Inspection on 23/05/07 for New Ridley Road, 27-29

This inspection was carried out on 23rd May 2007.

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 26 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

New Ridley Road, 27-29 12/05/09

New Ridley Road, 27-29 06/05/09

New Ridley Road, 27-29 12/05/08

New Ridley Road, 27-29 31/05/06

New Ridley Road, 27-29 02/12/05

New Ridley Road, 27-29 22/06/05

New Ridley Road, 27-29 11/11/04

New Ridley Road, 27-29 03/06/04

New Ridley Road, 27-29 24/02/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 New Ridley Road, 27-29 27-29 New Ridley Road Stocksfield Northumberland NE42 2TN Lead Inspector Glynis Gaffney Key Unannounced Inspection 21, 23, 24 and 30 May 2007 14:30 New Ridley Road, 27-29 DS0000000613.V338242.R02.S.doc Version 5.2 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.V338242.R02.S.doc Version 5.2 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.V338242.R02.S.doc Version 5.2 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 (wholly owned subsidiary of Minster Pathways Limited) Vacant Care Home 9 Category(ies) of Learning disability (9) registration, with number of places New Ridley Road, 27-29 DS0000000613.V338242.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. All persons may also have a physical disability Date of last inspection 31st May 2006 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 nine adults with a learning disability, some of whom also have a physical disability. The home was purpose built approximately nine years ago. All bedrooms are for single occupation. Each unit has a kitchen and lounge/dining area. Although there are no en-suite facilities, each bedroom had been fitted with a hand washbasin. The home is close to the centre of Stocksfield, giving easy access to local transport systems, shops, leisure amenities and the wider community. The home does not provide nursing care. The current weekly fee is £741.16. Additional charges are made for hairdressing, aromatherapy, clothing, leisure activities and toiletries. Copies of the Commission’s inspection reports were available to visitors, staff and residents. New Ridley Road, 27-29 DS0000000613.V338242.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. How the inspection was carried out: Before the visit: We looked at: • • • • • Information we have received since the last visit on the 26 May 2006; How the service dealt with any complaints & concerns since the last visit; Any changes to how the home is run; The acting manager’s view of how well they care for people; The views of people who use the service & their relatives, staff & other professionals. The Visit: An unannounced visit was made on the 21 May 2007. During the visit we: • • • • • • Talked with people who use the service, some of the staff and the manager; Looked at information about the people who use the service & how well their needs are met; Looked at other records which must be kept; Checked that staff had the knowledge, skills & training to meet the needs of the people they care for; Looked around the building to make sure it was clean, safe & comfortable; Checked what improvements had been made since the last visit. We told the manager what we found. A temporary manager started working at the home approximately two weeks before the commencement of the inspection. Mrs Dunn had already begun to make significant changes to the way in which the home operated. It was felt that the service now has the capacity to change and improve. A relative said that - “There has been a complete sea change in the operation of the home…for the first time the service users and their needs are being recognised and given precedence over the convenience of the carers…day services for the first time are being put in place, record keeping, which under the previous management was risible, has improved. I am very impressed by the knowledge, competence and dedication of the acting manager.” New Ridley Road, 27-29 DS0000000613.V338242.R02.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Since the acting manager took over the temporary management of the home approximately two weeks ago, the following improvements had been made: 1. 15 door closures had been ordered to enable staff to keep fire doors open during busy times of the day, whilst also ensuring fire safety; 2. Quotes had been obtained for redecorating the home; 3. A new mattress had been obtained for one person living at the home; 4. Arrangements had been put in place to improve the home’s gardens. A part time gardener had been employed. New patio furniture had been purchased and a water feature fitted; 5. A newsletter had been issued to family members providing them with an update about what was happening in the home; 6. A programme of staff supervision had been put in place; New Ridley Road, 27-29 DS0000000613.V338242.R02.S.doc Version 5.2 Page 7 7. Action had been taken to improve peoples’ use of community based facilities and activities. The majority of staff had received an induction in the use of the facilities available in the newly opened Alan Shearer Centre. Discussions are underway within the staff team to look at how people can be supported to go on holiday. Plans had been put in place to provide people with access to arts and garden projects, Pets in Therapy sessions and Music and Sound Therapy; 8. A review of staffs’ training needs had been undertaken and arrangements had been put in place to ensure that all training was up to date. Arrangements had been made for all staff to attend a healthy eating and special diets course and person centred planning training. Two staff had completed fire warden training. Arrangements had also been made to provide staff with more specialist training to enable them to better meet the needs of people living at the home; 9. A programme of staff meetings had been drawn up. The acting manager is about to hold her second staff meeting since joining the home; 10. Action had been taken to fill vacant posts; 11. Arrangements had been put in place to review each person’s care plans; 12. Action had been taken to obtain a more appropriate fire risk assessment format; 13. Arrangements had been put in place to purchase new dining tables and chairs. The previous manager had made improvements to peoples’ care plans and risk assessments. What they could do better: Ensure that the home’s statement of purpose and service user guide are reviewed and updated to reflect changes in the ownership of the home. The statement of purpose should be made available in an easy to understand version. This will help ensure that people wishing to use the service have access to all of the information they need to make an informed decision. Ensure that a recognised system of Person Centred Planning (PCP) is used within the home. This will help people to receive more individualised support and a better quality of life and experience. Ensure that staff complete training in person centred planning. This will help provide staff with the skills and knowledge they need to implement PCP. Ensure that each person living at the home has an up to date moving and handling risk assessment and management plan. Ensure that staff are familiar with each person’s assessment and management plan and follow the guidance contained within them. This will help to ensure that people are moved and transferred in line with the risk assessments and management plans that have New Ridley Road, 27-29 DS0000000613.V338242.R02.S.doc Version 5.2 Page 8 been developed for use within the home and reduce risks to both staff and the people living at New Ridley Road. Ensure that a comprehensive risk assessment has been completed for each person using bedside rails. This will help ensure that people are protected from injuries that could occur as a result of the inappropriate use of bedside rails. Ensure that people with profound support needs are not left unsupervised. This will help ensure that staff are available at all times to respond to peoples’ needs. Ensure that a person centred activity plan is devised for each individual. Ensure that staff know how to provide stimulating activities for people with profound learning disabilities. This will help to ensure that people are able to lead a fulfilling and stimulating life that suits their needs and abilities. Ensure that a recognised tool is used to assess peoples’ nutritional health care needs. This will help staff to promote peoples’ good nutritional health and well-being. Ensure that each person has a health action plan and that they are supported to receive community health care. Ensure that staff are provided with clear guidelines about how to meet peoples’ specialised health care needs. This will help to ensure that peoples’ good health and well-being is promoted. Ensure that the home’s medication policy is revised to include the required details. Ensure that the home’s medication practices and procedures are reviewed by a pharmacist. This will help ensure that staff are clear about how medication is to be managed within the home. It will also help keep people safe. Ensure that all staff are clear about their responsibilities in promoting and safeguarding the well being of people living at the home. This will help protect people from potential harm or abuse. Ensure that the premises related concerns identified during the inspection are addressed. This will help ensure that people are provided with a wellmaintained place within which to live. Ensure that staff records contain the required information. Also that the required pre-employment checks have been carried out. This will help protect people from individuals who are considered unsuitable to work with vulnerable adults. Ensure that staffs’ training in key statutory areas is updated on a regular basis. This will help ensure that staff have the skills and knowledge they need to provide people with safe care. New Ridley Road, 27-29 DS0000000613.V338242.R02.S.doc Version 5.2 Page 9 Prepare an annual development plan. This will help people, and their families, to see that there is a written programme that sets out how the home’s furnishings, fittings and fabric of the building are to be renewed, repaired and improved. They will also be able to see how the provider intends to improve the care and services provided at the home. Ensure that staff receive regular formal supervision and an annual appraisal. Complete a training needs analysis for each member of staff. This will help ensure that staff are well supported, appropriately supervised and aware of their responsibilities in protecting the welfare of people living at the home. Ensure that the required fire prevention checks are carried out. Ensure that staff have received fire safety training, and participated in fire drills, at the frequency set down by the fire service. This will help protect people from serious harm and danger. Ensure that the required workplace risk assessments have been completed. This will help to make sure that New Ridley Road is a safe place to live in and work at. 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. The summary of this inspection report can be made available in other formats on request. New Ridley Road, 27-29 DS0000000613.V338242.R02.S.doc Version 5.2 Page 10 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.V338242.R02.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Positive steps have been taken to produce a service user guide that can be more easily understood by people who have a learning disability. The information given to people who may be considering using the service was not up to date. Not having access to accurate and up to date information about the service, and who provides it, may place people at a disadvantage. EVIDENCE: Neither the home’s statement of purpose or service user guide had been updated to include the new provider’s details. A service user guide to the home was available in a pictorial format. The statement of purpose was not available in alternative formats. A family member told the inspector that they had received enough information when deciding whether their relative should live at the home. There had been no new admissions into the home since the last inspection visit in October 2006. The home’s current statement of purpose confirmed that people would only be admitted into the service following receipt of a full social New Ridley Road, 27-29 DS0000000613.V338242.R02.S.doc Version 5.2 Page 12 services needs assessment. Standard two was not assessed, as there had been no new admissions into the home since the last inspection. New Ridley Road, 27-29 DS0000000613.V338242.R02.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The system of care planning adopted by the home was inadequate and confusing. This meant that New Ridley Road staff did not always have clear guidance about how to meet peoples’ support needs. The arrangements in place for assessing the risks posed to people as they lived their daily lives were not fully adequate. This meant that people might be subject to unnecessary risks and potential harm. EVIDENCE: The care records of three people were examined. Each file contained a range of useful information such as: • A ‘pen picture’ of peoples’ needs; DS0000000613.V338242.R02.S.doc Version 5.2 Page 14 New Ridley Road, 27-29 • • • An outline of each person’s daily routines; An assessment of each person’s independent living skills; Details of how peoples’ needs should be met. The previous manager had begun reviewing and improving the care records for people living at the home. This was following a requirement set in the last inspection report. But, a number of concerns were also identified as follows: • • • • • The care plans examined did not contain clearly set out statements that outlined what the home hoped to achieve by implementing the plans that had been drawn up; A recognised system of person centred planning was not in use; None of the care plans examined included clear guidance on how often they should be reviewed; The person interviewed as part of the inspection arrangements had not signed the information held about him to confirm his agreement with the contents; Evidence showing how people living at the home had been involved in the care planning process was limited. Over a period of two hours, time was spent observing the interaction between staff and people living at the home. In one part of the home, there was no verbal communication between one member of staff and the three people using the lounge area. The member of staff spent the whole hour either watching the television or leaving the lounge to go about daily chores such as meal preparation. This meant that vulnerable people with high support needs were left unsupervised for short periods. Towards the end of the observation period, a person with good communication skills joined the group. The staff member engaged this person in positive conversation. Similar concerns about the lack of communication and interaction between staff and people living at the home were also identified in the other house. But, despite the concerns identified above, staff were observed providing physical care in a kind, respectful and sensitive manner. Peoples’ care records contained evidence that steps had been taken to minimise the risks experienced by people as they lived their daily lives. For the most part, the risk assessments examined were up to date. For example, assessments had been carried out to minimise the risks associated with moving and handling people. But, a number of concerns were also identified as follows: • One person had a moving and handling risk assessment and management plan prepared by their Occupational Therapist. But, staff were observed manually lifting this individual in a manner that was at odds with their moving and handling plan. Also, the risk assessment and management plan had not been reviewed since 2004. None of the staff whose files were checked had updated their moving and handling DS0000000613.V338242.R02.S.doc Version 5.2 Page 15 New Ridley Road, 27-29 • training in the last 12 months. (The acting manager had just made arrangements for staff to complete the necessary training); The risk assessment completed for each person requiring the use of a bedside rail did not cover each of the recommended areas. Peoples’ care records contained limited information about what choices and decisions people could make. Independent advocates had not been used to help identify what support people required to make daily choices and decisions New Ridley Road, 27-29 DS0000000613.V338242.R02.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The opportunities for people to develop and maintain social, emotional, communication and independent living skills, were not fully satisfactory. This meant that people did not always have positive opportunities to enjoy a full and stimulating lifestyle. People living at the home are provided with a good healthy diet. But, the arrangements for supporting people to have positive mealtime experiences were not fully satisfactory. This meant that mealtimes were not a relaxed, sociable experience. New Ridley Road, 27-29 DS0000000613.V338242.R02.S.doc Version 5.2 Page 17 EVIDENCE: Social services had allocated New Ridley Road 16 hours per week to provide each person living at the home with day services. Peoples’ records contained social care plans and guidance for staff to follow when providing activity sessions. Each person had an activity timetable showing what activities should be provided and when. But, the in-house activities scheduled to take place during the inspection were not carried out. The acting manager had started to address concerns she had about the lack of meaningful activities for people. For example: • • • • Arrangements were being made to take people on holiday; The majority of staff had been inducted in the use of the specialist facilities at the Alan Shearer Centre in Newcastle; A therapist had been invited to look at how people could be involved in gardening activities and arts and crafts projects; Specialist sensory equipment had been re-introduced into one of the lounges. The home has a mini-bus and staff were observed taking some people on trips out. A member of staff said that the previous manager had thought it was ‘undignified’ for people living at the home to go to pubs and restaurants and be ‘stared at.’ Another staff member commented that one of the people living at the home enjoyed ‘staring out of the window all day watching what was going on.’ During the inspection, the previous owners visited and took one of the people living at the home out for lunch. A person interviewed said that he was very happy with the range of activities and opportunities offered at the home. He enjoyed going out to work during the week. A family member also said that she was satisfied with the activities provided. The home had a policy on supporting people to maintain contact with their family members. People living at the home had been provided with opportunities to develop and maintain important family relationships. For example, peoples’ records contained important information about their families and friends. But, care plans supporting people to maintain contact with their families and friends had not been put in place. Staff interviewed said that the majority of people living at the home were unable to contribute to the day-to-day running of New Ridley Road. One person was observed setting the dining table for the evening meal. He appeared to enjoy this responsibility. New Ridley Road, 27-29 DS0000000613.V338242.R02.S.doc Version 5.2 Page 18 There were a number of people living in the home who required assistance with eating and drinking. The inspector observed a teatime meal in one of the houses. One person was fed artificially. Two others required verbal and physical prompts to eat and drink. Another person was independent and required no assistance. Two of the meals served had been cut into bite size pieces or pureed to enable people to eat their meals safely. One person was fed by a carer seated beside them whilst another was fed by a member of staff who stood up for the entirety of the meal. Staff were gentle and considerate in the way they helped people to eat. Although the meal lasted no longer than 15 minutes, staff did talk with each other and with the people sat at the dinner table. The person who required assistance with artificial feeding did not join the others at the dining table. Peoples’ care records contained useful information about the support they needed with eating and drinking. For example, information about peoples’ food likes and dislikes was in place. An assessment of peoples’ nutritional care needs had not been completed. In the care files examined, peoples’ weights had not been regularly checked. One person said that although the food was ‘tasty’ and ‘great’, he never knew what he was getting to eat until it was ‘plonked down’ in front of him. A printed copy of the home’s menu was available in each kitchen. The acting manager had just introduced a new set of four weekly rotating menus. The menus included the recommended information but it was also noted that: • • • • • Two courses were not available at the lunch and tea time meals; Two choices were not always available at the lunch time meal; A hot choice was not always available at the tea time meal; The approximate timing of meals was not given; Adequate details of the food to be served were not always available. New Ridley Road, 27-29 DS0000000613.V338242.R02.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The arrangements for meeting peoples’ health care needs were not fully adequate. This might mean that people are not able to lead healthy lives free from discomfort, pain and disability. The systems in place to support the safe administration, storage and disposal of medication were generally satisfactory and promoted peoples’ good health. This means that people are protected by the home’s policies and procedures for dealing with medicines. EVIDENCE: Staff were kind, considerate and gentle when looking after the people in their care. A person living at New Ridley Road said that he felt well cared for by staff. He said staff were always happy to help him whenever he asked for assistance. People living at the home looked well cared for. New Ridley Road, 27-29 DS0000000613.V338242.R02.S.doc Version 5.2 Page 20 The home had made arrangements for peoples’ health care needs to be met. For example: • • • • • • • Two of the people whose records were checked had received optical care in the last 12 months and dental care within the last six months; One person had received physiotherapy support on a regular basis; Each person had been registered with a local GP; Community nursing services visited the home as and when required; Pressure area care risk assessments had been conducted for each person; Staff had access to helpful information about peoples’ epilepsy care needs; Staff had been provided with training in how to carry out simple nursing tasks. A relative said that – “ on a personal note, (my relative’s health care needs) are being recognised for the first time.” But, it was also identified that: • • • • A comprehensive health action plan was not in place for each person; One person had not received dental care within the last year or optical care in over two years; Guidelines on the steps to be followed when administering enemas and emergency epilepsy medication had not been prepared for each individual; Not all staff had received training in managing continence promotion and caring for people at risk of developing pressure area skin care needs. The home had a medication policy. The policy did not cover all the required areas such as: - medications requiring cold storage; handling drug alert information and administration of medicines by specialised nursing techniques. The cupboard used to store medication was clean and hygienic. But, items other than medication, such as petty cash, were stored in the cupboard. All medication had been properly secured. Photos to identify each person had been placed on their medication records. Records were in place covering the ordering, receipt, administration and disposal of medicines. These records were generally well completed. Staff had completed accredited medication training. There were no people administering their own medication at the time of the inspection. No controlled drugs were being used. The following concerns were identified: • • Checks of the air temperature of the room in which medications were stored had not been undertaken; An inspection of the home’s medication practices and procedures by an experienced pharmacist had not taken place recently. New Ridley Road, 27-29 DS0000000613.V338242.R02.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The arrangements in place for handling complaints were satisfactory. This meant that people could be confident that their complaints would be listened to, taken seriously and acted upon. The arrangements for protecting people living at the home from harm or abuse were not fully adequate. This meant that people might not be fully protected in their own home. EVIDENCE: The complaints procedure provided staff with guidance about how to handle complaints. One person living at the home said that he would be happy to raise any concerns with staff. Other people living at the home were unable to comment. Neither the home, nor the Commission, had received any complaints since the last inspection. At the time of the inspection, a longstanding complaint was still under investigation. This was being dealt with through the local authority’s safeguarding procedures. The safeguarding policy provided staff with guidance about how to handle adult protection concerns. Apart from the matter referred to above, there had been no concerns raised with either the home, or the Commission, since the last inspection. One person told the inspector that he felt safe and secure living at New Ridley Road, 27-29 DS0000000613.V338242.R02.S.doc Version 5.2 Page 22 the home. All staff had received training in the protection of vulnerable adults. But, when asked to comment on how they would handle an allegation of abuse, a member of staff said that this would depend on who the allegation was about. They said they would not treat the matter as seriously if it involved a longstanding member of staff who had never acted in this way before. New Ridley Road, 27-29 DS0000000613.V338242.R02.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 27, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The arrangements for maintaining, replacing and improving the home’s decoration, furnishings and fittings were not fully adequate. This meant that people living at the home had not been provided with accommodation that was well maintained. The bedrooms had been attractively decorated and nicely furnished. This provided people living at the home with a comfortable and well-maintained private space where they could relax and receive visitors. The home was clean and hygienic. This meant that people using the service lived in a home that was clean and hygienic and which did not pose any health issues. EVIDENCE: New Ridley Road, 27-29 DS0000000613.V338242.R02.S.doc Version 5.2 Page 24 The premises provided a pleasant and safe place to live. A tour of the premises revealed no hazards. Peoples’ bedrooms were attractively decorated and furnished. There were no shared bedrooms. Staff had ensured that each bedroom was different and reflected the needs and personalities of the occupant. The layout and design of the home enabled people to live together in a domestic environment. Each side of the home had its own facilities, including kitchen, lounge and dining areas. The home was well lit, most areas were clean and tidy. There were no unpleasant odours. Staff had received training in the control of infection. Following a tour of the home, it was noted that: • • • • • • • • • Bedroom 1: the bedroom door did not fully close into its rebate due to catching on the carpet; Bedroom 2: the walls were marked and in need of redecoration; Bedrooms 3 and 4: the carpets were stained and looked grimy in places; Bathroom: a condemned chair had been placed at one side of the bath making it impossible for staff to gain access to the other side. The walls were marked and damaged. The back of the door was damaged; Kitchen: the surface of the deep fat fryer in one of the kitchens was very greasy as were the sides of the surrounding cupboards and walls; Doors, woodwork and corridor walls throughout the building were damaged and in a poor state of decoration; Bathroom: the door lock was broken; External areas: one of the fences at the back of the property and a gate were in a poor state of repair; Both lounges: the walls were marked and scuffed. The acting manager had already identified some of the above concerns and was already in the process of addressing the shortfalls. The home had been purpose built to meet the needs of the people living there. A range of specialist aids and equipment had been provided. For example: • • • • • Bathrooms had been fitted with grab rails; There were two mobile hoists to enable people to be safely lifted into the bath; A shower table and a shower commode had been installed in one of the bathrooms visited; There was a sit-on weighing scale which enabled staff to weigh those people who were unable to weight bear; Some people had been provided with their own adapted easy chair. But, in June 2006, an Occupational Therapist treating one of the people living at the home said that a specialist bed was needed to protect staff from injury whilst carrying out moving and handling tasks. The acting manager said that she would resolve this matter immediately following the inspection. New Ridley Road, 27-29 DS0000000613.V338242.R02.S.doc Version 5.2 Page 25 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Satisfactory arrangements were not in place to ensure that robust preemployment checks took place. This might mean that staff considered unsuitable to work with vulnerable people could be employed within the home. The arrangements for ensuring that staff regularly updated their training in key areas were unsatisfactory. This could mean that staff might not have the skills and knowledge required to meet peoples’ needs in a safe and professionals manner. A satisfactory programme of regular and structured staff supervision was not in place. This meant that staff were not properly supervised and their performance regularly appraised. EVIDENCE: New Ridley Road, 27-29 DS0000000613.V338242.R02.S.doc Version 5.2 Page 26 The provider had a recruitment and selection policy. A sample of staff personnel records was examined. For a member of staff appointed after April 2002, there was no documentary evidence available to confirm that: • • They had provided a full employment history. The home’s application form does not currently require applicants to provide a full employment history; Written references had been obtained. Also, in the sample of staff files examined at the local office, documentary evidence was not always available confirming that: • • • • Staff had been asked to declare whether they had any previous convictions and that they were mentally and physically fit to do the job for which they were employed; Staffs’ identity had been verified and an identification photo obtained; A satisfactory Criminal Records Bureau disclosure had been obtained; Staff had been given a copy of the General Social Care Council Code of Practice. A sample of rotas was checked and found to contain the required information. The acting manager said that the home’s staffing levels would be sufficient to meet the needs of the people living at the home once vacant posts had been filled. There was little use of agency staff. The turnover of staff since the last inspection had been low. Six of the thirteen staff employed at the home had obtained a relevant qualification in care and one member of staff was in the process of doing so. Staff that had completed a care qualification had covered equality and diversity issues as part of this training. Staff had up to date training in fire safety and first aid. But, some staff had not regularly updated their training in the following areas – moving and handling, basic food hygiene and infection control. At the time of the inspection the acting manager was in the process of taking action to resolve this concern. Staff had also completed more specialised training, which enabled them to meet the individual needs of people living at the home. For example, all staff had completed low vision training. Some staff had undertaken training in managing challenging behaviours, continence promotion and peoples’ specialised health care needs. None of the staff whose files were checked had received formal supervision during the last 12 months. Neither had staff undergone an annual appraisal. An up to date profile of staffs’ training needs was not in place. New Ridley Road, 27-29 DS0000000613.V338242.R02.S.doc Version 5.2 Page 27 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 41 and 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Satisfactory steps had not been taken to promote the health and well being of people living at the home. This meant that people lived in a home where health and safety concerns were not taken seriously. Arrangements for reviewing the quality of care provided at the home were not fully adequate. The views of people living at the home and relevant professionals had not been obtained. This means their views about the quality of the service did not inform any plans for developing the home. EVIDENCE: New Ridley Road, 27-29 DS0000000613.V338242.R02.S.doc Version 5.2 Page 28 Although there was no registered manager in place at the time of the inspection, the new provider had made temporary part time arrangements for the management of the home. The acting manager had obtained the Registered Manager’s Award and a National Vocational Qualification at Level 4 in Care. Ms Dunn had extensive experience of working in a residential setting with adults with learning disabilities and displayed the professional competence required to manage such a home. All of the people living at New Ridley Road had their money managed on a dayto-day basis by the home. Each person had their own separate purse in which their money was kept. Peoples’ money was securely stored. Two staff signatures had not always been obtained for money spent on behalf of people living at the home. Receipts had been obtained for money spent. Financial records did not show evidence of regular audits. Internal systems had been developed to monitor the quality of care provided in the home. For example: • • • A full quality assurance audit had been carried out in March 2006; Monitoring visits carried out by the provider had taken place on a regular basis; Quality questionnaires had been sent to peoples’ relatives in 2006. Generally positive responses were received. But, there was no evidence that other professionals having contact with the service, or staff, had been consulted about how well the home was meeting its objectives. The home did not have an annual development plan. A range of health and safety records was examined and there was an inspection of the premises. No hazards were identified during the inspection of the building. The home’s lifting and hoisting equipment had been serviced on two occasions in 2007. Generally, fire equipment had been serviced on a regular basis and faults had been addressed promptly. But, the following concerns were identified: • Some potential hazards had been assessed and control measures put in place to manage the risks identified. Some of these assessments had not been reviewed since 2002. Also, not all areas of potential risk had been assessed. For example, there was no risk assessment in place to prevent the spread of legionella within the home; Although a fire risk assessment had been completed, the format recommended by the Fire Authority had not been adopted. The required prevention checks had not always been completed. Staff had not received fire training, or participated in fire drills, at the frequency set down by the fire service. Regular checks had not been carried out to ensure that fire doors were operating properly. Fire doors throughout the building had been propped open using potholders, doorstops and DS0000000613.V338242.R02.S.doc Version 5.2 Page 29 • New Ridley Road, 27-29 • • • kitchen equipment. The acting manager took immediate action to resolve this problem and appropriate door closures have been ordered; The home did not have a current gas safety certificate. The manager took immediate action to address this concern; The home did not have a current periodic inspection report for its electrical installations; The previous provider had failed to replace a part on one of the home’s hoists following a maintenance report issued in June 2006 identifying this as a matter of concern. New Ridley Road, 27-29 DS0000000613.V338242.R02.S.doc Version 5.2 Page 30 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 Standard No Score 1 2 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 3 27 3 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 2 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 2 2 X LIFESTYLES Standard No Score 11 X 12 2 13 2 14 X 15 3 16 x 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 x 2 x 2 X 2 2 X New Ridley Road, 27-29 DS0000000613.V338242.R02.S.doc Version 5.2 Page 31 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&5 Timescale for action Ensure that the home’s 01/09/07 statement of purpose and service user guide are updated to reflect the change in provider as well as any changes made because of the transfer of ownership. Ensure that all staff receive 01/10/07 training in preparing and implementing Person Centred Plans (PCP). Ensure that a PCP is prepared 01/12/07 for each person living at the home. Involve (where appropriate) the following people in its preparation: • • • • The staff team; Family members; Friends; Other key professionals such as the person’s doctor or care manager. Requirement 2. YA6 15 3. YA6 YA7 15 The PCP devised should be in a format that can be understood by the person to whom it refers, wherever this is possible. New Ridley Road, 27-29 DS0000000613.V338242.R02.S.doc Version 5.2 Page 32 Each person’s PCP should set out how the home intends to: • • Help them retain contact with their family and friends; Meet their health care needs. Ensure that PCPs include clear outcome statements that show what the home hopes to achieve by implementing the PCP. 4. YA6 15 Ensure that the PCPs devised 01/03/08 are reviewed within the first three months to ensure that the plans put in place to meet peoples’ needs have been implemented. Ensure that each person’s PCP 01/12/07 addresses their communication support needs. Ensure that each member of staff receives appropriate training in how to communicate with people who have severe learning disabilities. (For guidance refer to the Foundation for People with Learning Disabilities Communication checklist – www.learningdisabilities.org.uk Also refer to: ‘See What I mean’ – British Institute of Learning Disabilities – www.bild.org.uk) 6. YA6 12 Use the PCP process to explore 01/09/07 what choices and decisions each person living at the home can make. Make arrangements for key 01/09/07 DS0000000613.V338242.R02.S.doc Version 5.2 Page 33 5 YA6 15 7. YA8 12(2)(3) New Ridley Road, 27-29 workers to establish, with specialist support and advice, the range of choices and decisions that each person living at the home is able to make. 8. YA9 13(4) Ensure that: • Each person has an up to date moving and handling risk assessment and management plan; All staff update their moving and handling training every 12 months; Staff are familiar with, and follow, each person’s moving and handling risk assessment and management plan. 01/09/07 • • 9. YA9 13(4) 10. YA9 13(4) Ensure that bedside rail risk 01/09/07 assessments address the areas set out in the latest advice issued by the Medicines and Healthcare Products Regulatory Agency. Ensure that staffing levels are 01/06/07 sufficient to ensure that people with profound support needs are not left unsupervised. 11. YA12 (The previous timescale for complying with this requirement expired on 31/10/06) 16(2)(m)(n) Ensure that: 01/12/07 • Staff are provided with training in how to provide stimulating activities for people with profound learning disabilities; Staff have access to the equipment and resources required to deliver each person’s activity plan. • New Ridley Road, 27-29 DS0000000613.V338242.R02.S.doc Version 5.2 Page 34 12. YA17 12 16(2)(i) Ensure that: • • The ‘MUST’ screening tool is used to assess peoples’ nutritional health; Peoples’ weight is checked on a regular basis and a record kept. 01/09/07 13. YA19 12 Ensure that: • People are given the opportunity to visit their dentist every six months and to receive optical care at least once every two years; Guidelines on the steps to be followed when administering enemas and emergency epilepsy medication are in place for each individual; The Occupational Therapy recommendation that one of the people living at the home be provided with a specialist bed is actioned; All staff complete training in promoting continence and caring for people with pressure area skin care needs. 01/09/07 • • • 14. YA20 13(2) Ensure that: • The home’s medication policy is updated to include guidance on the following areas: administering medication by specialised nursing techniques; medications requiring cold storage; handling medication alerts; Regular checks are made of the air temperature of 01/09/07 • New Ridley Road, 27-29 DS0000000613.V338242.R02.S.doc Version 5.2 Page 35 the room in which medications are kept. A written record should be kept. 15. YA23 13(6) Ensure that all staff are clear 01/09/07 about their safeguarding responsibilities under the Care Standards Act (2000), the Care Homes Regulations (2001), the provider’s safeguarding procedures and the Commission’s good practice guidance. Ensure that: 01/12/07 • • • • Bedroom 1: the bedroom door closes fully into its rebate; Bedroom 2: the walls are redecorated; Bedrooms 3 and 4: the carpets are either cleaned or replaced; Bathroom 1: the condemned chair is removed from the premises. Repair the damage to the walls and door and redecorate; Kitchen: the deep fat fryer and surrounding cupboards and walls are cleaned; The damage to the doors, woodwork and corridor walls is repaired. Redecorate as required. Repair the door lock; Bathroom 2: the door lock is repaired; External areas: the fence and garden gate are repaired. 16. YA24 23(2) • • • • 17. YA32 18 Ensure that 50 of the staff 01/01/08 team have obtained a relevant qualification in care. DS0000000613.V338242.R02.S.doc Version 5.2 Page 36 New Ridley Road, 27-29 18. YA34 Schedule 4 Ensure that, for all staff 01/09/07 appointed after April 2002, the following information is kept at the care home: • • A full employment history; Copies of two written references. Revise the home’s application form to ensure that it requests prospective applicants to provide a full employment history. 19. YA34 Schedule 2 Ensure that the following 01/09/07 information has been obtained for all staff employed in the home after April 2002: • An enhanced Criminal Records Bureau disclosure certificate. (The previous timescale for complying with this requirement expired on the 31/10/06); Verification of identity; An identification photograph; A signed statement confirming whether or not the applicant has any convictions; A signed statement that the applicant is physically and mentally fit to do their job. • • • • 20. YA35 18 Ensure that staff update their 01/09/07 statutory training in the following key areas: • • • • Moving and handling; Basic food hygiene; Infection control; Health and safety. Version 5.2 Page 37 New Ridley Road, 27-29 DS0000000613.V338242.R02.S.doc 21. YA36 18 Ensure that staff receive: • Supervision at the frequency set out in the National Minimum Standards; An annual appraisal. 01/01/08 • Ensure that a training needs analysis is completed for all staff and a written record kept. 22. YA37 9 Make arrangements for an 01/09/09 application to be submitted to the Commission to register a manager for the home Make arrangements to consult 01/09/08 with staff about their views regarding the conduct of the home, and the health and safety of people living at New Ridley Road. Prepare an annual development plan for the home. Ensure that: 01/08/07 • • • • Fire doors are checked at the frequency set down by the fire service; Staff participate in a minimum of two fire drills per year; Staff receive fire instruction every six months; The Fire Authority’s fire risk assessment documentation is used to record the home’s fire risk assessment; Fire doors are not propped open using inappropriate doorstops. 23. YA39 21 24. YA42 23(4) • New Ridley Road, 27-29 DS0000000613.V338242.R02.S.doc Version 5.2 Page 38 25. YA42 13(2) Ensure that: • • A gas safety certificate is obtained; A periodic inspection report for the home’s electrical installations is obtained. 01/07/07 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 YA2 YA6 Good Practice Recommendations The home’s statement of purpose should available in a range of different formats. be made A nationally recognised approach to person centred planning should be adopted for use within the home. Arrangements should be made to provide people with access to an independent advocate to assist in the development of their PCP. (Refer to: ‘The Watching Brief’ by Assist – advocacy guidance for people with high support needs or significant barriers to communication. Email: h.boon@bild.org.uk) YA6 4. 5. YA13 YA17 People living at the home should be provided with opportunities to use everyday community facilities. Review the Commission’s publication – ‘Highlight of the day’ – to establish whether any of the advice contained in this document could be used to improve the home’s dayto-day practice. DS0000000613.V338242.R02.S.doc Version 5.2 Page 39 New Ridley Road, 27-29 Staff should sit next to the person they are supporting to eat their meal. The home should consider how: • • • The person who requires assistance with artificial feeding could be helped to become part of each meal time; Meal times could be made more of a social occasion; To make their menus more accessible to people living at the home. The home’s menus should be amended to contain the recommended details. 6. YA20 All staff should read and sign the revised medication policy to confirm their understanding. The home’s medication cupboard should only used to store medication. An experienced pharmacist should be invited to review the home’s medication practices. 7. YA41 Two staff signatures should be obtained for every transaction involving money belonging to people living at the home. A record should be maintained of the audits carried out to ensure that peoples’ financial balance sheets are accurate. Receipts should be cross-referenced with entries made on financial balance sheets. New Ridley Road, 27-29 DS0000000613.V338242.R02.S.doc Version 5.2 Page 40 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V338242.R02.S.doc Version 5.2 Page 41 - 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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