Inspection on 20/10/05 for Muston Road (70)

This inspection was carried out on 20th October 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Muston Road (70) 08/08/07

Muston Road (70) 24/08/06

Muston Road (70) 15/06/05

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 Inspection 20th October 2005 11:30 Muston Road (70) DS0000007840.V257108.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 Muston Road (70) DS0000007840.V257108.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. Muston Road (70) DS0000007840.V257108.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Muston Road (70) Address 70 Muston Road Filey North Yorkshire YO14 0AL 01751 474740 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) The Wilf Ward Family Trust Mr Michael Clements Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Muston Road (70) DS0000007840.V257108.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered for 4 residents with a Learning Disability some of whom may also have Physical Disability 15th June 2005 Date of last inspection 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 its own facilities. A large private and secluded garden is situated to the rear of the premises. There is no lift. The staff provide care for adults with learning difficulties most of whom have complex needs and challenging behaviour. While the staff seek to promote independence among residents, all require some assistance with personal care including help with washing, dressing and bathing. The staff team takes responsibility for the catering, cleaning and domestic services in the home. Residents are encouraged to help according to their individual capabilities. Social activities are arranged 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) DS0000007840.V257108.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection upon which this report is based was the second to be undertaken in the inspection year April 2005 to March 2006. It was carried out over five hours including preparation time. The focus was on those key standards not assessed at the first inspection in June 2005 together with those parts of other standards that were subject to a requirement or recommendation. Care plans were examined together with some policies and procedures. Discussions were entered into with the registered manager, a senior staff member and other staff. The four residents were spoken with though their ability to communicate was in some instances limited. However feedback received from those able to communicate was positive. Observation showed a good rapport between residents and staff. What the service does well: What has improved since the last inspection? A copy of the revised multi-agency protocol on adult protection was available. Muston Road (70) DS0000007840.V257108.R01.S.doc Version 5.0 Page 6 Work continued on improvements to the premises. The extra deployment of staff meant residents were able to enjoy more oneto-one contact, extra activities in the home and outside and a reduction in confrontational incidents. The registered manager continued his work towards a National Vocational Qualification in care to level 4. The registered manager was adapting a quality assurance framework for use in the home. 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) DS0000007840.V257108.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 Muston Road (70) DS0000007840.V257108.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): 2 Residents could be assured their needs, preferences and choices would be assessed and recorded prior to admission. EVIDENCE: A new resident had been admitted since the last inspection in June this year. The assessment and pre-admission documentation was examined. This was comprehensive and detailed in content and gave a clear picture of the needs of the prospective resident. Information had been sought from the hospital where the prospective resident was currently accommodated, from other health care professionals, for example the occupational therapist and from the care manager. All their reports were on file. The registered manager and his deputy had visited the prospective resident in hospital and their written assessment was also on the file. Regular reviews had been undertaken following admission to update the needs and assessment and ensure that the appropriate care and services were being given. Muston Road (70) DS0000007840.V257108.R01.S.doc Version 5.0 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 the following standard(s): 6, 7 and 9. Residents’ needs, preferences and choices on aspects of daily living were well recorded and acted upon with proper attention given to risk management. Their finances were well managed. EVIDENCE: The case files and care plans of the four residents presently accommodated at the home were examined. Each detailed how the individual resident wished to spend their day, recorded on daily and weekly diary sheets. The resident’s preferences regarding a number of activities of daily living were also recorded. None of the residents was able to handle their own finances. The staff managed the money on their behalf. A clear record was maintained for each resident showing income, expenditure and running balance. Regular reconciliations of the record against the actual money were recorded. The money was checked and no discrepancies were found. Full risk assessments were seen on each file. They were comprehensive in nature clearly detailing any potential risk, those at risk and the actions to be taken to minimise or eliminate that risk. Strict guidelines were in place for Muston Road (70) DS0000007840.V257108.R01.S.doc Version 5.0 Page 10 dealing with challenging or inappropriate behaviour inside and outside the home. Residents also had risk and relapse management plans where necessary. These had been completed by the appropriate health care or social care professional. Muston Road (70) DS0000007840.V257108.R01.S.doc Version 5.0 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 the following standard(s): 16 and 17. Residents were assured daily routines met their individual preferences. Residents’ dietary needs and choices were met through the provision of a varied menu. EVIDENCE: Residents’ preferred daily routines were shown on their care plan. Home routines and rules were designed for the benefit of residents. Discussion with and observation of staff showed every care was taken to ensure residents’ right to independence, privacy and dignity were promoted and maintained. Some residents took part in the daily life of the home helping with cleaning and other domestic tasks. Staff had devised menus around the known likes, dislikes, preferences and choices of the residents. Nutritional needs were recorded where necessary. Staff spoke of the need to ensure the food provided was liked and enjoyed by residents. They were aware of “healthy eating” requirements and some general improvements had been noted in residents’ health. However menus did not rigidly adhere to such principles and occasional “treats” were enjoyed. Muston Road (70) DS0000007840.V257108.R01.S.doc Version 5.0 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 the following standard(s): 18 and 19. Residents had their health care needs properly assessed, recorded and met. EVIDENCE: The care plans showed each resident’s preferences for how and when care was to be given. The personal support plan detailed each resident’s wishes around the majority of activities of daily living. Discussion with and observation of staff showed that residents’ needs were given the necessary priority. They provided care with good attention to the maintenance of dignity and privacy. Male and female staff were on duty giving residents the right to care from a person of the same gender. Some residents were able to choose their own clothing with assistance from staff who ensured items purchased were age, sex and personality appropriate. For others, staff brought clothing into the home “on approval.” Health care needs were detailed on the care plan. The reasons for referral and outcome were recorded together with any follow-up. Specific health needs were fully recorded with the relevant information available for staff reference and use. The staff team had the support of and regular input from the Community Learning Disability Team. Muston Road (70) DS0000007840.V257108.R01.S.doc Version 5.0 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 the following standard(s): 22 and 23. Residents could be assured their concerns and worries would be addressed. Their safety from harm was promoted through good attention to issues of adult protection. EVIDENCE: The complaints policy and procedure were seen. A copy of the complaints procedure was displayed in the home. Written and pictorial versions were available. The procedure must be updated to reflect the change in the regulatory authority. A clear and precise policy and procedure were seen on adult protection. Staff had received training on this issue through induction, externally as part of the LDAF training (Learning Disability Award Framework) and units undertaken as work towards a National Vocational Qualification. They were well aware of the issues involved. They spoke with confidence about their approach to any suggestion of alleged or suspected abuse. The registered manager had obtained a copy of the revised multi-agency protocol on adult protection. This should be discussed with staff and then implemented. Physical interventions were required on occasions with some residents. These instances were well recorded with the actions taken being fully documented. The involvement of other health and social care professionals in drawing up the precise details of when and how restraint could and should be used were also recorded. The last review of the procedures was in July this year. Reviews take place every three months. The uses of medication administration on a pre-emptive basis were clearly shown. All staff who worked in the home had received the appropriate Conflict Management training. Muston Road (70) DS0000007840.V257108.R01.S.doc Version 5.0 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 the following standard(s): 24, 26 and 30. Residents were able to live in a safe and comfortable environment through the continual improvements being made to the premises. EVIDENCE: Improvements continued to be made to the premises including re-decoration, re-carpeting, new fabrics and furnishings. The registered manager and his staff team displayed a great commitment to the home and were eager to ensure it was a pleasant and comfortable place in which residents could live. Staff had a variety of talents that were put to good use in the maintenance and improvement of the home. Bedrooms were of a good size and met the needs of residents. All bedroom doors could be locked but none of the residents had a key as they had been assessed as unable to understand the concept of a lock and key. Those parts of the home seen were warm, clean, tidy and odour free. Good attention was given to matters of hygiene and cleanliness. Muston Road (70) DS0000007840.V257108.R01.S.doc Version 5.0 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 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. Residents’ needs were met by a committed, caring and well-motivated staff team. EVIDENCE: The home had a compliment of registered manager and 20 support workers including a deputy manager and senior staff. The new staff had undertaken induction training in the home and were currently working on their LDAF units. They were then expected to go on to undertake work towards a National Vocational Qualification. Presently three staff had achieved a National Vocational Qualification in care to at least level 2 and three were working towards the award. The registered manager was aware of the need for 50 of his staff to have achieved this latter award by 31st December 2005. The extra deployment of staff had meant that residents were able to enjoy more one-to-one contact, extra activities in the home and outside and a reduction in confrontational incidents. Muston Road (70) DS0000007840.V257108.R01.S.doc Version 5.0 Page 16 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 41. Residents were able to live in a well-managed environment. EVIDENCE: The registered manager was experienced and qualified to undertake his present role. He had achieved the Registered Manager (Adults) NVQ4 award. He was working towards a National Vocational Qualification in care to level 4. The registered manager was adapting a quality assurance framework based on Standards in Supported Living (REACH) for use in the home. Some of the material was being produced in pictorial form. The staff had begun to assess their performance in relation to a number of areas of care and services provided in the home. Residents were unable to understand or complete any written questionnaire though consideration was being through work on REACH to some form of pictorial representation. The registered manager and staff were in regular contact with relatives. Muston Road (70) DS0000007840.V257108.R01.S.doc Version 5.0 Page 17 The registered manager should consider the distribution of a questionnaire to relatives and visiting professionals seeking their views and opinions on the overall performance of the home. The staff records had been previously examined at the registered provider’s headquarters and found to contain the required information. Muston Road (70) DS0000007840.V257108.R01.S.doc Version 5.0 Page 18 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 Score 1 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X 3 X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 2 X X X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Muston Road (70) Score 3 3 X X Standard No 37 38 39 40 41 42 43 Score 3 X 2 X 3 X X DS0000007840.V257108.R01.S.doc Version 5.0 Page 19 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 YA22 Regulation 22(7) Requirement The complaints procedure must show the name, address and telephone number of the current regulatory authority. (Outstanding from 31/07/05) Timescale for action 30/11/05 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 2 Refer to Standard 32 39 Good Practice Recommendations 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 manager should circulate a written questionnaire on the overall performance of the home to relatives and visiting health and social care professionals. Muston Road (70) DS0000007840.V257108.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection York Area Office 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. Extracts may not be used or reproduced without the express permission of CSCI Muston Road (70) DS0000007840.V257108.R01.S.doc Version 5.0 Page 21 - 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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