Inspection on 03/11/05 for Kirkgate House

This inspection was carried out on 3rd 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Kirkgate House 05/04/07

Kirkgate House 21/04/05

Kirkgate House 11/11/04

Kirkgate House 07/07/04

Kirkgate House 19/02/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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

CARE HOME ADULTS 18-65 Kirkgate House Kirkgate Bridlington East Yorkshire YO16 7JU Lead Inspector 0Mr M. A. Tomlinson Unannounced Inspection 2nd November 2005 09:30 Kirkgate House DS0000019686.V259746.R02.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 Kirkgate House DS0000019686.V259746.R02.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. Kirkgate House DS0000019686.V259746.R02.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Kirkgate House Address Kirkgate Bridlington East Yorkshire YO16 7JU 01262 671185 01262 401735 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) Humberside Independent Care Association Limited Mrs Julie Elizabeth Wood Care Home 28 Category(ies) of Learning disability (28) registration, with number of places Kirkgate House DS0000019686.V259746.R02.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st April 2005 Brief Description of the Service: Kirkgate House provides personal care and accommodation for up to 28 younger adults who have a learning disability. It is owned and operated by Humberside Independent Care Association which is a ‘not for profit’ organisation. Nursing care is not provided. The home is situated on the outskirts of the town of Bridlington. The people who use this service have easy access to a variety of local shops, pubs and transport. The house is laid out over two floors with access to the second floor by a passenger lift. All the bedrooms are single rooms and two of them are arranged as a bed-sit with a seating area, kitchen area and private toilet facilities. There are also two small kitchen units for the sole use of the residents who are able to use this facility. The residents have the use of a number of small seating and dining areas and also a communal lounge area. Outside there is a small enclosed private garden with a patio area and greenhouse. On road parking is readily available. Kirkgate House DS0000019686.V259746.R02.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second of two statutory unannounced inspections to be undertaken during this inspectoral year. The inspection primarily focussed on the requirements and recommendations made during the previous inspection of the home and on those National Minimum Standards not addressed on that occasion. The inspection took seven and a half hours including preparation time. The registered manager was available throughout the inspection. An inspection of the premises was undertaken along with an examination of some statutory records. The opportunity was taken to have discussions with the available service users and the staff on duty at the time of the inspection. Feedback was provided for the registered manager at the end of the inspection. What the service does well: What has improved since the last inspection? The manager has continued to be pro-active in looking at possible ways of improving the lifestyle of the service users. Emphasis has been placed on the need for the service users to be integrated within the community. Staff training and development continues to have a high priority for all staff regardless of role and since the previous inspection several of the care staff have commenced a National Vocational Qualification. All of the requirements identified at the previous inspection have been addressed. Kirkgate House DS0000019686.V259746.R02.S.doc Version 5.0 Page 6 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. Kirkgate House DS0000019686.V259746.R02.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 Kirkgate House DS0000019686.V259746.R02.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 The service users have been provided with comprehensive pre.and post admission assessment that enabled a clear decision to be made with regards to the appropriateness of a prospective placement. EVIDENCE: A number of service users’ care records were inspected. These included evidence of the pre-admission assessments undertaken on prospective service users including those accommodated on a respite care basis. The registered manager considered the admission process to be important for a successful placement. The assessments were comprehensive and provided a sound basis on which as decision could be made as to the appropriateness of a planned admission. It was also evident that the assessments were the basis on which the service users’ initial care plan had been developed. Following the recommendation made at previous inspection action had been taken to ensure that the assessments and the care plans were signed in agreement by the respective service user or their representative. The registered manager acknowledged that a further assessment is often required on a service user shortly after their admission into the home as their needs and abilities often change with their change in environment. Kirkgate House DS0000019686.V259746.R02.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): 6 and 7 There is a clear, consistent and comprehensive care planning process in place that ensures that the staff have good standards of information available by which they can meet the service users’ needs EVIDENCE: The service users continued to be provided with a personal plan of care that was not only comprehensive but was clear and unambiguous. It was evident from the records and discussions with the staff that the care plans were seen as an important tool, which assisted in the provision of quality and consistent care. The care plans were split into elements of care to cover physical, social and emotional needs. There was recorded evidence that a service user’s abilities were also taken into account. It was apparent from the records that the care plans had been regularly reviewed and involved, where possible, the service user concerned, members of their family, their key worker and other professionals involved in the care of that individual. Following the requirement made during the previous inspection the wishes of the service users regarding terminal care and death had been obtained either from the individual service user or their representative. This process had been undertaken with Kirkgate House DS0000019686.V259746.R02.S.doc Version 5.0 Page 10 commendable sensitivity and tact by the manager. One service user had chosen not to make their wishes known. This had been recorded in their care plan. It was evident from discussions with the service users that they were encouraged to make decisions about their lives and that the staff discussed the possible consequences of these decisions with them. It was apparent that the service users’ independence was promoted and that they could follow a reasonably independent lifestyle even where this entailed a elements of risk. The manager provided examples of this. Kirkgate House DS0000019686.V259746.R02.S.doc Version 5.0 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): 14, 15, 16 and 17 The service users are provided with the opportunity to lead a varied and fulfilling lifestyle that enables them to develop as individuals. EVIDENCE: It was evident from an inspection of the care records and discussions with the service users that they lead active lifestyles and are able to participate in a range of social activities both within and external of the home. Many of these activities involved the use of community facilities such as local pubs, shops, restaurants, colleges of further education and leisure facilities. Several attended day placements for one or more days each week. One service user was employed at another home operated by the Humberside Independent Care Association. It was also apparent that service users were enabled to follow their personal interests and hobbies and several said that they enjoyed ‘doing their own thing’. The service users regularly go on holiday to destinations that they had chosen. On the day of the inspection several service users were preparing to go to a Centre Park for the weekend. The registered manager placed emphasis on the personal development of the service users particularly in the areas of social and domestic skills training. The majority of the service Kirkgate House DS0000019686.V259746.R02.S.doc Version 5.0 Page 12 users had retained good contact with their families and the manager endeavoured to involve the families in the routines and activities of the home. Evidence was available to confirm that with appropriate support and guidance the service users were able to develop personal relationships. Currently two service users were, on occasions, sharing a double room. The Community Learning Disability Team provided good support in such circumstances. It was evident from the discussions with the service users that they were well motivated, exuded confidence and displayed enthusiasm for the quality of their lives. The home employed dedicated cooks who had considerable experience in the dietary needs of younger adults. There was a ‘four week’ menu that indicated that the meals were varied, appropriate and nutritional. It was apparent that a reasonable balance had been achieved between the provision of ‘healthy’ food and the stated preferences of the service users. The menus were displayed in all three units. Those service users spoken to were aware of the planned meal and without exception expressed satisfaction with the quality of the meals. As part of the nutritional monitoring process, the service users weight was regularly checked and recorded. According to the staff and the records, one of the main topics of the service users’ monthly meetings was the food. The East Riding Council had provided the home with a ‘Healthy Eating Award’. The service users ate their meals in their respective unit. The dining areas in these units presented as domestic in character. The meals were transported in a ‘hot trolley’ to each unit. Kirkgate House DS0000019686.V259746.R02.S.doc Version 5.0 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): 18,19 and 20 The service users’ health and social care needs are met with good cooperation and input from health and social care professionals. EVIDENCE: The care records provided evidence that the service users’ care needs were met with good support from a range of health and social care professionals. Input from the Community Learning Disability Team was of a particularly good standard. It was also evident from discussions with, and observation of, the service users that they had established close but open relationships with the staff and were provided with a level of support commensurate with their ability and needs. It was observed that the staff had time to spend with the service users on a one-to-one basis thus providing them with the opportunity to discuss health care problems or issues. The home continues to use a monitored dosage system for the administration of the service users’ medication. The medication was appropriately secured and the administration process recorded. From a description of the procedure Kirkgate House DS0000019686.V259746.R02.S.doc Version 5.0 Page 14 provided by a member of staff, it was evident that the process was safe. Nominated and trained members of staff were responsible for administering medication. Those service users who had been assessed, as being competent and willing to administer their own medication had been provided appropriate secure facilities in their rooms. Following the previous inspection the use of a controlled drug had ceased. Arrangements were, however, in place for the administration and recording of such medication. Kirkgate House DS0000019686.V259746.R02.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 The service users have been provided with an appropriate complaints procedure and are provided with regular opportunities to make their views and opinions known. EVIDENCE: The home had an appropriate complaints procedure in place that was readily accessible to the service users and visitors to the home. The service users spoken to were aware of their right to make a complaint but could not envisage doing so as they had good contact with the manager and the staff. Regular service user meetings, good access to the manager and their key workers ensured that the service users had the opportunity to discuss concerns. The service users had also been provided with a good external support network. Kirkgate House DS0000019686.V259746.R02.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 28 and 30 The service users are provided with a homely and attractive place in which to live. EVIDENCE: An inspection of the premises was undertaken. As identified in the previous inspection report, Kirkgate House presented as being a safe and pleasant place in which to live. The service users’ bedrooms had been individualised in terms of furniture, fittings and décor. In the majority of cases the service users had furnished their rooms with their personal belongings and had displayed evidence of their achievements. This tended to reflect the personality of the occupant of a room. The home was subdivided into three units, which detracted from the ‘traditional’ approach to residential care and provided the service users with a degree of ownership and pride over their particular unit. The communal areas were furnished to a good standard and took into account the needs of the service users. It was observed that there were various adaptations and specialist equipment available to meet the needs of the service users and promote their independence. The outside of Kirkgate House belied its use as a care home and presented as normal domestic residential flats. This was, according to the registered manager, intentional so to minimise any stigmatisation of the service users. The entrance hall and other areas of the home continued this approach. On the day of the inspection the Kirkgate House DS0000019686.V259746.R02.S.doc Version 5.0 Page 17 home was clean, hygienic and free from any offensive odours. The cleaning staff confirmed that all parts of the home were cleaned daily. They demonstrated a good understanding of the service users’ needs and in particular the importance of ensuring that the premises were maintained to a high standard. The home also had the services of a maintenance person for repairs and general maintenance. Kirkgate House DS0000019686.V259746.R02.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 and 34 The staff have a good understanding of the service users’ needs and provide support and guidance for them in an appropriate manner. EVIDENCE: It was evident from the staffing roster and discussions with the registered manager that there had been no regression in terms of staffing since the previous inspection. It was evident from discussions with the staff that whilst they understood their roles they also held common aims being to provide the service users with a good quality of life. It was apparent, for example, that there was little, if any, staff demarcation in the home that consequently led to a cohesive and competent staff team. The staff records provided evidence that the staff had been provided with the opportunity to participate in a range of statutory and non-statutory training courses regardless of role. Appropriate levels of induction were provided for all new staff. The staff confirmed this. New care staff had also undertaken the Learning Disability Award Framework (LDAF) training before undertaking a National Vocational Qualification (NVQ). The staff records confirmed that the number of staff who had achieved, or were in the process of achieving a NVQ at level 2 or above ensured that the home will achieve the recommended level of 50 trained staff by the end of the year. Kirkgate House DS0000019686.V259746.R02.S.doc Version 5.0 Page 19 The staff records confirmed that appropriate and robust staff recruitment, selection and vetting procedures were in place. There was evidence that a minimum of two references had been obtained along with a CRB/POVA check. Where the ‘POVA First’ procedure had been used, appropriate supervisory procedures had been implemented until a full and satisfactory CRB check had been obtained. According to the manager, a part of the recruitment procedure included prospective staff meeting the service users. Following which the views of the service users were sought. Kirkgate House DS0000019686.V259746.R02.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 and 42 The service users have good access to the manager and are consequently able to discuss any concerns or worries with her. EVIDENCE: From an inspection of the records and discussions with the staff and service users, it was apparent that the home is run primarily for the benefit of the service users. The records were well maintained and the care records contained evidence of the involvement of the service users. All of the service users spoken to were aware of their care plan and of the name of their key worker. The registered manager was appropriately qualified as she is a registered nurse and had obtained the Registered Manager’s Award in 2004. She has had considerable experience in managing the care home. It was apparent that she employed a democratic and inclusive style of management. For example, the staff had been delegated appropriate tasks. The staff also confirmed that they received good support and guidance from the manager and that the manager was readily available to discuss issues or concerns. The manager was very Kirkgate House DS0000019686.V259746.R02.S.doc Version 5.0 Page 21 aware of the capabilities of the staff and actively encouraged them with regards to their personal and professional development. She was not complacent and did not readily accept the status quo but provided examples by which she hoped to improve the lives of the service users in the future. It was apparent that the staff reflected the attitude of the home’s manager and that this had a positive effect on the lives of the service users. The home had achieved the Investors in People Award and the Quality Award issued by the East Riding Council. There was evidence available to confirm that the home has been regularly subjected to internal and external audits and that action had been taken based on these audits to improve the standard of the service provided. Kirkgate House DS0000019686.V259746.R02.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 4 X X X Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 4 3 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 4 4 3 X 4 X 4 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 4 15 4 16 3 17 Standard No 31 32 33 34 35 36 Score X 2 X 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Kirkgate House Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 X X X X 3 x DS0000019686.V259746.R02.S.doc Version 5.0 Page 23 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 Timescale for action 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 YA32 Good Practice Recommendations 50 of care staff should achieve a National Vocational Qualification at level 2 by the end of 2005. Kirkgate House DS0000019686.V259746.R02.S.doc Version 5.0 Page 24 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 Kirkgate House DS0000019686.V259746.R02.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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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