Inspection on 06/05/05 for Knaresborough Road (151)

This inspection was carried out on 6th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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

Knaresborough Road (151) 03/01/07

Knaresborough Road (151) 13/12/05

Knaresborough Road (151) 16/12/04

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 18-65 151 Knaresborough Road Harrogate North Yorkshire HG2 7NW Lead Inspector Rob Padwick Unannounced 6 May 2005 at 11.00 am th 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 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 Stationary 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. 151 Knaresborough Road J53_s61613_151 Knaresborough Road_v225733_060505_Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 151 Knaresborough Road Address Harrogate North Yorkshire HG2 7NW Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01423 546326 Homes Together Limited Mrs Susan Linfoot Care Home 8 Category(ies) of Learning Disability (8) registration, with number of places 151 Knaresborough Road J53_s61613_151 Knaresborough Road_v225733_060505_Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Service users to have an associated sensory impairment. Date of last inspection 16 December 2004 Brief Description of the Service: 151 Knaresborough Road is registered to provide residential social and personal care for 8 adults who have learning disabilities and an associated sensory impairment. The home is a large well maintained property situated between Harrogate and Knaresborough and has good access to services and amenities. The registered provider is Homes Together Ltd. The responsible individual is Mr S Jones. The registered manager is Mrs S Linfoot. 151 Knaresborough Road J53_s61613_151 Knaresborough Road_v225733_060505_Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and lasted from 11.00 am until 4 pm with a previous half day of preparation time. During the inspection, a tour of the premises was completed, and time was spent with service users in the communal areas of the home observing their daily lives. Further time was spent reading care plans and files. Due to the severe levels disability experienced by service users it was not possible to gain feedback directly from them and discussions were held with the manager and staff throughout the day. What the service does well: 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. 151 Knaresborough Road J53_s61613_151 Knaresborough Road_v225733_060505_Stage 4.doc Version 1.30 Page 6 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 Standards Statutory Requirements Identified During the Inspection 151 Knaresborough Road J53_s61613_151 Knaresborough Road_v225733_060505_Stage 4.doc Version 1.30 Page 7 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 standard(s) None None of these standards were assessed on this inspection. EVIDENCE: 151 Knaresborough Road J53_s61613_151 Knaresborough Road_v225733_060505_Stage 4.doc Version 1.30 Page 8 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 standard(s) 6 Care planning arrangements were satisfactory and ensured that service users assessed needs were being appropriately met. EVIDENCE: The two service user files examined contained care plans that had been developed to highlight the assessed needs of the individual service users and evidence was seen that these were monitored and had been reviewed appropriately. 151 Knaresborough Road J53_s61613_151 Knaresborough Road_v225733_060505_Stage 4.doc Version 1.30 Page 9 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 standard(s) 12, 13, 15, 16 Service users rights to take part in the life of the local community were supported and encouraged by staff. EVIDENCE: Staff were supporting service users to access community services on the day of this inspection and examination of the home’s timetable confirmed that a range of peer and culturally appropriate activities including horse riding, music and fitness groups were accessed according to individual need. Evidence was seen of family input into the service users files and discussion with staff indicated that the home had an open visiting policy and that one service user regularly went to stay with relatives for weekends. Staff demonstrated a good awareness of the necessity to protect and safeguard the rights of service users, which were met within a flexible regime based around the individual service user’s needs. 151 Knaresborough Road J53_s61613_151 Knaresborough Road_v225733_060505_Stage 4.doc Version 1.30 Page 10 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 standard(s) 19, 20, Service users received good personal and health care support and their physical and emotional needs were well met. EVIDENCE: Service users were not able to manage their health care due to the severe levels of disability experienced by them and were dependent on staff for this. Files of the two service user’s casetracked, included documentation relating to monitoring of health care issues and the registered manager indicated that the home had a close working relationship with the local GP practice. On the day of this unannounced inspection, staff were supporting services users to access both primary and specialist community health services. The home had a medication policy that was displayed on the front of the medication cabinet. Staff indicated they were aware of good practice issues relevant to this and had received training in the safe use and handling of medication. Confirmation of this was seen in the home’s records. The home used the Monitored Dosage System and this was found to be appropriately maintained and secure. This ensured that service users received their required medication in a safe manner. 151 Knaresborough Road J53_s61613_151 Knaresborough Road_v225733_060505_Stage 4.doc Version 1.30 Page 11 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 standard(s) 22 Staff demonstrated a clear commitment to ascertaining and meeting the needs and wishes of service users. EVIDENCE: The home had a complaints policy and procedure that included timescales for action and how to contact the Commission for Social Care Inspection. The registered manager maintained a complaints book, but no entries were included in this. Staff had undergone training in communication methods relevant to the needs of the service users and observation of the care practices indicated that relationships within the home were based on high levels of knowledge concerning the service users needs and that this enabled staff to work pro actively and determine any course of action that might be needed. 151 Knaresborough Road J53_s61613_151 Knaresborough Road_v225733_060505_Stage 4.doc Version 1.30 Page 12 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 standard(s) 24, 30 Service users live in a comfortable and homely environment, but the building was in need of some repairs. EVIDENCE: The home was in keeping with the local community and well situated for access to local amenities. Since the last inspection the standard of general upkeep of the building had declined and various repairs and improvements were now needed; including a leak to a bath, maintenance of window frames in the front lounge and a programme of redecoration. The registered manager stated that the home experienced high levels of wear and tear associated with the challenging behaviours presented by the service users and a record of ongoing repairs was seen. The home was clean and tidy and free from offensive odours. Staff members indicated they were aware of the homes policies relating to the control of hazardous substances and had received training in infection control and this was confirmed from examination of their training records and individual staff files. 151 Knaresborough Road J53_s61613_151 Knaresborough Road_v225733_060505_Stage 4.doc Version 1.30 Page 13 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34, 35 Whilst staff were able to meet the needs of the service users, the recruitment procedures needed strengthening in order to ensure that service users were appropriately protected. EVIDENCE: Specialist staff training had been accessed that included sessions on visual awareness, communication skills, nature of disability and challenging behaviour. The home’s record of training and observation indicated that staff were able to meet the needs of the service users. Staff files contained evidence of a recruitment policy and procedure, but one of the three files inspected indicated that a staff member had begun work before the Protection Of Vulnerable Adults check had been fully completed and included only one reference. This posed a potential risk to the protection service users. 151 Knaresborough Road J53_s61613_151 Knaresborough Road_v225733_060505_Stage 4.doc Version 1.30 Page 14 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39, 42 Improved consultation with stakeholders was needed in order to ensure that service users needs are met. Health and safety procedures needed to be strengthened. EVIDENCE: A basic quality assurance questionnaire template was seen but this needed further development to enable consultation with stakeholders and a full analysis obtained to determine future direction for the home. Staff records indicated that training had been delivered in aspects of health and safety, including fire instruction, first aid, infection control and control of substances hazardous to health. Maintenance records were mostly up to date, however the Registered Person had contracted with an external person to undertake the requisite electrical checks and inspection of these revealed that those relating to emergency lighting and portable electrical appliances to be overdue. 151 Knaresborough Road J53_s61613_151 Knaresborough Road_v225733_060505_Stage 4.doc Version 1.30 Page 15 151 Knaresborough Road J53_s61613_151 Knaresborough Road_v225733_060505_Stage 4.doc Version 1.30 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 N/A N/A N/A N/A N/A Standard No 22 23 ENVIRONMENT Score 3 N/A INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 N/A N/A N/A N/A Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 N/A N/A N/A N/A N/A 3 Standard No 11 12 13 14 15 16 17 N/A 3 3 N/A 3 3 N/A Standard No 31 32 33 34 35 36 Score N/A N/A N/A 1 3 N/A CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 151 Knaresborough Road Score N/A 3 3 N/A Standard No 37 38 39 40 41 42 43 Score N/A N/A 1 N/A N/A 1 N/A J53_s61613_151 Knaresborough Road_v225733_060505_Stage 4.doc Version 1.30 Page 17 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 24 Regulation 23 (2 d) Requirement The registered person must ensure that the premises are of sound construction and kept in a good state of repair externally and internally; The registered person must ensure that all of the documentation required by the regulation are obtained for all staff before they commence employment in the home The registered person must ensure that a quality assurance system is developed for reviewing at appropriate intervals; and improving the quality of care provided at the care home. The registered person must ensure that the portable electrical appliances and emergency lighting system is tested Timescale for action 6/8/05 2. 34 19 and schedule 2 6/7/05 3. 39 24 (1 a,b)(2)(3) 6/9/05 4. 42 13(4 c) 6/6/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. 151 Knaresborough Road J53_s61613_151 Knaresborough Road_v225733_060505_Stage 4.doc Version 1.30 Page 18 No. 1. Refer to Standard Good Practice Recommendations 151 Knaresborough Road J53_s61613_151 Knaresborough Road_v225733_060505_Stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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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