CARE HOME ADULTS 18-65
Millgate House Millgate House 10 Oak Street Shawforth Rochdale OL12 8NU Lead Inspector
Mrs Susan Hargreaves Unannounced Inspection 24th January 2006 10:00 Millgate House DS0000047219.V269766.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 Millgate House DS0000047219.V269766.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. Millgate House DS0000047219.V269766.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Millgate House Address Millgate House 10 Oak Street Shawforth Rochdale OL12 8NU 01706-852356 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) gateway.leisure@zen.co.uk Rochdale Gateway Leisure Limited Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Millgate House DS0000047219.V269766.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. That Millgate House shall employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection The home is registered to accommodate 4 adults with a learning disability. 17th June 2005 Date of last inspection 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 disabilities. 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, and kitchen and dining area. Millgate House DS0000047219.V269766.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 three hours. At the time of the inspection three residents were having respite care at the home. A tour of the premises took place and staff files and care records were inspected. Members of staff on duty and residents were spoken to. Discussions also took place with the manager regarding issues raised during the inspection. What the service does well: 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. Millgate House DS0000047219.V269766.R01.S.doc Version 5.0 Page 6 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 Millgate House DS0000047219.V269766.R01.S.doc Version 5.0 Page 7 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): EVIDENCE: None of these standards were assessed. Standard 2 was assessed and met at the last inspection. Millgate House DS0000047219.V269766.R01.S.doc Version 5.0 Page 8 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 Care plans identified the needs of the service user and explained how these were met. EVIDENCE: The care plan of one service user was inspected. This plan identified the needs of the service user and explained how these needs were met. Service users and their relatives were involved in developing their care plan, which was illustrated and clearly written to promote understanding. Appropriate risk assessments were in place. Millgate House DS0000047219.V269766.R01.S.doc Version 5.0 Page 9 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 Leisure activities were organised and met the needs and preferences of individual service users. EVIDENCE: The service users accommodated at the home at the time of the inspection attended appropriate day care services. Leisure activities were organised according to the preferences of individual service users. These included, shopping, going out for meals, visits to the cinema and other local amenities. Millgate House DS0000047219.V269766.R01.S.doc Version 5.0 Page 10 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): 19 and 20 Care plans addressed the healthcare needs of the service users. Medication was managed efficiently promoting good health. EVIDENCE: The care plan inspected addressed the healthcare needs of the service user. Appropriate healthcare professionals were contacted if any problems arose during a service user’s stay at the home. Medication was stored in cupboards inside a locked utility room. The manager was advised to check and record the temperature of this room daily. Records relating to the management of medication were up to date and included details of medication received into and taken out of the home. However, hand written instructions on the medication administration records should be signed and witnessed. Members of staff responsible for the administration of medication had received appropriate training. Millgate House DS0000047219.V269766.R01.S.doc Version 5.0 Page 11 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 and 23 Complaints would be taken seriously and investigated. Appropriate procedures and training were in place to ensure the protection of service users at the home. EVIDENCE: All service users are given a copy of the complaints procedure. The home or the Commission has not received any complaints since the last inspection. Advocacy services were advertised in the home and service users received newsletters and leaflets. Policies and procedures relating to the protection of vulnerable adults were in place. Training about abuse procedures was included in the induction programme. Millgate House DS0000047219.V269766.R01.S.doc Version 5.0 Page 12 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 The home was clean and well maintained and provided a safe environment for the service users. EVIDENCE: At the time of the inspection the home was clean, tidy and well maintained. This provided a homely and comfortable environment for the service users. Communal rooms were suitable for a variety of social and cultural activities. Millgate House DS0000047219.V269766.R01.S.doc Version 5.0 Page 13 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 and 35 Staffing levels were appropriate to meet the assessed needs of the service users. Training for all members of staff was encouraged. EVIDENCE: Examination of the duty rota confirmed that a sufficient number of staff were on duty for all shifts 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. It was evident from discussion with the manager that training for all members of staff was encouraged. Five members of staff had obtained NVQ or Learning Disabilities Award Framework qualifications (55 ). An organisational training plan was available at head office. Individual staff training plans were seen at the home. Millgate House DS0000047219.V269766.R01.S.doc Version 5.0 Page 14 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 and 42 The home was effectively managed. Appropriate procedures were in place to safeguard the health, safety and welfare of service users. EVIDENCE: The manager is a qualified nurse with experience of caring for adults with learning disabilities. She has a certificate in management and maintains an up to date knowledge of current trends and practices in both management and care. She is planning to undertake training, which will enable her to train other staff in moving and handling. Policies and procedures relating to safe working practices were available. Risk assessments were detailed and gave clear directions for staff to follow to manage any identified risk. A member of staff qualified to administer first aid was on duty for all shifts. Members of staff had received training in fire safety, moving and handing and basic food hygiene. Records maintained in the kitchen included fridge and freezer temperatures. Records for the routine servicing of equipment was seen. However, the registered person explained that the gas safety certificate was kept at head office. She was advised to store all records relating to Millgate House on the premises.
Millgate House DS0000047219.V269766.R01.S.doc Version 5.0 Page 15 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 X X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X X X Standard No 24 25 26 27 28 29 30
STAFFING Score 3 X X X X X X LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 4 3 X 3 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Millgate House Score X 3 2 X Standard No 37 38 39 40 41 42 43 Score 3 X X X X 3 X DS0000047219.V269766.R01.S.doc Version 5.0 Page 16 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. Standard Regulation Requirement Timescale for action 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 2 Refer to Standard YA20 YA20 Good Practice Recommendations Hand written instructions on the medicines administration records should be signed and witnessed. The temperature of the room where medication is stored should be checked and recorded daily. Millgate House DS0000047219.V269766.R01.S.doc Version 5.0 Page 17 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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