CARE HOME ADULTS 18-65
Long Eaves 40 Stafford Avenue Clayton Newcastle Staffordshire ST5 3BJ Lead Inspector
Wendy Jones Unannounced 30 July 2005 2:30 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. Long Eaves E51-E09 S5112 Long Eaves V242132 300705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Long Eaves Address 40 Stafford Road Clayton Newcastle Staffordshire ST5 3BJ 01782 630375 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) Choices Housing Association Limited Mrs Jackie Furniss Care Home 5 Category(ies) of 5 LD registration, with number 5 LD(E) of places Long Eaves E51-E09 S5112 Long Eaves V242132 300705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 04 March 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 E51-E09 S5112 Long Eaves V242132 300705 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out on 30 July 2005. Information for the inspection was provided from discussion with service users and staff; from inspection of care records, fire safety records and the environment. What the service does well:
The service has all the information prospective service users require to enable them to make an informed decision about moving into the home in the Statement of Purpose. The service user guide contains, information about staffing, the terms and conditions of residency, a procedure for complaints and information about the facilities and services they can expect. There were comprehensive assessments of need. A model of person centred planning had been introduced, with evidence that service users were an integral part of the process, and had been involved in care planning and risk assessment. The records showed that regular reviews of care had been undertaken. Each service user had a range of possible participation options to choose from on a daily basis, an analysis of engagement was undertaken on a weekly and monthly basis, for quality monitoring purposes. Service users were regularly included in the daily domestic chores of the home, including cooking and cleaning their bedrooms and were involved in hobbies such as gardening if they chose to be. Service users right to privacy and to be involved in the day-to-day decisions affecting their lives. Service user meetings were arranged and recorded. All service users had taken a holiday or had a holiday planned. Records showed that the health care needs of service users were being appropriately met. Procedures for the administration of medication were satisfactory, protocols were in place for the administration of as required medication. A complaints procedure was displayed in the home, and another copy in a more user friendly format was included in the Service User Guide. Service user confirmed that they knew how to complain and expressed confidence in the staff and manager at the home. Long Eaves E51-E09 S5112 Long Eaves V242132 300705 Stage 4.doc Version 1.40 Page 6 The home was clean, tidy, well maintained decorated and furnished, with adequate communal space. All bedrooms were single and appeared to exceed the minimum standards in terms of size; 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, with an abundance of personal possessions, family memento’s and items of interest on display. Staff training records indicated that all staff had received both mandatory and supplementary training, and the well established staff team were trusted by service users to provide appropriate care. Throughout the visit there was evidence of positive interaction between service users and staff. Health and safety risk assessments had been carried out for individuals, and in general. 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:
Two bedroom doors were not self closing properly, the service had reported the fault on 26/07/05, but were awaiting action. It was required that this matter was addressed. Medication records were generally appropriately maintained, there was one occasion form the sample seen of staff not signing the medication administration charts; and one example of a code being used that was not defined. Information from the records indicated that social and recreational opportunities outside of the home had been reduced; this should be addressed. The staffing arrangements on the day of the inspection were not entirely satisfactory, but according to the records did not represent a typical day. It was accepted that two service users had been on holiday and reduced staff had been provided in the home. However the implication for service user, was of reduced opportunity to access the community and recreational and social events outside of the home.
Long Eaves E51-E09 S5112 Long Eaves V242132 300705 Stage 4.doc Version 1.40 Page 7 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 E51-E09 S5112 Long Eaves V242132 300705 Stage 4.doc Version 1.40 Page 8 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 Long Eaves E51-E09 S5112 Long Eaves V242132 300705 Stage 4.doc Version 1.40 Page 9 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 The homes Statement of Purpose and Service User Guide are excellent providing service users and prospective service users with details of the services the home provides enabling an informed decision about admission to be made. EVIDENCE: The Service has a Statement of Purpose and Service user guide, copies of both documents have been provided to the CSCI. They both provide prospective service users and their supporters with the information they require to enable them to make and informed decision about moving in to the home. The service user guide includes pictorial and simplified information for the benefit of service users. Long Eaves E51-E09 S5112 Long Eaves V242132 300705 Stage 4.doc Version 1.40 Page 10 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) 6,7,9. 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 records included detailed assessments, and person Centred plans, reviews of the PCP had been undertaken on a regular basis and formally six monthly. Action plans and protocols had been agreed and in one example a protocol for smoking in the home had also been signed by the service user. Service users meetings were recorded for 25/06/05 , 16/04/05 and 29/01/05, records showed that a number of topics were discussed and service users views were sought regarding activities the house rules and decisions regarding routines. Risk assessments were in place for individual service users the records showed that they were subject to regular review.
Long Eaves E51-E09 S5112 Long Eaves V242132 300705 Stage 4.doc Version 1.40 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) 12,13,16,17 The service supported service users to access a range of recreational activities in and outside of the home. Dietary needs of service users were well catered for with a balanced and varied selection of food available that meets service users tastes and choices. EVIDENCE: Two service users had returned from a holiday on the day of the inspection, other service users had holiday’s planned. Records showed that service users had access to a range of activities both in and out of the home. Participation records showed the number of activities service users were involved with on a daily basis. The records were audited on a weekly and monthly basis for quality monitoring purposes. Long Eaves E51-E09 S5112 Long Eaves V242132 300705 Stage 4.doc Version 1.40 Page 12 From the information available it was apparent that some service users had recently had limited opportunities to access social and recreational activities for a number of reasons. Weekly menus were planned with service users, records showed that there was a range of meals provided and good choice. Records of fridge freezer and hot food temperatures were maintained daily although some gaps were noted. Long Eaves E51-E09 S5112 Long Eaves V242132 300705 Stage 4.doc Version 1.40 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 standard(s) 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 generally well managed promoting good health. EVIDENCE: The health care needs of service user were being appropriately met, with evidence that service users, were supported by staff, to attend preventative and health related appointments. All service users were registered with General Practitioners, dentists, opticians and received input from other health specialists as necessary. An annual dietetic review was carried out and other health reviews by specialist services were evident. The medication records showed that they were generally well maintained with Just one example of a missing signature. On another occasion a code had been entered against one medication but was not defined. The storage and stock controls systems were satisfactory. One service user had been supported to self medicate. Long Eaves E51-E09 S5112 Long Eaves V242132 300705 Stage 4.doc Version 1.40 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 standard(s) 22. The home had a satisfactory complaints system with evidence that service users felt that their views are listened to and acted upon. EVIDENCE: Service users spoken to felt able to express any concerns they may have with the staff and manager of the home. A complaints procedure was displayed in the home and a pictorial version was included in the Service User Guide. The evidence from the service user meeting minutes indicated that service user views were listened to. Long Eaves E51-E09 S5112 Long Eaves V242132 300705 Stage 4.doc Version 1.40 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) 24,25,27,30. The appearance of this home creating a comfortable and safe environment for service users living there and those visiting. EVIDENCE: The standard of environment was good throughout, two easy chairs in the dining room were to be replaced; the invoice for the replacement furniture was provided as evidence. The communal areas in the home were pleasant and well maintained they included, a very nicely decorated and furnished lounge, a separate dining room which also had some comfortable seating and a spacious well equipped kitchen. All bedrooms were for single occupancy, none had en-suite facilities, a sample of bedrooms were seen with the kind co-operation of service users and were of a very good standard. There was evidence that staff had supported service users to personalise their rooms by choosing their colour schemes, displaying items of interest and evidence of family photographs, hobbies and interests. Two bedroom door did not self close properly, this issue must be addressed and is a requirement of the report.
Long Eaves E51-E09 S5112 Long Eaves V242132 300705 Stage 4.doc Version 1.40 Page 16 The service provides an attractive bathroom, where efforts have been made to provide service users with a relaxing environment in which to bathe. An additional shower room was also provided. The home offers a large garden to the front with a pleasant patio area, at the rear of the property there was an equally spacious garden area, with a large greenhouse and mature planting. Long Eaves E51-E09 S5112 Long Eaves V242132 300705 Stage 4.doc Version 1.40 Page 17 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) 32,33,36 Staff training records provided evidence that service users were being cared for by appropriately trained staff. Adequate staffing levels must be maintained at all timed to ensure that service users social and recreational activities can be met. EVIDENCE: From discussion it was established that the service had a number of staffing difficulties for period of time. Staffing hours for three weeks in June ranged from 196-174 per week. Staffing arrangements for the day of the inspection included one staff from 7.30am-3.30pm and one from 3.30pm-11pm. The usual staffing arrangements allow for additional staff at peak times, this was confirmed from the staff rota’s seen. The need to ensure that staffing levels are adequate at all times was discussed, as there were limitations as a result of the staffing arrangements on service users access to the local community and social and recreational activities. The service must keep staffing levels under review to ensure that service users social lives are not affected by poor staffing levels.
Long Eaves E51-E09 S5112 Long Eaves V242132 300705 Stage 4.doc Version 1.40 Page 18 The records of staff meetings indicated that the last meeting had taken place on the 13 April 2005. Verbal information regarding staff supervision indicated that there was a need for more regular individual supervision sessions. Staff training records showed that all staff had received mandatory training, and also supplementary training, in core values, record keeping, communication and sexuality. Long Eaves E51-E09 S5112 Long Eaves V242132 300705 Stage 4.doc Version 1.40 Page 19 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) 40,42. 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: Fire safety records were appropriately maintained and it was confirmed from the records and from discussion with staff that all staff and service users had been involved in fire drills. Individual and environmental risk assessments were in place, with evidence of regular reviews. Long Eaves E51-E09 S5112 Long Eaves V242132 300705 Stage 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 4 x x x x Standard No 22 23
ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 3 x x x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 2 x 3 x x 4 Standard No 11 12 13 14 15 16 17 x 2 2 x x 3 3 Standard No 31 32 33 34 35 36 Score x 4 2 x x 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Long Eaves Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score x x x 3 x 3 x E51-E09 S5112 Long Eaves V242132 300705 Stage 4.doc Version 1.40 Page 21 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 33 Regulation 18 Requirement The service must ensure that staffing levels are adequate to provide service user with regular acces to social and recreational activities. The two fire doors identified during this inspection must be addjusted to ensure they self close properly. Timescale for action 30/10/05 2. 25 23 02/08/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard 20 36 13 Good Practice Recommendations Medication should be signed for on every occasion it is administered. Staff supervision sessions should be take place at least six time per year. Further efforts should be made to ensure that service users social and recreational opportunities outside of the home are improved. Long Eaves E51-E09 S5112 Long Eaves V242132 300705 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Stafford - 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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