CARE HOME ADULTS 18-65
Long Eaves 40 Stafford Avenue Clayton Newcastle Staffordshire ST5 3BJ Lead Inspector
Ms Wendy Jones Announced Inspection 18 January 2006 13:00 Long Eaves DS0000005112.V272193.R01.S.doc Version 5.1 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 Long Eaves DS0000005112.V272193.R01.S.doc Version 5.1 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. Long Eaves DS0000005112.V272193.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Long Eaves Address 40 Stafford Avenue Clayton Newcastle Staffordshire ST5 3BJ 01782 630375 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) Choices Housing Association Limited Mrs Jackie Furniss Care Home 5 Category(ies) of Learning disability (5), Learning disability over registration, with number 65 years of age (5) of places Long Eaves DS0000005112.V272193.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 30th July 2005 Brief Description of the Service: Long Eaves is registered to care for five adults with learning disabilities. It is one of a group of homes managed by the Choices organisation, which is a provider of care for people with learning disabilities in North Staffordshire. Long Eaves is one of a cluster of six homes managed by Community Service Managers. It is situated in Clayton, a residential area of Newcastle-underLyme. It is located close to a range of amenities and is on a public transport route. The home is a dormer bungalow with a single storey extension to the rear. There are private gardens to the front and rear, including a seating and barbeque area to the front. The home is situated among ordinary housing stock and has limited off-road parking in the front driveway. All bedrooms in Long Eaves are single occupancy and located on the ground floor. The living accommodation and facilities are domestic in style and design. Long Eaves DS0000005112.V272193.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an announced inspection visit carried out on 18th January 2006. Information for this report was provided from discussion with the care manager and service users, interview of a support worker and conversation with other staff; from inspection of records and documentation relevant to the inspection process and from observation of the physical environment and service user and staff interactions. Feedback forms were returned by 3 relatives, 5 service users and a social worker and areas of concern identified were discussed with the care manager. What the service does well:
The service provides care and accommodation for 5 service users. Care records were well maintained and detailed, and reflected the care needs of service users. There was evidence of regular review and risk assessments were in place for individuals and for more general risk areas. Service users expressed satisfaction in the service and care they received. Service user meetings were arranged and recorded and there were plans to improve the meetings and increase service user involvement in decisionmaking. Records showed that the personal and health care needs of service users were being appropriately met. Procedures for the administration of medication were satisfactory. A complaints procedure was displayed in the home. Service users confirmed that they knew how to complain and expressed confidence in the staff and manager at the home. Staff had received training in recognising and reporting abuse. The environment was of a high standard throughout, the home was clean, tidy, well maintained, decorated and furnished, with adequate communal space. All bedrooms were single and none had en-suite facilities. Those inspected during this visit were of a very good standard with evidence that service users had been supported to make them their own. Staffing levels were sufficient to meet the needs of service users. Staff training records indicated that all staff had received both mandatory and supplementary training, and the standards of NVQ training were good.
Long Eaves DS0000005112.V272193.R01.S.doc Version 5.1 Page 6 Throughout the visit there was evidence of positive interaction between service users and staff. Systems were in place for monitoring the quality of the service provided. Health and safety risk assessments had been carried out and were subject to regular review. Fire records were accurately maintained with evidence that all service users and staff had been involved in fire drills and evacuations. 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. Long Eaves DS0000005112.V272193.R01.S.doc Version 5.1 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 Long Eaves DS0000005112.V272193.R01.S.doc Version 5.1 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 Service users assessed needs and wishes were well met, providing a satisfactory service for those requiring care. EVIDENCE: Assessment information provided an account of the needs of service users. Discussion with service users indicated that they had been involved in the assessment process. Long Eaves DS0000005112.V272193.R01.S.doc Version 5.1 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, 8, 9 Care plans were detailed, and addressed the assessed needs of service users, providing staff with the necessary information to effectively deliver care. The systems for service user consultation in this home were good with a variety of evidence that indicates that service users’ views were both sought and acted upon. EVIDENCE: Care plans, support action plans and 24-hour plans were in place providing staff with the information necessary for them to effectively deliver care. The records showed that reviews of care were undertaken monthly with key workers and service users. The Person Centred planning model of care included a major annual review/meeting. In one example the service user had not wanted a PCP meeting but participated in the process and agreed his aims, needs and aspirations for the following year. The manager showed that a review of the format for the plans had been undertaken to streamline the paperwork to provide staff and service users with a more user-friendly file.
Long Eaves DS0000005112.V272193.R01.S.doc Version 5.1 Page 10 Individual risk assessments recorded all recognised risk areas and the action required to reduce or minimise the risk. As with care plans there was evidence of regular reviews of risk assessments. Service users were able to give accounts of their care needs and knew who their key worker was. There was evidence of positive relationships between staff and service users. The deputy manager took responsibility for chairing service users meetings. There was an intention to discuss and include service user perceptions of the service in future meetings. Long Eaves DS0000005112.V272193.R01.S.doc Version 5.1 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): 13, 14, 15, 16, 17 Links with the community are good and support and enrich service users’ social and recreational opportunities. The service supported service users to access a range of recreational activities in and outside of the home. EVIDENCE: During this visit service users had been involved in activities in and out of the home. One service user independently accessed the local community using public transport. Other service users required more support, but were involved in activities of their choice outside of the home. From discussion with service users there was evidence provided that links with the community, including local churches, shops, pubs and neighbours had been established. Relatives feedback forms received prior to this visit, confirmed that service users were supported to maintain contact with families and friends, as stipulated in care records. Long Eaves DS0000005112.V272193.R01.S.doc Version 5.1 Page 12 Service users discussed their daily lifestyles, giving accounts of interests and hobbies they were supported to be involved with. Holidays had taken place for individuals. Two service users were involved in a project that tried to find employment, or work based experience/opportunities for persons with a Learning Disability. They had both been interviewed and were awaiting contact re: a possible placement. Three service users had paid part-time employment with the company’s handicare scheme, running errands for another of the services and carrying out vehicle checks and cleaning. Menus were planned with service users and records showed that a balanced and varied diet was provided. Service users confirmed that they could choose an alternative to the main meal choice available and that they were involved in shopping, meal preparation and cooking. All service users had free access to the kitchen to make snacks and drinks. Fridge, freezer and hot food temperatures were monitored and recorded daily. Long Eaves DS0000005112.V272193.R01.S.doc Version 5.1 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): 18,19,20 The health and personal care of service users were appropriately met with evidence of regular health appointments; involvement with specialist services, sensitive intervention and support to meet personal care needs. The medication at this home was well-managed, promoting good health. EVIDENCE: Service user health records indicated that health needs had been assessed, health action plans completed and support provided to seek intervention, monitor progress and attend appointments. There was evidence of consultation with other health professionals and ongoing review. Medication procedures were effective. One service user self-medicated and had a lockable facility in his bedroom to safely store medication. Long Eaves DS0000005112.V272193.R01.S.doc Version 5.1 Page 14 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, 23 The home had a satisfactory complaints system with evidence that service users felt that their views are listened to and acted upon. Adult Protection procedures ensure that arrangements are in place to protect service users from abuse. EVIDENCE: The manager stated that no complaints had been received in the 12 months prior to the inspection. Comments received in the relatives’ feedback forms were discussed for action, including providing relatives with a copy of the complaints procedure. Service users confirmed that they were aware of the complaints procedure and were confident that any concerns they had would be taken seriously. No complaints have been received by the Commission for Social Care Inspection in relation to this service. All staff had received training in recognising and reporting abuse. The manager reported that the organisation plans to provide regular updates for all staff and Vulnerable adults issues were included in the induction programme. Long Eaves DS0000005112.V272193.R01.S.doc Version 5.1 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 the following standard(s): 24, 25, 30 The appearance of this home created a comfortable and safe environment for service users living there and those visiting. EVIDENCE: The home was clean and well-maintained throughout. Since the last inspection some areas of the home had been redecorated and new furniture had been purchased for the dining room. Some changes to the garden had been made to make the area more accessible and usable. All bedrooms were for single occupancy and none had en-suite facilities. A sample of 3 bedrooms were seen with the kind co-operation of service users and were of a very good standard, with evidence that they had been supported to personalise them. Service users confirmed that they had chosen their colour schemes and furnishings for their bedrooms. The home provided communal space in a lounge and an additional lounge/dining room. There were sufficient shower, bathing and toilet facilities to meet the needs of service users. Long Eaves DS0000005112.V272193.R01.S.doc Version 5.1 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 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, 35, 36 Staff training records provided evidence that service users were being cared for by appropriately trained staff. Staff morale was good, resulting in an enthusiastic workforce that worked positively with service users to improve their whole quality of life. EVIDENCE: Staffing arrangements included, 240 hours per week inclusive of 5 for annual leave and illness. The service was contracted for 219 hours per week. On the day of the inspection there was 1 deputy manager 7.30am-3pm, 2 x 10am-6pm , 1 x 10-4pm and 1 x 3pm-11pm. There were no staff vacancies, and only occasional bank or cluster staff use. During this visit a bank staff was included in the numbers to accommodate a service user who required support to attend a hospital appointment. Samples of two recruitment records showed that the majority of records required by regulation were on file (including 2 written references, birth certificates, evidence of qualification, a photograph). In one example a CRB check was missing and there were no disciplinary records maintained in the home. The statement regarding the staff’s physical and mental wellbeing was also not included in the files. These matters were discussed with the manager.
Long Eaves DS0000005112.V272193.R01.S.doc Version 5.1 Page 17 Two staff were undertaking NVQ level 2 and 3 of the care team had achieved NVQ level. The deputy manager and manager were qualified nurses; the manager had achieved the Registered Managers Award and NVQ 4 in management and the deputy was undertaking it. The manager was also a Manual Handling and MAPA trainer and an NVQ assessor. The manager and a member of staff confirmed that the induction programme met the current guidance and the Learning Disability elements had been accredited with the British Institute for Learning Disabilities. There was also evidence provided that all staff were scheduled to undertake mandatory training updates. Additional in-house training was undertaken, with staff watching videos and completing questionnaires on an annual basis. Subjects included infection control, COSHH, Fire safety and Basic Food hygiene. Long Eaves DS0000005112.V272193.R01.S.doc Version 5.1 Page 18 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, 39, 42. The service appeared to be well run and managed. The manager provided leadership and was committed to improving the service for those living there. The home regularly reviews aspects of its performance through a good programme of self-review and consultations, which include seeking the views of service users, staff and relatives. The health and safety of staff and service users was promoted by good policies and procedures; detailed risk assessment and regular monitoring of safety systems. EVIDENCE: The manager discussed her commitment to improving the quality of life of service users and provided evidence of a well-run home. A system for assessing the quality of the service was in place. Monthly audits of health care, goals from Person Centred Plans, social, recreational and leisure opportunities were undertaken, with the outcomes displayed in the home. The
Long Eaves DS0000005112.V272193.R01.S.doc Version 5.1 Page 19 organisation facilitated two groups, which included service users to review policies, procedures and other paper work. Two service users from the home were members of the Focus Group, and were looking at methods of improving the format of some policies and procedures and the Service User Guide to ensure that they were service user-friendly. Outcomes of service user feedback on the quality of the service should be included in the Service User Guide. Fire safety records showed regular checks were carried out, fire drills and evacuations were undertaken and fire equipment serviced. Daily health and safety checks were also undertaken and recorded. Long Eaves DS0000005112.V272193.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 4 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 x 32 4 33 X 34 2 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X 3 3 X LIFESTYLES Standard No Score 11 X 12 X 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 X Long Eaves DS0000005112.V272193.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? No 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 YA34 Regulation 19, schedule 4 Requirement Ensure that staff records include evidence of Criminal Records Bureau Checks and any record of disciplinary action. Timescale for action 18/03/06 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 YA22 Good Practice Recommendations Ensure that relatives are aware of the complaints procedure. Long Eaves DS0000005112.V272193.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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