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Inspection on 22/06/05 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 22nd June 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 10 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. Residents are provided with the opportunity to access day services and other social events in the company`s specialised transport. The accommodation is maintained to a good standard. A management representative visits the home on a regular basis.

What has improved since the last inspection?

A manager is appointed and work has started on improving the systems used in the home.

What the care home could do better:

The manager is new to management and should be supported and have a thorough induction into management. A plan of action should be produced with those areas of greatest importance being prioritised. The home should be assessed for safety, care plans should adequately reflect the needs of individual residents and training should support staff in providing quality care. A quality based assessment system should be introduced by the company.

CARE HOME ADULTS 18-65 27-29 New Ridley Road Stocksfield Northumberland NE42 2TN Lead Inspector Allan Helmrich Unannounced 22 June 2005 10:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 27-29 New Ridley Road Version 1.10 Page 3 SERVICE INFORMATION Name of service 27-29 New Ridley Road Address Stocksfield Northumberland NE42 2TN 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) 01661 844112 01661 844113 newlife.care@btinternet.com Newlife Care Services Limited Elaine Coulson (application pending) CRH 9 Category(ies) of LD Learning disability (9) registration, with number of places 27-29 New Ridley Road Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: No conditions are applied. Date of last inspection 11th Novembetr 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. 27-29 New Ridley Road Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over seven hours and follows a recent visit after a complaint about the service was received by the Commission. The inspection was also used to assess the suitability of the manager for registration purposes. Much of the inspection was spent talking to the manager and her deputy and reviewing the records maintained in the home. A tour of the premises was undertaken and some time was spent talking to residents and staff. 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 27-29 New Ridley Road Version 1.10 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 Standards Statutory Requirements Identified During the Inspection 27-29 New Ridley Road Version 1.10 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 standard(s) 1, 2, 4, 5. A Statement of Purpose is available in draft, containing good quality information for prospective residents. Professional assessments are obtained to ensure placements are suitable and trial visits are encouraged. Contracts are obtained and pre admission information is collected. EVIDENCE: A draft Statement of Purpose containing a range of useful information for residents, their supporters and prospective service users is produced. The home’s fire precautions and associated emergency procedures should be added. Documentation is available to collect the information required prior to admission, to limit the possibility of unsuitable admissions being accepted. The process of admitting a resident was discussed with a care manager during the inspection and was considered to be appropriate. Case records viewed contained contracts/terms of admission. 27-29 New Ridley Road Version 1.10 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 standard(s) 6, 7, 9, 10. Considerable work is required to achieve a desirable standard of care planning. Those residents capable of choice are encouraged to do so. Risk assessments to develop independence should be produced. Information is handled appropriately. EVIDENCE: Care plans do not contain the quality of information required to ensure consistently good care is provided. A new structure for care planning was introduced recently for the provision of consistent healthcare. This is a pilot and has only been developed for one resident. Current risk assessments are not in place. Staff were observed encouraging residents to make decisions regarding everyday matters in the home. This type of decision making was not reflected in care planning. The standard of confidentiality expected of staff is detailed in the Statement of Purpose and in the home’s policies. 27-29 New Ridley Road Version 1.10 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 standard(s) None of these standards were reviewed at this inspection. EVIDENCE: 27-29 New Ridley Road Version 1.10 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 standard(s) 18, 19, 20, 21. Appropriate equipment is available in the home to assist in the provision of personal and healthcare support. Some training related to the healthcare needs of residents is required. The system for recording and dispensing of medicines is satisfactory. EVIDENCE: A range of equipment to assist in the provision of appropriate care is available to staff. A record of professional involvement in the provision of healthcare is maintained, as is some information regarding the individual personal care requirements. The records did not fully reflect the way personal care is provided, nor that appropriate training related to the assessed needs was in place. The manager is aware of the need for training related to understanding epilepsy and this is to be provided. The manager stated that care planning was being addressed with the upgrading of the existing care plans (see Individual Needs and Choices, Standards 6-10). The system for ordering and dispensing medicines in the home was reviewed and found to be generally satisfactory. Information relating to resident’s wishes upon their death is obtained when possible and the detail is recorded in the individual case records. 27-29 New Ridley Road Version 1.10 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 standard(s) 22, 23. An effective complaints process is in place in the home. There is a lack of training associated with the protection of vulnerable people. EVIDENCE: 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 investigation is currently ongoing and will be included in the next inspection report together with any requirements made of the home. The substance of the complaint concerned the ability of staff to provide appropriate healthcare support to a resident. Some staff training is to be provided by the company to address part of the complaint. None of the staff have received training related to the Protection of Vulnerable Adults, although this was a requirement at the last inspection. Procedures are in place for dealing with Vulnerable Adults, Aggression and Restraint. 27-29 New Ridley Road Version 1.10 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 standard(s) 24, 25, 26, 27, 28, 29, 30. The home is clean,well maintained and provides comfortable accommodation with easy access to all internal areas. Each bedroom is equipped to a good standard and is individual in style. Door locks provide privacy. Communal areas are appropriate and a range of equipment is available to maximise independence. The home does not meet the standards expected of a new registration. EVIDENCE: Access to the home is from an un-adopted road with building works still in progress. In practice, none of the residents are able to walk any distance, therefore this does not present a problem. The home is purpose built to a good standard with single accommodation throughout. Communal facilities consist of a kitchen and lounge/diner on each wing with a central lounge used both by staff for paperwork and as a sensory room. Bathrooms and toilets have suitable facilities and these have been reviewed recently by an occupational therapist for a prospective new resident. 27-29 New Ridley Road Version 1.10 Page 13 The home was found to have a good standard of hygiene, and with the exception of a hole in the wall caused by a door handle, a good standard of maintenance. A call system is not available in the home and no risk assessment is in place. A separate laundry contains washing facilities that meet current disinfection standards. 27-29 New Ridley Road Version 1.10 Page 14 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, 35, 36. The home is staffed in appropriate numbers. Further staff training is needed, as well as a process for monitoring training. EVIDENCE: The manager has instigated staff supervisions and these are recorded and filed. Only 13 of the staff team has achieved NVQ level 2 or above. The manager could not provide a clear record of staff training. 27-29 New Ridley Road Version 1.10 Page 15 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, 39, 42. The home’s manager is relatively inexperienced and would benefit from company support in addressing the many issues highlighted in the previous inspection report. No quality monitors are used to identify the requirements of the service users. Health and safety procedures should be reviewed to ensure the safety of residents. EVIDENCE: The manager has worked in care for many years but is relatively new to management. She has a NVQ level 3 in care and is working towards the Registered Managers Award. Many issues identified at the last inspection remain unresolved and require a systematic approach. The manager has addressed several requirements but has not put in place a structured plan. The manager is receiving support from a director of the company, but this again is not formal and has no timescales. A quality monitoring system has not been introduced into the home and there is no strategy developed to achieve a standard acceptable to the company and the Commission. 27-29 New Ridley Road Version 1.10 Page 16 Many of the home’s systems although in place have not been regularly reviewed. Some risk assessments are outdated. The periodic fire checks were generally in place, fire extinguishers should be checked on a monthly basis and fire scenarios should be produced for use in staff fire instruction training. 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. Where there is no score against a standard it has not been looked at during this inspection. 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 2 3 x 3 3 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 2 x 2 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 2 3 3 3 3 Standard No 27-29 New Ridley Road Standard No 31 32 Version 1.10 Score x 2 Page 17 11 12 13 14 15 16 17 x x x x x x x 33 34 35 36 x x 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 3 Standard No 37 38 39 40 41 42 43 Score 2 x 2 x x 2 x 27-29 New Ridley Road Version 1.10 Page 18 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 YA1 Regulation 4 Requirement Add to the homes Statement of Purpose, the fire precautions and associated emergency procedures. Each case record should be reviewed and updated with appropriate assessments and care plans. Improve the independence of service users with risk assessments, e.g. use of the kitchen. Produce a training matrix and ensure appropriate training related to the assessed needs of the residents is provided for staff. Provide training for staff dealing with the Protection of Vulnerable Adults. THIS IS AN OUTSTANDING REQUIREMENT. The manager should be provided with a thorough induction into management. The process should include a statement of goals and should be signed off as completed by a company representitive. At the conclusion the Commission should be informed and a registration interview will be conducted Version 1.10 Timescale for action 31/7/05 2. YA6, YA7 15 31/10/05 3. YA9 12 31/8/05 4. YA19, YA35 18 31/8/05 5. YA23 18 30/9/05 6. YA37 9 30/9/05 27-29 New Ridley Road Page 19 7. YA39. 24 8. YA42 12 A plan of action should be 31/7/05 agreed between the company and manager to meet the required standards. An effective quality monitoring system should be developed that includes a system for consistant monitoring Ensure the safety of residents 31/8/05 and staff by; reviewing the risk assessments for the home, conducting all fire checks and producing a set of fire scenarios for use in training and instruction. 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 YA26 YA32 Good Practice Recommendations Conduct a risk assessment associated with the lack a call alarm system in the home. Continue with staff training to provide a staff team 50 of whom have a NVQ level 2 or above in care. 27-29 New Ridley Road Version 1.10 Page 20 Commission for Social Care Inspection 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 27-29 New Ridley Road Version 1.10 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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