Inspection on 03/11/05 for Midmoor Road (19)

This inspection was carried out on 3rd November 2005.

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 2 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) 21/02/06

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 Lesley Scriven Unannounced Inspection 3rd November 2005 09:10 Midmoor Road (19) DS0000015773.V250684.R01.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 Midmoor Road (19) DS0000015773.V250684.R01.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. Midmoor Road (19) DS0000015773.V250684.R01.S.doc Version 5.0 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.V250684.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th March 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.V250684.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over two hours and thirty-five minutes on one day. The length of the visit was kept short so as not to interfere with plans that had already been made by service users and staff. Even so, time was spent with all six of the people living at the home. Because each has limited communication skills, the inspector was very dependent upon the observations she made of the relationships between users and staff, although individual communication ‘passports’ also proved very helpful. As part of a case-tracking exercise one service user file was read. A sample audit of the home’s system for receiving, storing, administering and disposing of medication was carried out and fire logs and the home’s emergency fire procedure was read. Personal financial records for one service user were also checked. A copy of the home’s fire risk analysis was sent to the inspector for checking after the visit and the results of an earlier quality assurance visit made by the Trust were also taken into consideration. A partial tour of the premises looked at the standard of accommodation and facilities on offer and arrangements for maintaining safe living and working conditions. One lady took the time to show the inspector her bedroom and pointed out where redecoration had taken place around the rest of the home. Four staff were asked about the running of the home and the support and training they receive to enable them to do their jobs. The Trust’s auditor, who was also visiting at the time, explained some of the home’s financial management procedures. What the service does well: What has improved since the last inspection? The home is being redecorated throughout and finishing touches are being added to the living room and bedrooms, which have just been completed. This makes the home a pleasant and comfortable place to live and to welcome Midmoor Road (19) DS0000015773.V250684.R01.S.doc Version 5.0 Page 6 visitors. Some new bedroom and living room furniture has been purchased and some new carpets have been fitted. The manager is now applying for health authority funding for specialist equipment for service users and this means that individuals don’t have to use their own savings to pay for equipment such as adjustable beds. One new appointment has been made to the staff team and interviews for another vacancy are taking place shortly. This ensures the home is adequately staffed by competent workers at all times. 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.V250684.R01.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 Midmoor Road (19) DS0000015773.V250684.R01.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): 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. Not everyone who lives at Midmoor Road has a contract, or statement of terms and conditions with the home that is presented in a suitably accessible format and includes all of the information required by national minimum standard. EVIDENCE: All service users are provided with a contract, or statement of terms and conditions with home. The introduction of photographs and pictures to a new version of this document will help to aid understanding for those unable to read the written word. However, not everyone has been provided with a copy of the contract in the new accessible format. Additionally, clear information about what is and is not included in service user’s fees is still not being provided, despite this being requested at the last inspection. Information that mentions the Trust’s policy on how much user’s are expected to pay towards staff support costs for social activities, e.g. travel fares, entrance fees, refreshments and holiday accommodation, is important and should form part of each person’s agreement. Unless service users and their supporters know how much the Trust have agreed to spend on these things, they cannot properly plan how much of their own money will be needed Midmoor Road (19) DS0000015773.V250684.R01.S.doc Version 5.0 Page 9 to supplement the number of trips and holidays they would like to take each year. Midmoor Road (19) DS0000015773.V250684.R01.S.doc Version 5.0 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 and 9. Service users are as far as possible involved in the personal planning process. Up-to-date individual plans show exactly what support each person needs each day to reach individual goals. People are supported to be as independent as possible, but this can sometimes be limited in an agreed way to minimise risk of emotional or physical harm. EVIDENCE: Everyone who lives at the home has a personal plan and is involved as far as they are able in the drawing-up of this with a named ‘key worker’. There are different versions of the plan and one of these is presented in an easy to understand booklet, with symbols and pictures. Both are written from the point of view of the service user and are very personalised. The plans look at all aspects of service user’s lives, both within and outside the home. They set out in very good detail exactly what kind of physical and emotional support each person requires to achieve their personal goals whilst remaining as safe as possible. The plans are kept up-to-date and altered as people’s circumstances change, and include information about individual preferences, as well as abilities and needs. However, more written information Midmoor Road (19) DS0000015773.V250684.R01.S.doc Version 5.0 Page 11 is required following reviews where ‘no change’ in a user’s needs has been found and plans have remained the same. Such judgments need to be clearly evidenced. As individual abilities allow, service users are encouraged to be independent in their daily lives: in areas such as personal care, and taking part in social and leisure activities in and outside of the home for example. This can involve taking responsible risks, but the manager always carefully assesses the hazards involved and weighs up the benefits and pitfalls first. Clear guidelines are then put in place so that staff can give people the right amount of assistance to reduce the chances of anything going wrong. Sometimes however, when the assessed hazards are too great, choices or freedom of access inside the home (into areas such as the kitchen) and especially outside, might be restricted to ensure a person’s safety. Where these sorts of limitations are necessary, they are only put in place after consultation with the service user and their supporter and other professionals, such as social workers. Midmoor Road (19) DS0000015773.V250684.R01.S.doc Version 5.0 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): 15 and 17. At the last inspection standards 12 and 16 were met, and 13 and 14 were exceeded. All service users are actively encouraged to maintain friendships and links with families. Meals on offer at the home are prepared with each individual’s preferences in mind, and are nutritious and nicely presented. Mealtimes are structured to suit service user’s needs and people eat in homely surroundings. EVIDENCE: People living at Midmoor Road are encouraged to keep in touch with friends and family. They are able to do this in many ways. Visitors are made welcome at the home, people are supported in sending relatives cards and examples of craft work produced at the Nookside Centre and there are also opportunities for meeting up outside at cafes or pubs for example, where staff assistance will be provided. Service users and staff generally eat together in the home’s dining room, which is nicely decorated and furnished and provides a relaxing atmosphere. Midmoor Road (19) DS0000015773.V250684.R01.S.doc Version 5.0 Page 13 People can however choose to eat elsewhere if they prefer. On the day of inspection, breakfast was different for each person according to individual choice, and taken in the dining room and kitchen. Meal times are sociable and unhurried and where support is needed, this is respectfully and discreetly offered so that no-one’s dignity is undermined. Meals are varied, tasty and nicely presented and people’s special dietary needs are met. A range of options is always available – with some users helping out with the weekly grocery shop - and everyone is still encouraged to adopt healthy lifestyles. Midmoor Road (19) DS0000015773.V250684.R01.S.doc Version 5.0 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): 20. Standards 18 and 19 were assessed and met at the last inspection. Very good systems are in place to enable staff to safely assist people with medication. At the present time, no one living at the home is able to keep or administer their own medication independently, but suitable procedures are in place if needed. EVIDENCE: Properly trained staff follow sound policy and procedural guidance to make sure service users are safely assisted with medications. Medicines are carefully ordered, securely stored and appropriately administered and accurate records are kept. Regular audits of the system are carried out to check staff competence. Assistance with medications is given discreetly, to avoid unnecessary attention or embarrassment. Midmoor Road (19) DS0000015773.V250684.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23. Standard 22 was assessed and met at the last inspection. The home works to satisfactory policy and procedure to ensure that people living there are protected from all types of abuse. EVIDENCE: Northgate and Prudhoe NHS Trust has a very good policy for ensuring the protection of vulnerable adults. Staff have received training to help them put this into practice and know what to do if any concerns about service user’s well-being or safety come to light. Service user’s finances are properly managed and records kept are regularly audited to protect against financial abuse. Midmoor Road (19) DS0000015773.V250684.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 29 and 30. People who live at the home benefit from an environment which is suitably equipped to meet individual needs and is well maintained, safe, clean and comfortable. EVIDENCE: Midmoor Road has a homely feel and is nicely decorated with good quality furniture that suits the age and lifestyle choices of the people who live there. Bedrooms all reflect individual interests and personalities and assisted by ‘key workers’, users are involved in choosing colour schemes, furniture, bedding and accessories. Many rooms have been redecorated since the last inspection, some new bedroom furniture has been purchased, and some new carpets have been fitted in communal areas. A new three piece-suite has been ordered for the living room and will be delivered shortly. This makes the home an inviting and comfortable place to live and to entertain visitors. The home’s manager is now accessing health funding for specialist equipment, such as adjustable beds for those people who need them, and this means that service users own savings do not have to be used. All specialist equipment is regularly checked to ensure it is in good and safe working order. Midmoor Road (19) DS0000015773.V250684.R01.S.doc Version 5.0 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 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. Standards 34 and 35 were assessed and met at the last inspection. The staff team at Midmoor Road are offered good training opportunities to enable them to enhance their practice and improve the quality of the support they offer to service users. EVIDENCE: Personal training and development plans are in place for each member of the staff team. These are put together by the manager, who takes into account each worker’s experience, skills, specialist interests and learning needs. Staff confirmed that as well as being able to keep up to date with essential health and safety (or mandatory) training and attend National Vocational Qualification (NVQ) courses, they are offered good opportunities to learn about a wide range of topics, particularly in relation to the assessed needs of the people who live at the home. One example of this is the training given by the health authority in the physiotherapy techniques needed by one user on a daily basis. As a result service users and their supporters can be sure that staff are properly able to do their jobs in a way that recognises the very different care needs of each individual at Midmoor Road. Midmoor Road (19) DS0000015773.V250684.R01.S.doc Version 5.0 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 and 42. Since the home’s manager was not available, it was not possible to assess standard 37. User’s satisfaction with the service is regularly monitored through case review and key worker observation. Supporter’s views too are regularly sought and listened to, and used to help improve the way the home is run. The team work hard to ensure Midmoor Road is a safe and pleasant place to live. EVIDENCE: Northgate and Prudhoe NHS Trust has a positive approach towards measuring the quality of its provision, which includes procedures (such as use of pictorial questionnaires) for gathering the views of everyone who uses its service. Service users, with advocacy support where necessary, and their relatives and supporters are invited to make suggestions about how the home and service might be improved and these will be listened to and acted upon. On a less formal basis, user satisfaction is observed by key workers on a daily basis too, Midmoor Road (19) DS0000015773.V250684.R01.S.doc Version 5.0 Page 19 and staff use the knowledge they build up of people’s likes and dislikes to offer personalised care that respects individual’s preferences. Additionally, the manager and team take responsibility for carrying out audits of the premises and of staff practice and records to check that things are running as they should be and quickly put right anything that is wrong. As a result, service users are offered a very good standard of support in a safe environment. Midmoor Road (19) DS0000015773.V250684.R01.S.doc Version 5.0 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 x 2 x x x Standard No 22 23 Score x 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 x x 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x 3 3 LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 3 16 x 17 Standard No 31 32 33 34 35 36 Score x 3 x x x x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Midmoor Road (19) Score x x 3 x Standard No 37 38 39 40 41 42 43 Score 2 x 3 x x 3 x DS0000015773.V250684.R01.S.doc Version 5.0 Page 21 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. The Manager must achieve a management qualification at NVQ Level IV by the year 2005. Timescale for action 03/02/06 2 YA37 9 (2 (b(i)) 31/12/05 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 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.V250684.R01.S.doc Version 5.0 Page 22 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. Extracts may not be used or reproduced without the express permission of CSCI Midmoor Road (19) DS0000015773.V250684.R01.S.doc Version 5.0 Page 23 - 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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