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Inspection on 02/12/05 for New Ridley Road, 27-29

Also see our care home review for New Ridley Road, 27-29 for more information

This inspection was carried out on 2nd December 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 7 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Care is provided in a modern setting on a small residential development and the accommodation is maintained to a good standard. Residents are provided with the opportunity to access day services and other social events in the company`s specialised transport. A company director visits the home on a regular basis to review the quality of care provided.

What has improved since the last inspection?

The majority of requirements and recommendation made at the last inspection have been addressed. The manager has received a thorough induction into management. A training needs assessment has been put in place for the staff team and a quality assessment system is now in place. The majority of staff have had training related to the protection of vulnerable adults.

What the care home could do better:

Although the manager has produced some new risk assessments, many of the assessments relating to safety in the home are over four years old and others take away residents` choices rather than increasing them. Individual resident care plans are being revised and further work is required in this area.

CARE HOME ADULTS 18-65 New Ridley Road, 27-29 27-29 New Ridley Road Stocksfield Northumberland NE42 2TN Lead Inspector Allan Helmrich Announced Inspection 2nd December 2005 10:00 New Ridley Road, 27-29 DS0000000613.V258915.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 New Ridley Road, 27-29 DS0000000613.V258915.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. New Ridley Road, 27-29 DS0000000613.V258915.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service New Ridley Road, 27-29 Address 27-29 New Ridley Road Stocksfield Northumberland NE42 2TN 01661 - 844112 01661 844 113 newlife.care@btinternet.com 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) Newlife Care Services Limited Care Home 9 Category(ies) of Learning disability (9) registration, with number of places New Ridley Road, 27-29 DS0000000613.V258915.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. All persons may also have a physical disability Date of last inspection 22nd June 2005 Brief Description of the Service: New Ridley Road comprises two modern semi-detached bungalows connected internally by a communal lounge. The home is set at the head of a private road in its own grounds and provides ground floor accommodation for 9 adults with a learning disability, some of whom also have a physical disability. The home is owned by New Life Care. It was purpose built approximately nine years ago. All bedrooms are for single occupation, and the accommodation and furnishings are maintained to a good standard. Each unit has a kitchen and lounge/dining area. Bedrooms are not en-suite but have wash hand basins fitted. Residents have use of a mini bus to access educational, training and social events. The home is close to the centre of Stocksfield, with access to local transport systems, shops, leisure amenities and the wider community.The home does not provide nursing care. New Ridley Road, 27-29 DS0000000613.V258915.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the home’s second annual inspection and it was announced. The inspection took 8 hours and included talking with the manager and a selection of staff on duty. The home’s records were reviewed and a tour of the premises was undertaken to assess the standards of hygiene and maintenance. The majority of residents have no verbal communication but some time was spent in their company to assess their level of contentment with the service. Seven relatives, two professional visitors and a resident, returned questionnaires regarding the service provided. In general the responses were positive regarding the standard of care provided. Some concerns were expressed about staffing levels, administration and communication. 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. New Ridley Road, 27-29 DS0000000613.V258915.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 New Ridley Road, 27-29 DS0000000613.V258915.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): 1. Information to inform prospective service users about the home is available. EVIDENCE: A Statement of Purpose containing a range of useful information for residents, their supporters and prospective service users is available in the home. New Ridley Road, 27-29 DS0000000613.V258915.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, 7, 9. The ability of each resident to communicate their desires is limited; some information is available in the home detailing residents’ needs. Staff and family support is available to residents and some limited risk assessments are in place. A review of each residents care should be provided every six months. The majority of information provided by the home could be expanded and improved. EVIDENCE: Four residents’ case files were reviewed. These plans contained each resident’s daily routine, historical information and an assessment of current healthcare needs. The residents have no verbal communication and much of the information that was written in the first person was speculative. There was information relating to behaviour management and quality of life, but these were not signed or dated. Each resident has a separate healthcare file but these did not include any monitoring of residents health and the individuals weight was not recorded. The home is currently having difficulty obtaining a care managers review and the majority of home reviews were out of date. It is important for this resident New Ridley Road, 27-29 DS0000000613.V258915.R01.S.doc Version 5.0 Page 9 group, due to the limited abilities to communicate their feelings, that a comprehensive assessment of their needs is regularly conducted. The manager has recently introduced some risk assessments to ensure residents are safe. Some risk assessments are over four years old and require reviewing and another that takes away a resident’s independence should be revised. Generally there is some improvement in the home’s care planning information and the manager is aware that further work is required to return these records to a standard previously achieved. New Ridley Road, 27-29 DS0000000613.V258915.R01.S.doc Version 5.0 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 the following standard(s): 12, 13, 15, 16, 17. Residents have meaningful social lives and are enabled to maintain regular contact with both family and the community. A regular programme of activities is in place for each resident and staff in the home promote a healthy diet. EVIDENCE: Each resident is supported to be active and attend a range of activities in the community. An activities plan is in place but as yet the manager has not reviewed this plan to ensure the activities are still appropriate to the individual resident. The ability of most residents is very limited, however staff encourage residents to be part of everyday life in the home by involving them in conversation while they carry out normal domestic routines. Those residents that are able are encouraged to participate in the day-to-day activities of the home. The manager is looking at different formats to provide information in the home and with permission has started a photograph album showing residents attending activities and events. Information is also provided in different formats to assist residents in making choices. New Ridley Road, 27-29 DS0000000613.V258915.R01.S.doc Version 5.0 Page 11 Some risk assessments are in place for individual residents and action is taken to minimise identified risks and hazards. However, as stated previously, some assessments are outdated or take away independence. During the week residents attend day and community centres. Each resident has a set time for activities although this may be affected by staffing issues. An enabler takes residents to places of interest in the home’s specially adapted transport and this is also used for outings and other social visits. Residents’ are involved in the weekly shopping trips and the menus demonstrated a good range of substantial foods is provided. New Ridley Road, 27-29 DS0000000613.V258915.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): 19. Appropriate equipment is available in the home to assist in the provision of personal and healthcare support and professional support is regularly provided. EVIDENCE: The community nursing service regularly attends the home and staff that assist in providing healthcare are trained by them. Appropriate equipment is obtained to ensure a good standard of health is maintained. The home’s records show that annual healthcare appointments are obtained but individual weight records are not kept and some health monitors are to be developed. Staff have recently received training related to residents with epilepsy and this is to be upgraded. New Ridley Road, 27-29 DS0000000613.V258915.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, 23. An effective complaints process is in place in the home and training associated with the protection of vulnerable people is provided. EVIDENCE: The home has a complaints procedure that is provided to residents and their next of kin. The complaints process was explained to each resident using pictures and an assessment of their capacity to understand are included in the individual case records. A recent complaint from the next of kin of one resident was recorded by the home. The manager and a director of the company addressed the complaint. The Commission were involved at the second stage due to dissatisfaction with the outcome. The complaint concerned the care provided by the home and after an investigation by me the complaint was partially upheld. As a result a requirement was made that further staff training should be provided. Procedures are in place for dealing with vulnerable adults, aggression and restraint. Staff have received training and the manager is shortly to attend a more intensive course. New Ridley Road, 27-29 DS0000000613.V258915.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, 30. The home is homely, comfortable and safe. There is a reasonable standard of cleanliness and hygiene. The home does not meet the standards of a new registration. EVIDENCE: The home was found to be homely, safe and comfortable. Residents’ bedrooms were individual in style. There was a reasonable standard of cleanliness throughout. The lock to a bathroom door was broken and a shelf in the laundry needed additional support brackets. There is no call/alarm system in the home. A recommendation to carry out a risk assessment to ascertain if one is needed to promote residents’ safety and independence is outstanding from a previous inspection. New Ridley Road, 27-29 DS0000000613.V258915.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, 34, 35. A training plan is in place to enable staff to meet desired standards of competence. Appropriate recruitment practices are in place and a system for meeting with the manager on a regular basis is in place. EVIDENCE: Since the last inspection the manager has created a training plan and appropriate training is made available to the staff team. Currently only 3 of 14 staff have a National Vocational Qualification in care. However a further 5 staff have completed the award and are awaiting a result. Two staff files were reviewed; they contained appropriate information and references. A photograph of the staff member should be included. Four respondents to a questionnaire commented that occasionally insufficient numbers of staff are on duty. The duty rotas showed that although five staff are on duty at times this reduces to three at weekends and occasionally during the week. The manager should ensure the home is staffed with appropriate numbers of staff to meet the needs of the residents at all times. New Ridley Road, 27-29 DS0000000613.V258915.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): 37, 39, 42. The manager is working towards the desired qualification in care management. A method of quality assessment is being introduced into the home. The home is reasonably safe. EVIDENCE: The manager is working towards the Registered Managers Award and since the last inspection has completed a management induction course developed by the company. New Ridley Road, 27-29 DS0000000613.V258915.R01.S.doc Version 5.0 Page 17 The company has provided the home with a quality assessment document. The manager is about to start using this document to assess the quality of care provided. The manager is reviewing the home’s standards of health and safety. Periodic fire checks are done and a scenario has been produced and used in staff fire instruction. A fire risk assessment of the building is not in place and the certificate confirming the gas installation at 27 New Ridley Road is satisfactory is not in place. As mentioned earlier some house risk assessments have not been reviewed for four years. New Ridley Road, 27-29 DS0000000613.V258915.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 3 X X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 2 X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X 3 X X X 3 LIFESTYLES Standard No Score 11 X 12 2 13 3 14 X 15 3 16 2 17 Standard No 31 32 33 34 35 36 Score X 2 X 2 2 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 New Ridley Road, 27-29 Score X 2 X x Standard No 37 38 39 40 41 42 43 Score 2 X 2 X X 2 X DS0000000613.V258915.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 YA6YA19 Regulation 15 Timescale for action Ensure the information contained 28/02/06 in care plans is current and dated. Healthcare details including regular weight records should be included. Each plan should be reviewed formally at 6 monthly intervals. Ensure residents are safe both in 28/02/06 the home and when undertaking activities. Risk assessments should be in place and reviewed regularly. Risk assessments should promote as much independence as the resident is able to achieve. Repair the bathroom door lock 31/12/05 for privacy. Re-fix the shelf for safety. The manager should obtain the 31/08/06 Registered Managers Award Attend to health and safety 31/12/05 matters. Produce a fire risk assessment for the building. Obtain a certificate confirming the standard of the gas appliances in the home. Requirement 2 YA9YA16 14(2) 3 4 5 YA24 YA37 YA42 23 9 23(4) New Ridley Road, 27-29 DS0000000613.V258915.R01.S.doc Version 5.0 Page 20 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 4 5 6 7 Refer to Standard YA7 YA12 YA24 YA32 YA34 YA35 YA39 Good Practice Recommendations Review the information in the care plans that is written in the first person to ensure it is accurate. Ensure each resident’s activity programme is appropriate to meeting their needs and expectations. Conduct a risk assessment associated with the lack of a call/alarm system in the home. Continue with staff development to achieve a workforce of 50 with NVQ level 2 or above in care. Obtain a recent photograph of each staff member and retain in the home. Review the needs of residents and ensure sufficient staff are on duty at all times to meet the assessed needs. Introduce the company quality assurance assessment document into the home. New Ridley Road, 27-29 DS0000000613.V258915.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 New Ridley Road, 27-29 DS0000000613.V258915.R01.S.doc Version 5.0 Page 22 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!