. The care worker has undertaken core training such as food hygiene etc but has not yet begun her NVQ 2 in care. The manager should provide in-house training to develop her knowledge and skills. The required checks were carried out when the last member of staff was recruited. Karline Care Home DS0000007598.V262903.R01.S.doc Version 5.0 Page 15 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 The manager has the skills, qualifications and experience to run the home. She has reduced her outside commitments so that she has the time to manage the home properly. 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 is no longer working outside the home though she is doing a part-time degree. This allows her more time to carry out the management side of her role as well as providing day-to-day care for residents. Karline Care Home DS0000007598.V262903.R01.S.doc Version 5.0 Page 16 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 X x Standard No 22 23 Score X x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X X 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 3 13 3 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 2 X CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Karline Care Home Score 2 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 X X X X X X DS0000007598.V262903.R01.S.doc Version 5.0 Page 17 Yes 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 YA6 Regulation 15 Requirement Care plans must include guidelines on preventing and responding to challenging behaviour. The manager must train staff to develop their understanding of residents behaviour. The manager must establish a system for reviewing the quality of care. The manager must assess health and safety arrangements when a resident spends time at a member of staffs home. T Timescale for action 15/12/05 2 3 4 YA32 YA39 YA42 18 24 13 15/12/05 31/01/06 15/12/05 Karline Care Home DS0000007598.V262903.R01.S.doc Version 5.0 Page 18 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 3 Refer to Standard YA20 YA23 YA26 Good Practice Recommendations The manager should record why residents are not considered able to look after their own medication. Residents should, whenever possible, sign for receipt of money returned to them. Residents needs and wishes about having wash hand basins in their bedrooms should be recorded and reviewed at least yearly. Karline Care Home DS0000007598.V262903.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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. 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