CARE HOME ADULTS 18-65
Millgate House 10 Oak Street Shawforth Rochdale, Lancashire OL16 8NU Lead Inspector
Susan Hargreaves Announced 17 June 2005 11:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Millgate House F57 F07 S47219 Millgate House V226192 170605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Millgate House Address 10 Oak Street Shawforth Rochdale Lancashire OL12 8NU 01706 852007 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Rochdale Gateway Leisure Limited Ms Janet Dawn Stewart Care Home only Personal Care 4 Category(ies) of Learning diability (LD) 4 registration, with number of places Millgate House F57 F07 S47219 Millgate House V226192 170605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: 1 That Millgate House shall employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 2 The home is registered to accommodate 4 adults with a learning disability. Date of last inspection 15 December 2004 Brief Description of the Service: Millgate House offers 24 hour personal care for up to 4 adults between the ages of 18 and 65 years. The service aims to provide planned respite care that responds to the needs of service users and their carers. Millgate House is situated in a quiet residential area of Shawforth on the outskirts of Rochdale. The residential service is located on the first floor of the building. The ground floor is used as a day centre for people with learning and physical disabilites. Access to the residential facilities is via a passenger lift or staircase. Accommodation is provided in single rooms. Communal rooms include a spacious lounge, activities room, kitchen and dining area. Millgate House F57 F07 S47219 Millgate House V226192 170605 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This announced inspection took place over 6 hours. No additional visits have been made since the last announced inspection. A tour of the premises took place and staff files and care records were inspected. Members of staff on duty, a resident currently accommodated at the home, a resident and relatives who had previously used the service were spoken to. Discussions also took place with the registered person regarding issues raised during the inspection. What the service does well: What has improved since the last inspection?
Since the last inspection several members of staff have been recruited from the South Asian community to enable appropriate cultural and language support for a number of service users. Training for the Learning Disabilities Award Framework was encouraged. Arrangements were to be made for LDAF training to be done in Urdu for members of staff whose first language was Urdu. Millgate House F57 F07 S47219 Millgate House V226192 170605 Stage 4.doc Version 1.30 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. Millgate House F57 F07 S47219 Millgate House V226192 170605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Millgate House F57 F07 S47219 Millgate House V226192 170605 Stage 4.doc Version 1.30 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 standard(s) 2 Admission procedures were thorough. Comprehensive pre-admission assessments were completed for each service user prior to admission. EVIDENCE: Individual records of three service users were inspected. Each contained a preadmission assessment of need. A senior member of staff visited all prospective service users in their own home prior to admission. They were also encouraged to make several visits to Millgate House for meals and an overnight stay. This ensured that the assessed needs of the service user could be met. All service users and their relatives were supplied with a copy of the service user guide. Millgate House F57 F07 S47219 Millgate House V226192 170605 Stage 4.doc Version 1.30 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 standard(s) 6, 7 and 9 Service users were involved with developing their care plan. Appropriate risk assessments were in place. The cultural needs of service users were met. EVIDENCE: The individual care plans of three service users were inspected. These plans identified the needs of each service user and explained how these needs were to be met. Service users were involved with developing their care plan, which was illustrated and clearly written to promote understanding. One relative said, “the care plan is a working document, it’s reviewed and added to.” Service users were encouraged to make decisions and choices about their lifestyle including daily routine and activities. Cultural needs of residents were recorded and addressed. A member of staff able to communicate with a service user whose first language was Urdu was always on duty. Appropriate risk assessments had been completed. When necessary risk assessments were carried out for planned activities e.g. wall climbing. Millgate House F57 F07 S47219 Millgate House V226192 170605 Stage 4.doc Version 1.30 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 standard(s) 12, 13, 15, 16 and 17 The daily routine was flexible in order to meet the needs and preferences of all service users. Visits to local amenities were arranged. The service users planned all meals. EVIDENCE: Service users were supported to continue with any educational activities undertaken prior to admission e.g. one service user attended classes at the local community centre. Service users were encouraged to choose how to spend their time and activities were arranged as and when requested. Activities included; bowling, discos, visiting relatives, cinema, shopping, climbing wall and going to the pub. A service user explained that she enjoyed artwork. Pictures she had coloured were displayed on the wall. One relative said her daughter had really enjoyed the respite care. Visitors were welcomed into the home at any reasonable time. Meals were prepared and cooked to meet the cultural needs and preferences of all service users. Menus were not pre-planned unless there were more than two service users resident at the home. Service users were asked what they wanted to eat and taken shopping to buy the food if they chose to do so.
Millgate House F57 F07 S47219 Millgate House V226192 170605 Stage 4.doc Version 1.30 Page 11 The daily routine of the home was flexible and determined by the service users. Millgate House F57 F07 S47219 Millgate House V226192 170605 Stage 4.doc Version 1.30 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 standard(s) 18, 19 and 20 Care plans addressed the healthcare needs of each resident. Care was given in a manner, which promoted the privacy and dignity of all service users. Not all members of staff responsible for the administration of medication had received training. This could potentially put service users at risk. EVIDENCE: Members of staff consulted considered promoting privacy and dignity for all service users to be an important part of their care. One service user said, “I’m really well looked after.” Care plans addressed the healthcare needs of service users. Appropriate healthcare professionals were contacted if any problems arose during a service user’s stay at the home. Medication was stored correctly and appropriate records kept. However, only two members of staff had received training in the management of medication. The responsible person was asked to arrange training for all members of staff responsible for the administration of medication. The Commission must be informed when this had been done. Millgate House F57 F07 S47219 Millgate House V226192 170605 Stage 4.doc Version 1.30 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 standard(s) 22 and 23 Relatives were familiar with the complaints procedure. Appropriate procedures and training were in place to ensure the protection of residents at the home. EVIDENCE: A comprehensive complaints procedure was in place. The home or the Commission has not received any complaints since the last inspection. One relative said that she would be able to raise any concerns but was delighted with the care. Policies and procedures relating to the protection of vulnerable adults were in place. This issue was discussed with three members of staff. They were aware of the procedure and said they would report any concerns immediately. Millgate House F57 F07 S47219 Millgate House V226192 170605 Stage 4.doc Version 1.30 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 standard(s) 24 and 30 The home was clean and comfortable, which meant that residents had a homely place to live. Laundry facilities were appropriate for the size of the home. EVIDENCE: The home was clean, tidy, free from offensive odour and well maintained. This provided a safe and comfortable environment for the service users. Accommodation was provided in single rooms. Communal rooms were suitable for a variety of social and cultural activities. One relative said they had been able to choose the bedroom and also said that the environment was safe. Laundry facilities were suitable for the purpose and contained appropriate equipment. A member of staff explained that one service user liked to supervise her washing. Millgate House F57 F07 S47219 Millgate House V226192 170605 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34 and 35 Staffing levels were appropriate to meet the assessed needs of the service users. Recruitment procedures were not thorough. Several members of staff were working before a CRB check had been obtained. Training for all members of staff was actively encouraged. EVIDENCE: Examination of the duty rota confirmed that a sufficient number of staff were on duty for all shifts in order to meet the assessed needs of the service users. There was always a senior member of staff on call during the night when only one member of staff was on duty. Two members of staff explained that the person on call always telephoned to check that everything was all right. It was evident from discussion with the registered person and examination of staff files that six members of staff were working without a CRB check. To ensure the protection of all service users the registered person was told to make sure that these members of staff worked under constant supervision. She was also asked to supply the Commission with a copy of the duty rota to confirm this was being done. Discussion with members of staff confirmed that training was actively encouraged. This included induction training for new employees, moving and handling, basic food hygiene, fire safety and the Learning Disabilities Award
Millgate House F57 F07 S47219 Millgate House V226192 170605 Stage 4.doc Version 1.30 Page 16 Framework (LDAF). Arrangements were to be made for LDAF training to be done in Urdu for members of staff whose first language was Urdu. Millgate House F57 F07 S47219 Millgate House V226192 170605 Stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39 and 42 In the absence of a registered manager appropriate arrangements to manage the home were in place. Although equipment was serviced regularly an up to date gas safety certificate was not available. A member of staff qualified to administer first aid was not on duty for all shifts. This could potentially put service users at risk. EVIDENCE: At the time of the inspection a registered manager was not in post. However, the registered person explained that a suitable candidate had been interviewed and was hoping to start work in August. In the absence of a registered manager the registered person and senior members of staff were managing the home. Members of staff consulted felt supported by the management team. Staff meetings took place regularly and minutes were taken. Health and safety was included in the induction training for new employees. Fire alarms were tested weekly and fire drills were held regularly.
Millgate House F57 F07 S47219 Millgate House V226192 170605 Stage 4.doc Version 1.30 Page 18 Records of the routine servicing of equipment were seen. However, an up to date gas safety certificate was not available. Although several members of staff had completed first aid training a member of staff qualified to administer first aid was not on duty for all shifts. Millgate House F57 F07 S47219 Millgate House V226192 170605 Stage 4.doc Version 1.30 Page 19 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 x x Standard No 22 23
ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 3 x 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 4 Standard No 31 32 33 34 35 36 Score x x 3 2 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Millgate House Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 2 3 x x x 2 x F57 F07 S47219 Millgate House V226192 170605 Stage 4.doc Version 1.30 Page 20 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 20 Regulation 13(2) Timescale for action The registered person shall make 30 Sept 2005 arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. All members of staff responsible for the administration of medication must receive appropriate training (Timescale of 14 Feb 2005 not met) Immediate The registered person shall not employ a person to work at the 17 June care home unless - (a) the 2005 person is fit to work at the care home; (b) subject to paragraph (6), he has obtained in respect of that person the information and documents specified in paragraphs 1 to 7 of schedule 2. All members of staff must have a POVA first check before starting work. The registered provider shall 30 Sept 2005 appoint an individual to amnage the care home where - (a) there is no registered manager in respect of the care home; and (b) the registered provider is an organisation or partnership (2)
Version 1.30 Page 21 Requirement 2. 34 19(1)(a) (b) Schedule 2 3. 37 8(1)(a)(b) (2)(a)(b) Millgate House F57 F07 S47219 Millgate House V226192 170605 Stage 4.doc 4. 42 13(4)(a) 5. 42 13(4) Where the registered provider appoints a person to manage the care home he shall forthwith give notice to the Commission of - (a) the name of the person so appointed; and (b) the date on which the appointment is to take effect. The registered person shall ensure that - (a) all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety. An up to date gas safety certificate must be obtained. The registered person shall make suitable arrangements for the training of staff in first aid 30 Sept 2005 30 sept 2005 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 Good Practice Recommendations Millgate House F57 F07 S47219 Millgate House V226192 170605 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection 1st Floor, Unit 1 Petre Road, Clayton-Le-Moors Accrington Lancashire. BB5 5JB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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