Inspection on 21/02/06 for Midmoor Road (19)

This inspection was carried out on 21st February 2006.

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

The inspector 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Midmoor Road (19) 31/10/06

Midmoor Road (19) 03/11/05

Midmoor Road (19) 29/03/05

Midmoor Road (19) 09/09/04

Midmoor Road (19) 17/03/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 Midmoor Road (19) Pallion Sunderland SR4 6UP Lead Inspector Gillian McCabe Unannounced Inspection 21st February 2006 10:00 Midmoor Road (19) DS0000015773.V276678.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 Midmoor Road (19) DS0000015773.V276678.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. Midmoor Road (19) DS0000015773.V276678.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Midmoor Road (19) Address Pallion Sunderland SR4 6UP 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) 0191 510 3612 0191 510 8099 Northgate & Prudhoe NHS Trust Miss Amanda Louise Hunter Care Home 6 Category(ies) of Learning disability (5), Learning disability over registration, with number 65 years of age (1), Physical disability (5), of places Physical disability over 65 years of age (1) Midmoor Road (19) DS0000015773.V276678.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd November 2005 Brief Description of the Service: Midmoor Road is a small registered care home, run by Northgate and Prudhoe NHS Trust. It provides personal care and support services for up to six people who have a learning disability and may also have difficulties with mobility. The home is not registered to provide an emergency admission service, and it cannot provide nursing care. Accommodation is provided in a spacious purpose built detached bungalow, which stands in it’s own enclosed gardens with extra space for off street parking. It is situated in a residential area of Sunderland and is within easy reach of local shops, parks, Churches, pubs and other facilities. The area is well served by public transport and people living at the home have the use of a privately owned ‘people carrier’ too. Closed circuit television (CCTV) is not used within the home, but it is installed outside at the entrance and in the parking area to ensure the security of the people living and working there. Midmoor Road (19) DS0000015773.V276678.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over five hours during the morning and afternoon, and was a scheduled unannounced inspection. As the inspection was unannounced the views of service users, relatives and other visitors to the home were not gathered before the inspection. The inspector met with all service users briefly on the morning and during the afternoon, time was also spent with some service users observing their life in the home. The majority of service users were going out to various places during the inspection. Time was spent speaking with four members of staff about the running of the home and the support and training they receive to enable them to do their jobs. As part of case tracking two service users files were looked at, service users contract/statement of terms and conditions, service users health records, activity plans, fire log records and the homes policies and procedures. A tour of the home was carried out looking at the standard of accommodation on offer and the plans for maintaining a safe living and working environment. What the service does well: What has improved since the last inspection? The home looks very nice and has recently been redecorated in some areas. The lounge has a new sofa and soft furnishings, the dining room is currently being decorated and new soft furnishings are going to be purchased. This will ensure that people living at the home are comfortable and have a pleasant place to live. Midmoor Road (19) DS0000015773.V276678.R01.S.doc Version 5.1 Page 6 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. Midmoor Road (19) DS0000015773.V276678.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 Midmoor Road (19) DS0000015773.V276678.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): 5, because one requirement relating to this standard remains outstanding. Standard 2 was not assessed because no new service users have been admitted to the home since the last inspection. Very comprehensive and up-to-date assessments are in place for each person. All service users are provided with an individual written contract/ statement of terms, which clearly sets out what services a person will receive in the home. Details of Fees are not detailed enough to show what a person might need to pay. EVIDENCE: All service users have a written contract/statement of terms and conditions in their individual files and in their rooms. The contract/statement of terms and conditions is very informative and has been developed in a format that is understood by service users at Midmoor Road. The contracts/statement of terms and conditions are explained in written words with pictures alongside, indicating what the words mean. Details included in the contract are conditions of occupancy, responsibilities of the trust, service users rights, ending the agreement, how to make a complaint etc. The home has recently reviewed the contract to include any costs that may be payable by service users. However, the costs detailed provide a very general overview of payments and do not give a detailed enough breakdown to ensure service users know exactly what they will pay Midmoor Road (19) DS0000015773.V276678.R01.S.doc Version 5.1 Page 9 for. Things such as holiday accommodation, staff support costs for social activities, for example entrance fees, travel fares etc. Unless the information is detailed service users may have difficulty in planning for holidays and trips throughout the year. Midmoor Road (19) DS0000015773.V276678.R01.S.doc Version 5.1 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 the following standard(s): 6 Service Users assessed needs are reflected in individual support plans within individual plans of care however some areas of need, such as pressure care would benefit from a more detailed support plan. This would ensure consistency and clear guidance for members of staff. Staff at Midmoor Road encourage and support service users to make decisions about their lives. EVIDENCE: All service users have good individual support plans in place developed by the person’s key worker. The plans are developed in an accessible format with pictures and symbols. As part of case tracking two service users files were looked at, and each plan showed a lot of detail and covered a broad range of a person’s care needs. Each plan highlights service users abilities, strengths and preferences, as well as areas of need. Staff confirmed that plans are regularly evaluated to reflect any changing needs, goals or aspirations. Midmoor Road (19) DS0000015773.V276678.R01.S.doc Version 5.1 Page 11 One person has a plan in place detailing how support should be given to manage pressure areas. As part of ‘pressure care’ support that is required, the person’s position needs to be frequently changed. The plan does not give enough detail to inform staff how often this is needed. For example, the plan states ‘frequent position changes’. Staff confirmed they support this person to change position between two – four hours throughout each day, it is vital that information in support plans are specific to ensure the correct amount of support is always given. Service users plans are reviewed on a regular basis. However some outcomes of reviews would benefit from being recorded more descriptively. Some evaluations were written in the same context. For example, ‘no change, continue with care plan’. It was clear from observations and discussion with staff that appropriate interventions are carried out to support service users. However these good practices are not always reflected in evaluations or reviews of care plans. Midmoor Road (19) DS0000015773.V276678.R01.S.doc Version 5.1 Page 12 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 & 16 Staff support service users to lead active and fulfilling lifestyles by accessing a wide range of community facilities and by having regular community presence. EVIDENCE: The home has an activities plan in place which is planned on a weekly basis with service users and their keyworkers. Keyworkers at Midmoor Road have a very good knowledge of what service users like to do. Some service users access day activities at Nookside while other service users like to spend their time going to the Metro Centre for shopping trips and eating out at restaurants such as Frankie and Benny’s. The home has use of its own transport that is accessible for all service users at Midmoor Road. Quite often staff support service users to go on trips to places like Edinburgh. Four rail rickets have recently been purchased for service users who like to travel using the train. Staff confirmed that service users also like to get involved in weekly shopping which is carried out at local supermarkets. People also enjoy going to local shops and cafes and some service users like to go to pop concerts and shows at the Telewest Arena and the Empire Theatre. Midmoor Road (19) DS0000015773.V276678.R01.S.doc Version 5.1 Page 13 Service users are encouraged to keep in touch with friends and family members. Staff at Midmoor Road encourage friends and family members to visit the home at any time throughout the day, and service users may entertain their guests in the privacy of their own rooms or in the communal areas of the home. Midmoor Road (19) DS0000015773.V276678.R01.S.doc Version 5.1 Page 14 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 Service Users receive support that is appropriate to their needs and preferences, which helps to ensure privacy and dignity is respected. Service users health care needs are identified in individual support plans and arrangements are made to ensure health care needs are promoted and met. This contributes to service users health and well-being EVIDENCE: Good relationships between staff and service users are evident and key worker have a good knowledge of service users needs and preferences. This helps staff to give support in a personalised way. Service users individual support plans detail clearly how they would like support to be given and what staff need to do to ensure the correct level of support is given. For example, one service users likes to a bathe at a certain time of day with support from staff. The persons support plan has been developed so that this person bathes at a time that is suitable, using products they prefer. Staff also support people with decision making. One service user likes to watch particular television programmes throughout the day and listen to music. This is very clearly documented in support plans again giving instruction to staff on how to support this person to carry out these daily activities. Midmoor Road (19) DS0000015773.V276678.R01.S.doc Version 5.1 Page 15 Service users living at Midmoor Road each have their personal care and health needs outlined in individual support plans known as ‘OK Health Checks’. The health checks cover areas such as mobility, digestion, oral hygiene, hearing, sleep patterns, and any other interventions that may involve specialist consultants. Good records are kept giving details of hospital and G.P visits and records for monitoring fluids (where necessary). Staff on duty confirmed that the all health records are regularly reviewed and amended to reflect any changing needs. All service users health care needs are well monitored and any concerns are dealt with immediately by referral to the appropriate professional. Midmoor Road (19) DS0000015773.V276678.R01.S.doc Version 5.1 Page 16 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): All key standards assessed and previously met at last inspection. EVIDENCE: Midmoor Road (19) DS0000015773.V276678.R01.S.doc Version 5.1 Page 17 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): All key standards assessed and previously met at last inspection. EVIDENCE: Midmoor Road (19) DS0000015773.V276678.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Midmoor Road has a robust policy and procedure to be followed when recruiting new staff into the home. Members of staff at Midmoor Road receive regular training opportunities that ensure service users are appropriately supported and protected by competent and qualified members of staff. EVIDENCE: Staff confirmed the homes policy when recruiting new staff to the home would be and initial interview with two members of staff normally the Manager and the Assistant Manager. Staff confirmed that service users could be involved in the interview process if they would like to. Service users would have the opportunity to meet the prospective employee and ask any questions if necessary. Prospective employees would have all the necessary employment checks, required by regulations, prior to commencing duties. Staff records were not available for inspection. Discussion with the manager over the telephone during the inspection confirmed that all staff have received all mandatory training, and refresher courses are carried out on a yearly basis. The manager receives a training plan from the Trust on a yearly basis and carries out a needs analysis identifying Midmoor Road (19) DS0000015773.V276678.R01.S.doc Version 5.1 Page 19 where staff need training. Any new members of staff will receive additional training in the form of Induction Training. The Manager confirmed that all staff have received training in areas such as Safe Handling of Medicines and Person Centred Planning Training. The home has a team of support workers, an Assistant Manager and a Manager. The Manager confirmed that eight members of staff have completed an NVQ Level II in ‘Care’. Staff records relating to training could not be inspected, as they are stored in a locked cupboard for confidentiality reasons. The manager was not available during the inspection to gain access to the files. Midmoor Road (19) DS0000015773.V276678.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Manager not available to assess standard 37. Some shortfalls were found in relation to health and safety issues, regarding fire records. EVIDENCE: Some areas of fire records were incomplete. Records of testing of the fire alarm system were not completed fully, some parts of the record showed blank lines. Records of equipment testing were not completed fully, again some parts of the record showed blank lines, signature and dates were missing too. One emergency light in the home had been reported as needing repair however, twelve days had passed since the report was made and the light is still awaiting repair. It is vital that repairs such as emergency lighting are dealt with quickly, and fire records are completed in full so that service users and members of staff’s safety and welfare is promoted and protected. Midmoor Road (19) DS0000015773.V276678.R01.S.doc Version 5.1 Page 21 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 X 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X X X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 X X X X X X X 2 X Midmoor Road (19) DS0000015773.V276678.R01.S.doc Version 5.1 Page 22 Yes 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 YA5 Regulation 5 (1) Requirement Northgate and Prudhoe NHS Trust must further develop its service user contract/statement of terms and conditions, as described in the main body of this report. TIMESCALE OF 29/05/05 NOT MET. 2. YA6 14 (2)(b) The Registered Manager should further develop care-planning guidance in relation to pressure care needs of a specific service user. The Manager must achieve a management qualification at NVQ Level IV by the year 2005. Fire records must be completed fully to show all fire procedures and checks have been fully carried out. Emergency lighting must be repaired with immediate effect 28/02/06 Timescale for action 30/06/06 3. YA37 9 (2 (b(i)) 30/06/06 4. YA42 23 (4)(e) 22/02/06 5. YA42 23(2)(p) 22/02/06 Midmoor Road (19) DS0000015773.V276678.R01.S.doc Version 5.1 Page 23 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 YA6 Good Practice Recommendations Following care plan reviews where ‘no change’ in a user’s needs has been found and plans have remained the same, information should be recorded to evidence staff judgments. Midmoor Road (19) DS0000015773.V276678.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection South of Tyne Area Office Baltic House Port of Tyne Tyne Dock South Shields NE34 9PT 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. 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