Inspection on 15/06/05 for Muston Road (70)

This inspection was carried out on 15th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 but made no statutory requirements on the home.

Other inspections for this house

Muston Road (70) 08/08/07

Muston Road (70) 24/08/06

Muston Road (70) 20/10/05

Muston Road (70) 26/10/04

Muston Road (70) 25/05/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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

CARE HOME ADULTS 18-65 Muston Road (70) 70 Muston Road Filey North Yorkshire YO14 0AL Lead Inspector David Blackburn Unannounced 15 June 2005 09:30 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. Muston Road (70) J53-J04 S7840 Muston Road V231454 160605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Muston Road (70) Address 70 Muston Road Filey North Yorkshire YO14 0AL 01723 514292 01723 514292 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) The Wilf Ward Family Trust Mr Michael Clements Care home only 4 Category(ies) of LD Learning disability (4) registration, with number of places Muston Road (70) J53-J04 S7840 Muston Road V231454 160605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 26/10/2005 Brief Description of the Service: Muston Road is a large detached property situated on a main road into Filey. It is within walking distance of the town centre. A former hotel on two floors, it provides accommodation for four residents. There are three large bedrooms without en-suite facilities and a separate flat with en-suite provision. A large, private and secluded garden is situated to the rear of the property. There is no lift. The staff provide care for adults with a learning disability most of whom have complex needs and challenging behaviour. While the staff seek to promote independence among the residents, all require some assistance with personal care including help to wash, dress and bathe. The staff team takes responsibility for the catering, laundry and cleaning services in the home. Residents are encouraged to help according to their individual capabilities. Social activities are arranged by staff in-house and at external locations. Some residents attend formal day care placements. All are registered with the local medical practice in the town. The staff team has developed a good relationship with the Community Learning Disability Team who provide a valuable resource and input into the home. The premises are owned by the local health authority. The care and services are provided by the Wilf Ward Family Trust, a registered charity. Muston Road (70) J53-J04 S7840 Muston Road V231454 160605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection on which this report is based was the first to be carried out in the inspection year April 2005 to March 2006. It was undertaken over 6 hours including preparation time. The focus was on a number of key standards together with those where requirements and recommendations were made at the last inspection. An inspection of some parts of the premises including bedrooms was carried out. A number of policies, procedures and records were examined including case files and staff records. Discussions were held with the registered manager, assistant manager, some of the staff on duty and two residents. A survey in the form of a questionnaire had been sent, prior to the inspection, to family, visiting professionals and other people with an interest in the care of the residents. The responses received formed part of the evidence used in this report. What the service does well: Good assessment procedures were available should a vacancy arise in the home. These procedures would ensure any person admitted would have their personal needs, hopes and aspirations fully identified, understood and met. A well-defined care planning system was in operation that was easy to follow and understand. The wealth of information on each resident clearly showed in great detail their needs and how they would be met. Care plans were subject to regular review and updates. Responses on the comments cards recorded views such as “we are totally satisfied with the care our son receives.” Staff were pro-active in encouraging residents to make full use of the local community and the multi-purpose vehicle ensured easy access to facilities and amenities. One resident said “I enjoy going for a cup tea and a bun. They (the staff) come with me and help me.” Residents continued to enjoy contact with family and friends. One written response from a relative said “We are always made welcome.” Proper medication procedures were in place. The premises were clean, warm, and free from offensive odours. Proper attention was given to the maintenance of hygiene. Muston Road (70) J53-J04 S7840 Muston Road V231454 160605 Stage 4.doc Version 1.30 Page 6 Following a period of great difficulty, staff were now a stable group with good morale who had received the relevant training. Relatives said “many thanks are due to the staff for the excellent care of our son.” The home was well managed. Appropriate attention had been given to matters of health and safety to ensure the home was a safe place in which to live and work. 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. Muston Road (70) J53-J04 S7840 Muston Road V231454 160605 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 Muston Road (70) J53-J04 S7840 Muston Road V231454 160605 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. Residents were assured their needs and choices would be properly assessed and met. EVIDENCE: The last admission to the home had taken place over nine years ago. Assessments had been undertaken and completed as part of the admission process. The criteria for admission were shown in the Statement of Purpose and within the policies and procedures of the registered provider. The expectation was that the funding authority would carry out the assessment process and produce the initial care plan using their selection criteria. The registered provider expected those carrying out this assessment would make full use of and take into account the views of existing residents, family and advocates, visiting professionals and those giving either a social care or health care input to the home. The registered provider had produced an Individual Needs Assessment proforma that the registered manager said would be used alongside the funding authority’s assessment. This covered a large number of the activities of daily living. Muston Road (70) J53-J04 S7840 Muston Road V231454 160605 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. Residents could be confident their needs, choices and preferences were well recorded ensuring they were properly understood and met. EVIDENCE: All four case files were examined in relation to care planning. The files were well organised with an index and coloured dividers. This system promoted ease of use and retrieval of information. Staff had signed each care plan regularly to say they had been read. Each file contained a wealth of knowledge and information on the particular resident and gave a clear picture of their needs and how they were to be met. A personal support plan had been devised showing particular activities of daily living, the objective(s) to be achieved and the support needed to reach that goal. The care plans fully recorded the involvement of outside agencies. Risk assessments for particular activities of daily living were on each file. Care plans had not been signed by residents as they were unable to understand the concept. There was evidence of six monthly reviews or earlier if circumstances dictated. All care plans had been or were to be reviewed in conjunction with the funding authority. The plans were also subject to on-going review at all times. All Muston Road (70) J53-J04 S7840 Muston Road V231454 160605 Stage 4.doc Version 1.30 Page 10 reviews were signed and dated. A daily diary was maintained for each resident that showed the events and occurrences as they affected the particular person. A visiting social care professional noted “a continued improvement in the quality of the care over the past few months.” Muston Road (70) J53-J04 S7840 Muston Road V231454 160605 Stage 4.doc Version 1.30 Page 11 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 and 15. Residents’ use of local facilities and amenities, regular contact with family and opportunities for social interaction are promoted and maintained enabling them to have a number of different life experiences. EVIDENCE: None of the residents could undertake paid or voluntary employment. None was able to take advantage of local further educational classes. One resident had a day care placement one day each week at their request. Other residents accessed leisure type placements for example dance evenings at a local centre. Residents were encouraged to make full use of the facilities and amenities in the local community. Staff said their disabilities were seen as no bar to any activity they might wish to choose. A full assessment of the particular facility would be undertaken together with a risk assessment on the particular resident. A number of new activities had been introduced with the residents becoming more articulate about what they wished to do and much more involved in the planning of such activities outside the home. One resident said “I like to go out and staff help me.” A multi-purpose motor vehicle was used by staff in the home and facilitated easier access to amenities. Muston Road (70) J53-J04 S7840 Muston Road V231454 160605 Stage 4.doc Version 1.30 Page 12 All residents had regular contact with family and friends. This was maintained through visits and telephone calls. Some families were able to visit their relatives at the home. For those unable to visit the staff made arrangements to take the particular resident to see them. One relative said “at the present I cannot get to Filey, but they (the staff) bring P over regularly to see me.” Other relatives were complimentary about their reception in the home. “They always make us welcome.” Muston Road (70) J53-J04 S7840 Muston Road V231454 160605 Stage 4.doc Version 1.30 Page 13 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) 20. Residents’ health needs were promoted through a well-managed medication system. EVIDENCE: A medication policy and procedure produced by the registered provider was seen. Those particular to the home were on display. Proper procedures were being followed for the receipt, storage, administration and recording of medication. Medication supplies were kept in a locked cabinet. A monitored dosage system was used though a small number of medicines were administered directly from the original packaging or bottle because they could not be stored in blister packs. Any special instructions were recorded in the medication file. A good method of stock control had been introduced. The records were seen. The medication administration record sheets were scrutinised. They had been completed correctly. Reconciliation between medicines and records showed no discrepancies. All staff had undertaken in-house medication training. Those with responsibility for medicine administration in the home had completed external accredited training. This was confirmed by staff on duty. Muston Road (70) J53-J04 S7840 Muston Road V231454 160605 Stage 4.doc Version 1.30 Page 14 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. Residents had the confidence their concerns and worries would be listened to and acted upon. EVIDENCE: A complaints policy and procedure was seen. Leaflets were available “How to Make a Complaint” and had been produced in pictorial form. Copies were displayed in the home. The procedure showed how to complain, to whom and gave timescales for a response. The leaflets showed the name and address of the previous regulatory authority. They must be reprinted with the name and address of the current regulatory authority clearly shown. The registered manager felt that as two residents had regular visitors and others saw their family away from the home or had regular telephone contact if there were concerns about their care these would be raised without delay. A number of relatives and visitors indicated they were aware of the complaints procedure and the location of the registered provider’s headquarters. Muston Road (70) J53-J04 S7840 Muston Road V231454 160605 Stage 4.doc Version 1.30 Page 15 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, 26 and 30. Residents were provided with a homely, comfortable, safe and hygienic place in which to live. EVIDENCE: Muston Road, a former hotel, was situated on a main road into the town. There was no indication that it was a care home. Its’ location made it convenient for access to local amenities and facilities. The building appeared to be well maintained internally and externally. The premises had been adapted to provide accommodation for four residents, three in single rooms and one in an adjacent self-contained flat. Level access was afforded to all exit doors. Ramps gave safe access to the garden. There was adequate communal space. A number of improvements had been made to the premises both internally and externally including new paths and driveway, landscaping to the garden, new windows, redecoration and some new carpets. The home was safe, comfortable, bright, clean and free from offensive odour. There was sufficient natural light, ventilation and heat. Furnishing, fittings and fixtures were domestic in nature, of a good quality and in a serviceable condition. Muston Road (70) J53-J04 S7840 Muston Road V231454 160605 Stage 4.doc Version 1.30 Page 16 Bedrooms were of a good size though none had an en-suite facility. The separate flat had its’ own facilities. The resident said “she was very happy with the flat.” All bedroom doors could be locked. None of the rooms apart from the flat had a place for safe storage. If residents are not to be issued with keys or with safe storage facilities then the reasons for these decisions should be recorded on their individual case files. The laundry was located in the garage accessed through the kitchen. Suitable procedures were in place for the proper transportation of laundry. The necessary bags and baskets had been provided. The laundry had been cleaned and the floor repainted. Muston Road (70) J53-J04 S7840 Muston Road V231454 160605 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 34 and 35. Following a period of instability, residents were now given good and consistent care by a motivated, well-trained and competent staff team. Residents were protected from harm through good recruitment and vetting procedures. EVIDENCE: Further changes had been made to the staff team since the last inspection. Extra staff hours had been agreed and appointments made. These would lead to the availability of more one-to-one or two-to-one activities for residents. In discussion with staff it was felt they were now well motivated, with good morale and an ability to work constructively together. The registered manager said much hard work had been undertaken to foster feelings of mutual support and to provide a focus firmly on the residents. Staff were observed throughout the inspection to respond to residents in a warm, friendly and supportive manner. Residents appeared to appreciate the attention given. Of the 20 support workers four had achieved a National Vocational Qualification in care to at least level 2. Others were working towards this award. Staff confirmed they undertook induction and foundation training to TOPSS and LDAF standards. Evidence of the work undertaken was seen. Further training was identified through supervision and the introduction of staff Personal Muston Road (70) J53-J04 S7840 Muston Road V231454 160605 Stage 4.doc Version 1.30 Page 18 Development Plans. Copies were seen. A variety of other specific and general courses were on offer from the registered provider and external trainers. Relatives and visiting professionals were very complimentary about the staff team. “The management and staff work co-operatively with us (social services).” “The effort and time staff give to our son is much appreciated.” Good recruitment, selection and vetting procedures were in place to ensure that only staff with the right skills, knowledge, interest and commitment were appointed. The registered manager was fully involved in these procedures. Muston Road (70) J53-J04 S7840 Muston Road V231454 160605 Stage 4.doc Version 1.30 Page 19 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, 41 and 42. Residents were able to live in a well-managed, safe and secure environment. EVIDENCE: The registered manager had been in post since May 2004 and was approved by the regulatory authority in November 2004. He was undertaking work towards a National Vocational Qualification at level 4 in care and management. The registered manager had a variety of skills, knowledge and experience together with training in areas specific to the present resident group. A number of records were seen. All were being maintained in a satisfactory manner. It was noted that not all staff records as required by Regulations were available in the home. These were held centrally at the registered provider’s headquarters. An inspection of these records had been carried out at this location last year. It was proposed that these records would be inspected again during the current year. Policies and procedures were seen on the promotion and maintenance of health and safety. Proper attention was given to the storage of hazardous Muston Road (70) J53-J04 S7840 Muston Road V231454 160605 Stage 4.doc Version 1.30 Page 20 substances. Staff confirmed attendance on courses such as fire safety and food hygiene. Hot water temperatures were checked and found to be within the required range. A number of satisfactory safety reports and certificates related to the premises and equipment. Muston Road (70) J53-J04 S7840 Muston Road V231454 160605 Stage 4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score 1 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 2 x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 x x Standard No 31 32 33 34 35 36 Score x 2 x 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Muston Road (70) Score x x 3 x Standard No 37 38 39 40 41 42 43 Score 2 x x x 1 3 x J53-J04 S7840 Muston Road V231454 160605 Stage 4.doc Version 1.30 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 22 Regulation 22(7) Requirement Timescale for action 31/07/05 2. 41 17(2) Schedule 4.6 The complaints procedure must show the name, address and telephone number of the current regulatory authority. Staff records to be kept in the 31/07/05 home must contain the information required by Schedule 4.6 to the Care Homes Regulations 2001. (Previous timescale of 31/03/04 not met) 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. 3. Refer to Standard 26 32 37 Good Practice Recommendations If bed door keys are not issued or lockable storage facilities are not provided the reasons for these decisions should be recorded on the individual s case file. The registered provider is reminded of the need for at least 50 of the care staff to have achieved a National Vocational Qualification in care to level 2 by 2005. The registered provider is reminded of the need for any manager to achieved a National Vocational Qualification in care and management to level 4 by 2005. Muston Road (70) J53-J04 S7840 Muston Road V231454 160605 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Unit 4, Triune Court Monks Cross YORK YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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