Inspection on 02/11/06 for Manor Road (14)

This inspection was carried out on 2nd November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Manor Road (14) 05/01/06

Manor Road (14) 04/11/04

Manor Road (14) 12/05/04

Manor Road (14) 03/12/03

Manor Road (14) 14/08/03

Manor Road (14) 22/10/02

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

CARE HOME ADULTS 18-65 Manor Road (14) 14 Manor Road Knaresborough North Yorkshire HG5 0BN Lead Inspector Terry Downey Key Unannounced Inspection 2nd November 2006 09:00 Manor Road (14) DS0000007896.V320992.R01.S.doc Version 5.2 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 Manor Road (14) DS0000007896.V320992.R01.S.doc Version 5.2 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. Manor Road (14) DS0000007896.V320992.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Manor Road (14) Address 14 Manor Road Knaresborough North Yorkshire HG5 0BN 01423 868918 01423 868918 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) None United Response Miss Jenny Louise Bailey Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Manor Road (14) DS0000007896.V320992.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered for a maximum of 4 Service Users with Learning Disabilities who also have Physical Disabilities 5th January 2006 Date of last inspection Brief Description of the Service: 14, Manor Road is registered to provide residential personal and social care for 4 service users with learning and physical disabilities. The property is a purpose built bungalow situated on a residential housing estate close to Knaresborough town centre and with good access to the towns services and amenities. All parts of the home are wheelchair accessible. The home is part of the United Response organisation and benefits from the support of the companys training and management structure. The registered manager is Ms Jenny Bailey. On 2nd November 2006 the fees for the home were £16669.79. Manor Road (14) DS0000007896.V320992.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection consisted of a review of the information held on the homes file since the previous inspection, information submitted by the home in the Pre Inspection Questionnaire, and a 4 hour unannounced site visit to the home on 2nd November 2006. At the time of the site visit the manager Jenny Bailey was available, with three members of staff in the home, and four service users. They all assisted with the inspection, and were very helpful. It was difficult to communicate with the residents but care staff assisted which was very helpful, but some of the comments are also based on observation. The site visit also included discussion with the staff, a check on the requirements and recommendations from the previous inspection, a tour of the premises and a check on the records kept by the home. Survey forms were completed by two people and both were complimentary about the home, the staff and the care provided. The inspection showed that the residents were well cared for in a clean, well maintained, home. The home has had to use a lot of agency staff which is not appropriate for the residents but the manager is making efforts to recruit permanent staff and some success was seen. There is a core of well trained and committed staff, and a manager, who work hard to improve the residents’ quality of life and this was also witnessed. What the service does well: The residents live in a clean, well maintained home. Staff are kind and helpful and make an effort to provide the service the residents’ want. Residents are able to make choices in many areas of their lives. Examples included rising and retiring times, activities, clothes, and food. This ensures that they maintain some control. The residents are able to access the primary health care team and other professionals ensuring that their health care needs are met. A good choice of well prepared food, and drinks are available. This ensures that they receive a varied and nutritious diet. The home gets the views of the residents and others, about the service provided so as to make changes which improve the residents’ quality of life. Manor Road (14) DS0000007896.V320992.R01.S.doc Version 5.2 Page 6 The staff are provided with comprehensive training to improve their knowledge and skills. This promotes best practice and ensures that residents receive a good quality service. Staff are recruited in a way that seeks to make sure that only suitable people are employed and ensuring the safety and protection of the residents. 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 summary of this inspection report can be made available in other formats on request. Manor Road (14) DS0000007896.V320992.R01.S.doc Version 5.2 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 Manor Road (14) DS0000007896.V320992.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and their representatives have the information required to choose a home which meets their needs. EVIDENCE: There haven’t been any admissions to the home requiring a full pre admission assessment in recent years. Two service users files examined showed that the needs of people who use the service are regularly reviewed and that every effort is made to ensure that service users are involved in determining how their needs and aspirations will be met. Written admission documentation on current service users was good and included a copy of the care management assessment. There was a lot of information available about the home to give to prospective residents which included the Service User Guide, and an information pack with photographs. Very good information was available to staff to ensure they could meet the social, emotional and care needs of new residents. Manor Road (14) DS0000007896.V320992.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Good care planning and risk assessments ensure that lifestyle needs of the residents are met. EVIDENCE: The care plans are good and developed using the principles of person centred planning. They contain the information required to help the staff meet the needs of the individual resident and are set out in an easy to read and understand format. Two residents were case tracked and this indicated that their personal care needs were met appropriately. Efforts are made to involve the residents in their care plan but it would be difficult to verify their understanding of it. Manor Road (14) DS0000007896.V320992.R01.S.doc Version 5.2 Page 10 Staff had a very good understanding of the needs of the residents and were knowledgeable about the contents of their care plans and risk assessments. They were seen to be patient and kind when interacting with the resident and clearly provided individual care. The residents were unable to communicate verbally but with the help of staff expressed levels of satisfaction with the home and their care. Surveys confirmed that relatives were consulted and kept informed about important matters. Manor Road (14) DS0000007896.V320992.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The social and recreational activities meet the residents’ needs and they eat a healthy and varied diet. EVIDENCE: Each resident has an individual timetable designed to ensure that they are given the opportunity to take part in a variety of activities both within the home and the community, and staff are usually available to support them. The staff are constantly looking for new activities which will interest the residents and provide further stimulation and development to enable them to live an ordinary and meaningful life. None of the residents were at day services during the inspection but each had a planned activity for the day. The Manor Road (14) DS0000007896.V320992.R01.S.doc Version 5.2 Page 12 information in the home showed very good liaison between the home and the day services to ensure continuity and development of skills. There was a lot of evidence in the daily records relevant to the activities they enjoyed and participated in, which demonstrates the homes commitment to ensure that the residents are able to achieve their goals. There was evidence that the disability equipment required has been obtained and environmental adaptations made to meet the needs of the service users. A new bath had been installed recently which was very popular with the residents and also helped the staff. Menus were varied and nutritionally balanced. Mealtimes were said to be relaxed and social events. The residents are involved each week in choosing the menus for the following week and they also assist with the shopping. Manor Road (14) DS0000007896.V320992.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The residents are well supported and the medication procedures ensure that their health care needs are met. EVIDENCE: There was a lot of evidence to demonstrate good liaison with the healthcare services and this clearly benefits the residents and gives the staff the support and guidance they require to meet the complex needs of the residents. Specialist health and dietary requirements are recorded and provide an overview of each resident’s health needs. They also act as an indicator of the change in their healthcare needs. Staff understand the principles of giving personal support and are responsive to the individual requirements of each resident. Attention is given to ensuring privacy and dignity when delivering personal care and staff are sensitive to the changing needs of residents. Manor Road (14) DS0000007896.V320992.R01.S.doc Version 5.2 Page 14 The home’s medication procedure was observed and staff were able to explain the individual procedure for each resident. Medication was safely stored and records were well maintained and up to date. Information for each resident was clearly marked and contained information about their individual medicines. All staff responsible for the administration of medication have had accredited training. None of the residents administer their own medication. Manor Road (14) DS0000007896.V320992.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected from abuse because staff are trained, work closely together and are well managed. EVIDENCE: The complaints procedure is available to all the residents in varying formats and is easily available in the home. The residents may not be able to understand the procedure and because of their complex needs the staff explained that they have to be alert to subtle changes in behaviour and check out the causes to establish if a resident is not happy. Staff spoken to had a good understanding of service users’ rights as citizens. The evidence indicated that residents are protected from abuse, the staff had done a training course in adult abuse and they were aware of the procedure. The training is regularly reinforced at staff meetings. The recruitment procedure is good and ensures that only suitable people are employed in the home. Manor Road (14) DS0000007896.V320992.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home enables residents to live in a safe, well maintained and comfortable environment. EVIDENCE: The home was clean, well decorated and furnished and very appropriate to the needs of the residents. Residents had all personalised their bedrooms and some had purchased some of their own furniture. The decorations and furnishings provided in the lounge were comfortable and welcoming. There was a programme of routine maintenance and decoration for the home, and a good infection control policy which ensures that the home is a safe and comfortable place live. Manor Road (14) DS0000007896.V320992.R01.S.doc Version 5.2 Page 17 Specialist equipment was provided in the home and all was of good quality and serviced regularly and met the needs of the residents. A new specialist bath had recently been installed which was popular with the residents and helpful to the staff. There was very good access to the garden which was tidy and well maintained. Manor Road (14) DS0000007896.V320992.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35, 36. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The residents benefit from a well trained and committed staff team. EVIDENCE: The rota indicated that there were sufficient staff on duty and this was confirmed on the day of the inspection. Staff were observed assisting the residents and also having time to spend talking and caring for them. It was clear observing the interactions between the staff and the residents that there was a mutual respect and staff tried to help the residents, and involve them in their care rather than do it for them. There is a core of well trained and committed staff, but also a lot of Agency staff employed in the home and the manager explained that it had been very difficult to recruit suitable staff. It is not ideal for the residents in this home to have staff who do not know them well, but the manager said that she had tried to ensure that the Agency sent staff who were known to the residents. The home has recently appointed two new members of staff and this will provide Manor Road (14) DS0000007896.V320992.R01.S.doc Version 5.2 Page 19 more stability for the residents and more staff hours in the home. The manager explained that because the agency staff are more expensive the number of staff hours has to be reduced so that budget targets are met. The staff hours in the home must be based on the needs of the residents. The staff spoken to were very encouraged by the appointments and were hoping to have a settled team again. Three staff files were inspected but not all the records were kept in the home some were kept in the main office in York. The full records must be kept in the home and available for inspection. The home does have a robust recruitment procedure. A good induction and training programme is in place to ensure that staff are equipped to carry out their jobs well. This training includes the protection of vulnerable adults as well as the mandatory training to meet service users basic needs, such as manual handling and health and safety. Specific training relevant to the needs of the residents was also provided. Staff were clear about their role and knew what was expected from them. Staff had regular supervision which was clearly recorded. They said they worked well as a team and that the manager was very good, approachable, and supportive. Manor Road (14) DS0000007896.V320992.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good management arrangements ensure that the home is run to meet the needs of the residents. EVIDENCE: The manager was available on the day of the inspection and was well organised and helpful. She has the required qualifications and experience and is competent to run the home. There were three staff members on duty and they were aware of their responsibilities. Staff said that they were kept informed of relevant management issues, and they considered the manager to be very Manor Road (14) DS0000007896.V320992.R01.S.doc Version 5.2 Page 21 approachable and supportive. Survey forms mentioned good communication, good organisation, and satisfaction with the care being provided. Staff considered that they were well supported by the management and that they worked well together as a team. The quality assurance systems in place are effective and the manager is proactive in addressing quality issues within the home. The views of service users, staff members, relatives and professionals visiting the home are sought on how the service can be improved. The home has a Health and Safety policy and regular checks and staff training ensure that the home is a safe place to live and work. Another manager visits the home monthly and completes a quality audit which is mainly health and safety led. These visits cannot be regarded as support visits under regulation 26 as they are not unannounced, do not meet the requirement, and a report is not provided to the Commission. Manor Road (14) DS0000007896.V320992.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME 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 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 1 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 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 Manor Road (14) DS0000007896.V320992.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 YA33 Regulation 18 Requirement The home must ensure that there are sufficient staff on duty to meet the needs of the residents at all times. Timescale of 14/02/06 not met. Staff numbers must be based on the needs of the residents All information relating to the recruitment of staff must be available in the home and available for inspection. The registered provider must arrange for an unannounced visit to be made to the home and prepare a written report in accordance with this regulation and submit a copy to the Commission. Timescale for action 31/12/06 2 YA34 17 18/12/06 3 YA37 26 31/12/06 Manor Road (14) DS0000007896.V320992.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA32 Good Practice Recommendations The particular needs of the residents in this home are best met by permanent staff who know them well and every effort should be made to reduce the number of agency staff being used. Manor Road (14) DS0000007896.V320992.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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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