Inspection on 05/01/06 for Manor Road (14)

This inspection was carried out on 5th January 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Manor Road (14) 02/11/06

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 Unannounced Inspection 09:30 20 December 2005 th Manor Road (14) DS0000007896.V271420.R02.S.doc Version 5.0 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.V271420.R02.S.doc Version 5.0 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.V271420.R02.S.doc Version 5.0 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) www.unitedresponse.org.uk United Response *** Post Vacant *** Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Manor Road (14) DS0000007896.V271420.R02.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered for a maximum of 4 Service Users with Learning Disabilities who also have Physical Disabilities 4th May 2005 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. There is no registered manager at present. Manor Road (14) DS0000007896.V271420.R02.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out on 20th December 2005 as part of the inspection process. The manager was not available for the early part of the inspection but two members of staff assisted and helped to communicate with the two residents in the home at the time. The manager, another resident and another member of staff arrived later. The residents all use wheelchairs, and communicate in a very specialised way. The staff were able to assist and to help to interpret the responses for the inspector, but many of the findings are based on observation. It was possible during the inspection to witness some of the care practices and the interactions between the residents and the staff. The inspection also involved a tour of the premises, a check on the requirements and recommendations from the previous inspection, and a check on some of the records kept by the home. The inspection took 5 hours which includes preparation time. The inspection showed that the home has a cheerful atmosphere and is clearly run for the benefit of the residents. The home has a settled, well trained staff team who provide a high level of care for the residents but at times are short staffed. What the service does well: It ensures that the residents can lead fulfilling lives by having meaningful day activities and a variety of social outings. The staff are trained to help them to meet the specific individual needs of the residents. It helps the residents to communicate and make choices so that they have control over their lives. It creates a nice atmosphere in the home so that it is a pleasant place to live. It ensures that residents have regular contact with family and / or friends which makes them feel part of life outside the home. Manor Road (14) DS0000007896.V271420.R02.S.doc Version 5.0 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. Manor Road (14) DS0000007896.V271420.R02.S.doc Version 5.0 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.V271420.R02.S.doc Version 5.0 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): 2,4,5. Residents know that if they choose to live in the home that they will be well cared for. EVIDENCE: Assessments involving residents’ family / carers and other professionals are carried out prior to admission to ensure that the staff can meet their needs. All residents have an individual contract and reasonable steps have been taken to ensure that it is explained to them. This makes sure that they are aware of the terms and conditions of their stay in the home and that their needs can be met by the staff in the home. Manor Road (14) DS0000007896.V271420.R02.S.doc Version 5.0 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): 6,7,9.10. The residents’ health and personal care needs are met and they are encouraged and supported to make choices about their daily lives. This helps them to have control over their lives in the home. EVIDENCE: All residents have a detailed care plan which identifies their personal and social needs. The plan is discussed with the resident and a note made of how it was agreed. The staff have regular meetings to discuss the changing needs of the residents and review the care plans. This ensures that staff are kept up to date and a consistent approach is achieved. The recording of these meetings highlighted a problem with confidentiality and Data Protection and a recommendation was made on how to overcome this. Residents have weekly and monthly meetings to make decisions about the home, the menus, and social activities. Manor Road (14) DS0000007896.V271420.R02.S.doc Version 5.0 Page 10 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): 12,13,15,16,17. The residents eat well and enjoy a wide range of activities both inside and out of the home and are part of the local community. EVIDENCE: Each resident had an individual programme aimed at developing their skills and staff are available to support them. The staff are constantly looking for new activities which will interest the residents and provide further stimulation and development. This will be a challenge to the staff in July when one resident will require a new full programme of activities. It was possible to speak to the key worker and the manager and work has already commenced, with other professionals, to ensure that a suitable programme will be in place. All residents use the local facilities in Knaresborough and Harrogate e.g. theatre, cinema, cafes, church. They meet with residents from other homes, and three residents go home regularly to their families. One has a close circle of friends who visit weekly. Manor Road (14) DS0000007896.V271420.R02.S.doc Version 5.0 Page 11 Food is an important part of the residents lives and they help to choose the menus weekly and each resident will take part in helping with the shopping. They also like to eat out and are well known in local cafes. Manor Road (14) DS0000007896.V271420.R02.S.doc Version 5.0 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 the following standard(s): 18,19,20 Individual resident’s physical and emotional needs are met. EVIDENCE: Residents have their personal support needs identified in detailed care plans and include clear instruction about how support is provided safely and according to the service users preference. Key workers meet regularly with their resident to make any changes and to set short term goals. These are then presented to the staff at care plan meetings to make everyone aware of the changes and achieve a consistent approach. The staff felt that the system worked very well and was a good way of meeting the residents individual needs. Staff induction and on going training includes care practice that ensures and promotes privacy and dignity. Three of the residents have Individual Day Support (IDS) to help them to access, and participate in suitable day services. The home uses the Boots monitored dosage system and has a clear policy for the storage and administration of medication. The pharmacist visits regularly and provides a report. None of the service users self medicate. All records were well maintained and demonstrates the professional approach taken by the staff. Manor Road (14) DS0000007896.V271420.R02.S.doc Version 5.0 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 the following standard(s): 22,23. Residents are protected from abuse, neglect, and self harm. EVIDENCE: The home has a detailed complaints procedure, in suitable formats for the residents. The vulnerable adults procedure is available in the home and training of staff has been recorded. It was recommended that the procedure be reinforced regularly at staff meetings and also with agency staff. The home has a ‘Getting it Right ‘ booklet which covers areas such as residents rights and this is in a suitable format and also discussed with the residents at their meetings. All the residents go out regularly and meet with many people who could be advocates for them if they were not being cared for properly. The home has a robust recruitment procedure Manor Road (14) DS0000007896.V271420.R02.S.doc Version 5.0 Page 14 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): 24,28,29,30. The home is clean and well provided with specialist equipment to meet the resident’s needs. EVIDENCE: The home has been redecorated and a new serviceable floor covering provided since the last inspection. A new bath with spa and massage facilities has been installed and this is very popular with the residents. There are also plans for a new kitchen in April. The improvements help to make the home a more pleasant place to live and to work. The staff considered that there was sufficient specialist equipment in the home to meet the needs of the residents. Good cleaning and hygiene programmes were in place to prevent the risk of any infection and the home was clean and free of any offensive odours. Manor Road (14) DS0000007896.V271420.R02.S.doc Version 5.0 Page 15 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): 32,33,34,35,36. The staff are well trained and a settled staff team provides the consistency of care required by the residents but at times there are insufficient staff on duty. EVIDENCE: The home has a more settled staff team and almost a full compliment of permanent staff so is less reliant on agency staff. Both the manager and the staff considered this a big improvement and provides more consistency, and stability for the residents. The home has a robust recruitment procedure to help to safeguard the residents. The home operates a key worker system which helps the residents to communicate their care needs. All staff receive supervision at least 6 times per year and this ensures that they are aware of the ethos of the home and feel supported by the management. The inspector considered that the duty rota indicated that at times there were insufficient staff on duty, to meet the residents needs. The staff and the manager agreed but the manager explained that, although, the duty rota was designed around the needs of the residents, a set amount of hours were Manor Road (14) DS0000007896.V271420.R02.S.doc Version 5.0 Page 16 budgeted to the home. On closer examination it transpired that the IDS hours, which should be additional to these set hours, had been included in the homes allocation. The manager agreed to consult her senior manager to resolve the issue. Manor Road (14) DS0000007896.V271420.R02.S.doc Version 5.0 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 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 health and safety and welfare of the residents is consistently promoted by the home which makes it a safer place to live and to work. . EVIDENCE: The home has a ‘ Getting It right ‘ document which is explained to the residents and sets out their ethos of the home and makes them aware of their rights. Some of the staff and two of the residents have been in the home since 1998 and it is clear that they have been able to influence the development of the home. There are weekly, monthly and annual health and safety checks carried out in the home by a variety of staff, managers and outside contractors. Records of the checks are well maintained and demonstrate how serious the home is regarding health and safety. Manor Road (14) DS0000007896.V271420.R02.S.doc Version 5.0 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 X 3 X 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 2 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X 3 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 1 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Manor Road (14) Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 3 X DS0000007896.V271420.R02.S.doc Version 5.0 Page 19 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 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 for action 14/02/06 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 NU10 Good Practice Recommendations It was recommended that resident’s personal information discussed at staff meetings should be recorded to ensure confidentiality and compliance with the Data Protection Act. It was recommended that the Protection of Vulnerable Adults Procedure is reinforced regularly at staff meetings and includes agency staff. 2 YA23 Manor Road (14) DS0000007896.V271420.R02.S.doc Version 5.0 Page 20 Commission for Social Care Inspection York Area Office 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 Manor Road (14) DS0000007896.V271420.R02.S.doc Version 5.0 Page 21 - 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. 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