Inspection on 07/06/05 for Lifestyles

This inspection was carried out on 7th June 2005.

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

Lifestyles 29/07/08

Lifestyles 07/08/07

Lifestyles 19/07/06

Lifestyles 02/02/06

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

Pennine Camphill

Muston Road (70)

Grayling

The Cornerstone

John Street Nursing Home

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

CARE HOME ADULTS 18-65 The Cusicks 55-59 Wentworth Road Scarcroft Hill York YO24 1DG Lead Inspector Mary Slattery Unannounced 7 June 2005 9:30 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. The Cusicks J53_J04_S62824_The Cusicks_V231452_070605_stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Cusicks Address 55-59 Wentworth Road Scarcroft Hill York YO24 1DG 01904 645650 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) Dove Care Ltd Care Home 19 Category(ies) of Mental disorder, exluding learning disability or registration, with number dementia (MD) of places Learning disability (LD) The Cusicks J53_J04_S62824_The Cusicks_V231452_070605_stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection This is the first inspection of the service since registration. Brief Description of the Service: The Cusicks is a care home and provides personal care, support and accommodation for up to 19 service users with learning disabilities and a mental dissorder. The home comprises of three large terraced houses linked together. There are variety of communal rooms, single and double bedrooms and a patio garden at the rear of house. The home is located close to the city of York its amenities and facilities. The Cusicks J53_J04_S62824_The Cusicks_V231452_070605_stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report relates to an unannounced inspection of the home which was carried out on the 7th June 2005. The inspection took four and a half hours with two hours preparation time. The focus of the inspection was to look at a number of the key standards, inspecting care plans of a number of service users and a selection of other records. Time was spent listening and talking to service users and inspecting the premises including the service users private accommodation. A number of requirements and recommendations were identified through the course of the inspection and the investigation into a complaint against the service was also carried out. Discussions of the findings were had with the registered proprietor at the end of the inspection. What the service does well: A full review of the service users care plans has been done and service users are involved in developing their own care plans and keeping their own records. Daily meetings are held with service users and the staff at which the activities of the day ahead are discussed and agreed. This is also a time to plan for future social events, planning the menu and arranging for the shopping to be done. Enabled more service users to be responsible for their own medication and making health care appointments. Working with external agencies to secure advocates for service users and arranging reviews. The Cusicks J53_J04_S62824_The Cusicks_V231452_070605_stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Cusicks J53_J04_S62824_The Cusicks_V231452_070605_stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection The Cusicks J53_J04_S62824_The Cusicks_V231452_070605_stage 4.doc Version 1.30 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 standard(s) 1 and 2. Considered information is made available to help people make an informed choice about moving into the home. EVIDENCE: The registered person has produced and made available a statement of purpose and a service user guide with relevant information about what the service provides. There have been no new admissions to the home but there is information that all new service users needs would be assessed prior to an admission being agreed. The Cusicks J53_J04_S62824_The Cusicks_V231452_070605_stage 4.doc Version 1.30 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 standard(s) 6, 7,8 and 9.and 10. People living in the home make decisions about their lives and the day-to-day running of the home. They live as independently as they are able, taking into account any risks that need to be considered. EVIDENCE: The service users care plans have been reviewed and each service user is involved in developing their own plan of care. All aspects of their care their wishes and aspirations are discussed with them to encourage and support them in taking greater control of their own lives, making decisions and understanding the risks involved. Where restrictions are imposed frank discussions are had about these and agreements reached to ensure safety. Daily house meetings are held where all aspects of daily life are discussed and plans are made for the day. The Cusicks J53_J04_S62824_The Cusicks_V231452_070605_stage 4.doc Version 1.30 Page 10 Arrangements need to be made to revisit the homes’ confidentiality policy and procedure to be sure that both staff and service users are clear about the sharing of information. All the records are kept secure. The Cusicks J53_J04_S62824_The Cusicks_V231452_070605_stage 4.doc Version 1.30 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 standard(s) 13, 14 and 17. The service users have a varied lifestyle and enjoy a wide range of social activities. EVIDENCE: The service users made positive comments about life in the home, they said they are able to take responsibility for more aspects of their lives and they are involved in making decisions about the day- to- day activities. These activities include being involved in the cleaning and preparing meals, working in local charity shops, delivering newspapers, gong on holiday and following their favourite sport either by going to sport events or watching on television. The service users have access to the kitchen with some supervision and they are involved in all aspects of preparing food, shopping and in choosing the menu. A healthy eating menu has been introduced and everyone seems happy with this. The Cusicks J53_J04_S62824_The Cusicks_V231452_070605_stage 4.doc Version 1.30 Page 12 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) 18 and 20. There are good systems in place to ensure that the service users personal and health care needs are met. EVIDENCE: The service users are registered with a General Practitioner and have input from other health care professional where needed Each person living in the home needs different levels of support with their personal and health care. Their needs are assessed and arrangements made to provide support. A number of the service users are capable of attending to their own personal care needs. The service users said that staff are available when service users need to talk and discuss problems. Plans are ongoing to change the current medication system to the monitored dosage system. A number of the service users administer their own medication and risk assessments are carried out and agreements reached between staff and service users regarding the monitoring of medication. Lockable facilities are provided for the safe keeping of their medication. All staff should undertake a recognised medication training course. The Cusicks J53_J04_S62824_The Cusicks_V231452_070605_stage 4.doc Version 1.30 Page 13 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 and 23. The home has a relevant complaints policy and procedure. The staff would benefit from abuse awareness training. EVIDENCE: The service users said their views were listened to and actions taken to make changes where needed. A recent complaint was made against the service to the Commission for Social Care Inspection and this was investigated at the time of the inspection. The complainant raised the following concerns. Insufficient numbers of staff working in the home. Inexperienced staff working in the home. Concerns about the staffing arrangements when a group of service users and staff go on holiday for one week. The findings were as follows: There are two staff on duty during the day and at times three. There is one member of staff on waking night duty and one member of staff sleeping in on call. There are no staff employed to carryout domestic and catering duties. There was no evidence to confirm that the staff were inexperienced. Appropriate arrangements have been made to ensure that there will be sufficient staff working in the home to provide care to those service users who are not going on holiday. The staffing levels need to be increased to ensure that there are sufficient staff to carryout care tasks, management tasks and domestic and catering tasks. The Cusicks J53_J04_S62824_The Cusicks_V231452_070605_stage 4.doc Version 1.30 Page 14 There is an adult protection policy in the home but arrangements need to be made for all staff to attend abuse awareness training and to obtain a copy of the local authorities adult protection policy. Clear guidance needs to be in place for staff for reporting abusive practice. The home operates a restraint policy and procedure and arrangements have been made for staff to attend an appropriate training regarding the use of restraint. The Cusicks J53_J04_S62824_The Cusicks_V231452_070605_stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 and 25 and 30. Work needs to be done to improve some of the communal rooms in the home. EVIDENCE: The home was found to be clean and there are systems in place for safety checks to be carried out. All of the service users bedrooms are decorated and furnished to their individual tastes. They have their personal possessions around them and have keys to their own rooms. The registered person is working towards making all rooms single occupancy. Work has commenced on a new bedroom but before any further work is carried out advice must be sought from the fire safety officer and written notification of the intended change must be submitted to the Commission. The smoking room used by the service users needs to be redecorated and new flooring laid. The dining room needs to be redecorated and new flooring laid. The Cusicks J53_J04_S62824_The Cusicks_V231452_070605_stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33,34 and 36. The numbers of staff are not sufficient to carryout all the required duties. EVIDENCE: The majority of the care staff have completed the required TOPPS induction and a number have completed NVQ training. A number of the staff have experience in providing care to people who have learning disabilities, mental illness and challenging behaviour. Training planned includes a mental health foundation course and arrangements are to be made for updates on health and safety, fire, food hygiene, infection control, fire safety, adult protection and restraint. A number of the staff have worked in the home for a long time and there records need to be reviewed to ensure that the required checks have been completed. The staffing levels need to be increased and formal supervision needs to be in place. The Cusicks J53_J04_S62824_The Cusicks_V231452_070605_stage 4.doc Version 1.30 Page 17 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) 37 and 42. The registered proprietor is currently implementing changes to the service in line with the statement of purpose. EVIDENCE: The registered proprietor is undertaking the day to day management of the home and implementing Dove Care’s policies and procedures. Plans are in place for changes to the environment, staff training and service user led care planning. The registered proprietor needs to allocate dedicated time to implement new policies and to monitor the performance of the staff through supervision. The service users said they have confidence in the registered proprietor and they are happy with the changes that have been made. The Cusicks J53_J04_S62824_The Cusicks_V231452_070605_stage 4.doc Version 1.30 Page 18 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 3 3 x x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 2 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 3 x x x x 3 Standard No 11 12 13 14 15 16 17 x x 3 3 x x 3 Standard No 31 32 33 34 35 36 Score x 3 1 2 x 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Cusicks Score 3 x 1 x Standard No 37 38 39 40 41 42 43 Score 3 x x x x 3 x J53_J04_S62824_The Cusicks_V231452_070605_stage 4.doc Version 1.30 Page 19 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 20 Regulation 18 (c ) (i) Requirement The registered person is required to make arrangements for all staff to undertakethe following training: medication training, abuse awareness traing,and health and safety training. The registered person is required to redecorated and replace the flooring in the smoking room and the dining room. To consult with the fire safety department before further work is done on the new room. The registered person is required to increase the staffing levels to ensure that all care, domestic and management tasks can be carried out effectively. Timescale for action 30th July 2005. 2. 24 23 (d) 30th July 2005. 3. 33 18 (1) (a) 30th July 2005. 4. 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 10 Good Practice Recommendations It is recommended that the confidentiality policy is revisited to ensure that service users and staff are clear J53_J04_S62824_The Cusicks_V231452_070605_stage 4.doc Version 1.30 Page 20 The Cusicks 2. 3. 34 36 about the sharing of information. It is recommended that a review of the staff records is carried out to ensure all required records are in place. It is recommended that all staff receive formal supervision at least six times each year. The Cusicks J53_J04_S62824_The Cusicks_V231452_070605_stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection 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 The Cusicks J53_J04_S62824_The Cusicks_V231452_070605_stage 4.doc Version 1.30 Page 22 - 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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