CARE HOME ADULTS 18-65
Newby Drive Residential Care Home 63 & 64 Newby Drive Huyton Knowsley Merseyside L36 2QT Lead Inspector
Mrs Joanne Revie Unannounced Inspection 2nd November 2005 10:00 Newby Drive Residential Care Home DS0000021471.V263897.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 Newby Drive Residential Care Home DS0000021471.V263897.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. Newby Drive Residential Care Home DS0000021471.V263897.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Newby Drive Residential Care Home Address 63 & 64 Newby Drive Huyton Knowsley Merseyside L36 2QT 0151-489-3053 0151 290 0632 newbynewby@pss.org.uk 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) Personal Social Services Mrs Sharon Cooper Care Home 13 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (13) of places Newby Drive Residential Care Home DS0000021471.V263897.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Service users to include up to 13 MD Date of last inspection 21/01/05 Brief Description of the Service: Newby Drive is a detached house, which has been divided into four selfcontained flats. Each flat is run as a separate unit and is staffed 24 hours a day. Three of the flats cater for the needs of Service Users who have long-term mental health problems. The service aims to enable and empower its Service Users to participate in community life with the objective of an eventual move to more independent living. The Local Authority for respite care has purchased the two beds in the fourth flat for Service Users who are living in the community who also suffer from long term mental health problems. The home aims to support the Service Users in maintaining and in some cases raising levels of independence. The home is operated as a Shared Living Project and is owned by the organisation P.S.S. It is close to Huyton village, and is situated on a residential estate. The home blends in well to the local community as the building was originally built as a domestic dwelling. The service does not provide nursing or personal care. Newby Drive Residential Care Home DS0000021471.V263897.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This visit was unannounced. `Six service users were on holiday in Newquay. Discussions were held with the manager and three service users. A variety of documentation was viewed which is referred to in the evidence section of the report. What the service does well:
Service users receive a thorough assessment prior to admission to ensure that the service can meet their needs and that Newby Drive is a suitable place for them to live. Service users are encouraged to live independent lifestyles with staff support. Staff understand the service users needs and have clear documentation to refer to if they are unsure. Service users are encouraged to make decisions about their every day life either individually with a particular staff member (key worker system) or as a group through unit meetings. The meetings are mainly used to discuss progress and events within the home such as forthcoming trips out, arrangements for Christmas etc. One service user commented, “Its great here, staff are good, they help me loads”. Staff recognise the potential risks for each Service User, and they also recognise how these risks could impact on their life at Newby drive. Good structures have been developed to reduce risks with the involvement of the Service Users. Service Users are supported to make decisions about how they spend their time. All Service Users visit local shops, doctors etc either alone or with staff support. Planned activities are arranged for those Service Users who wish to take part. Examples of this are attending, pop concerts, theatre shows, races etc. Sometimes these are group activities and some times these are arranged at the request of a specific Service User Service Users are encouraged to take holidays way from the home with staff support. During summer some Service Users experienced a youth hostelling holiday. A further holiday is planned in the near future for those Service Users who didn’t want to go to Newquay.
Newby Drive Residential Care Home DS0000021471.V263897.R01.S.doc Version 5.0 Page 6 Family ties and friendships continue within Newby drive. One Service User discussed how they regularly visit family at home and have overnight stays- It was commented” I can do what I like, I’m free to come and go as I please, I’ve got me own room the way I like it, Its great ” ` Each flat holds a weekly meeting to discuss what to buy to eat for the forthcoming week and who will shop etc. Staff support Service Users to make healthy choices particularly for those who have dietary needs. Even though weekly menus are planned Service Users are free to change their mind if they feel like eating something different. Service Users do not receive personal care from the staff due to the ethos of independent living. However Service Users are supported to receive or visit health care professionals either on their own or with staff support. These include chiropodists, district nurses, G Ps, hospital consultants, etc Staff are quick to respond to changes in the Service Users physical and psychological needs. Strong links have been developed with outside agencies to enable this to happen. Those Service Users who wish to manage their own medication are supported to do so, however systems exist for staff to look after and administer medication for those who don’t. The organisation ensures staff are offered regular training, which is relevant to their role and the Service Users needs. Part of this training means that staff are able to uphold the Service Users rights and understand what to do if they suspect these rights have been ignored or abused. The building is well maintained and each flat has a dining, living space and kitchen. Each is furnished and decorated differently which helps to promote a homely atmosphere. Service Users take responsibility for keeping the flats clean although this is often with staff support. The organisation ensures that “deep” cleaning is performed periodically to reduce the risk of infection occurring. Some communal areas of some of the flats are non-smoking but this is at the request of Service Users. The service has a conservatory, which is used as a smoking lounge The service ensures that Health and Safety legislation is followed, reviewed and upheld by strong policies, regular reviews and maintenance of all equipment such as fire alarms, extinguishers, gas and electrical devices. This means that the home is a safe environment to live in. What has improved since the last inspection?
Requirements, which were issued following the last inspection, have been addressed. This means that clear procedures are in place for new admissions
Newby Drive Residential Care Home DS0000021471.V263897.R01.S.doc Version 5.0 Page 7 and contracts, which are issued, to Service Users have been improved. This means that Service Users are provided with full written information regarding their rights. Many areas of the environment have been improved as follows: New cookers being fitted in all flats; A bathroom is being converted to a walk in shower, as this is more suitable for the Service Users, who live in that particular flat, Plans have been implemented for two bedrooms to be redecorated – a Service User was deciding which colour scheme he would prefer. A window has been fitted to an upstairs landing so that the hallway has natural daylight Extractor fans have been fitted to all dining rooms so that cigarette smoke can be ventilated away from the room. The conservatory has new furniture The garden area has been greatly developed and Service Users have benefited from growing their own vegetables such as peppers, tomatoes and strawberries. Although not necessarily an improvement it was evident that levels of independence for several Service Users have progressed. This has promoted self worth and raised self-esteem. This has been further promoted by Service Users taking the responsibility to monitor Health and Safety routines within the flats (with staff support). Fire training has also been given to the Service Users so that they would have a good understanding of what to do should a fire occur. Medication is managed safely as staff are completing clear records. 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.
Newby Drive Residential Care Home DS0000021471.V263897.R01.S.doc Version 5.0 Page 8 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 Newby Drive Residential Care Home DS0000021471.V263897.R01.S.doc Version 5.0 Page 9 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): 3 The service ensures that it receives as much information as possible regarding a potential Service Users needs prior to admission taking place EVIDENCE: A discussion took place with the manager. Two Service Users plans were viewed. Copies of professional assessments from Community Psychiatric nurse and the homes own assessment documentation was viewed. All were found to be very clear and detailed. Newby Drive Residential Care Home DS0000021471.V263897.R01.S.doc Version 5.0 Page 10 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 Service Users are supported to live independent lives according to their individual needs. Service Users plans contain information, which enables staff to provide correct support. The management of risk is managed well by the service. EVIDENCE: A discussion was held with three Service Users and the manager. All confirmed that they are happy at the home and that staff support them to live their lives independently. Three plans viewed also reflected this. Copies of Unit meeting minutes showed that Service Users are involved in making decisions, which affect their everyday lives. Service Users plans were found to be clear, detailed and showed input from the Service Users. Regular reviews occur to ensure the information is up to date. Service Users are not always signing to say they have taken part in this process. Risk assessment documentation was viewed within the plans, which was individual to the Service User and gave specific guidance of how to reduce risks, which could exacerbate mental health problems and also risks that could occur during life at Newby Drive.
Newby Drive Residential Care Home DS0000021471.V263897.R01.S.doc Version 5.0 Page 11 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,17 The service supports Service Users to engage in activities that are chosen by them and are appropriate to their needs. Service Users are supported to choose, shop and prepare healthy meals according to their needs and abilities. EVIDENCE: A discussion took place with the manager, and three Service Users. Three Service Users plans and copies of minutes from Unit meetings were viewed. Service Users are encouraged to make preferred choices about how they spend their time. This is recorded in their plans of care. Group events are discussed at unit meetings. All Service Users are encouraged to access the local community either independently or with support. This includes using local public transport. Service Users receive visitors of their choice `as frequently or infrequently as they desire. Service Users are also supported to have overnight stays with families and friends. Newby Drive Residential Care Home DS0000021471.V263897.R01.S.doc Version 5.0 Page 12 Menu choices were also viewed. Discussions take place in each flat on a weekly basis. Service Users discuss and plan their menu for the forthcoming week. Those with dietary needs are supported by staff to make appropriate choices. Service Users are supported to shop and cook either independently or with support according to needs. Last minute changes of menus occur if the Service Users change their minds. Newby Drive Residential Care Home DS0000021471.V263897.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20 The service does not provide personal care. Staff are quick to respond to a Service Users health needs. Medications are managed safely EVIDENCE: Three care plans were viewed. Three discussions took place with Service Users. A discussion was held with the manager. Medication administration records and storage systems were viewed. Viewing care plans showed that staff respond quickly to changes in both physical and psychological needs of the Service Users and that their needs are regularly reviewed. Two Service Users spoken with confirmed this to be true Strong links have been developed with other Health Care professionals and staff make contact quickly if they require advice. Service Users are supported to visit health care professionals either independently or with staff support Medications are stored appropriately. Assessment tools have been developed for those service users who wish to retain their own medication. Staff have had training to administer medication to those who don’t. Each flat has its own medication cupboard. The medication administration records are stored on the office on the ground floor of the home. This was discussed with the manager. Newby Drive Residential Care Home DS0000021471.V263897.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Service users are protected from potential Abuse. Staff have the skills and knowledge to recognise when their rights have been ignored or abused. EVIDENCE: Training files were viewed and a discussion was held with the manager. All staff undertake abuse awareness training as a mandatory subject with two yearly refresher training taking place. The service has signed up to Knowsley’s Local guidelines on the Protection of Vulnerable People. The senior staff of the service have undertaken training so that they are aware of what to do should suspected abuse occur. Newby Drive Residential Care Home DS0000021471.V263897.R01.S.doc Version 5.0 Page 15 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 The home is comfortable, clean and well maintained EVIDENCE: All communal areas, kitchens and bathrooms in all flats were viewed. Improvements since the last visit were discussed with the manager. A discussion was held with one Service User who was deciding on a colour scheme for his bedroom. All areas were found to be clean and smelt pleasant. Newby Drive Residential Care Home DS0000021471.V263897.R01.S.doc Version 5.0 Page 16 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): 35 Staff have had appropriate training to ensure they have the skills to meet the needs of the Service Users. EVIDENCE: A copy of the training plan and staff training records were viewed. A discussion was held with the manager. Viewing the plan showed that staff have attended all mandatory training, plus extra subjects which are relevant to their role.’ Newby Drive Residential Care Home DS0000021471.V263897.R01.S.doc Version 5.0 Page 17 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): 42 The service, staff and Service Users all ensure that Health and Safety legislation is followed. EVIDENCE: Records relating to Health and Safety were viewed as follows: Recording of fridge temperatures, gas and electrical safety certificates, fire training log, contracts for maintaining fire fighting equipment, Portable appliance testing, maintenance of smoke detectors, accident records and testing of water temperatures. All were found to be current A tour of the environment was undertaken and no new risks were identified. A staff member takes responsibility for Health and Safety within the home. Each flat takes responsibility for its own Health and Safety with staff support. Newby Drive Residential Care Home DS0000021471.V263897.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score x 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 x 3 x Standard No 24 25 26 27 28 29 30
STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 x 15 3 16 x 17 Standard No 31 32 33 34 35 36 Score X X X X 3 x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Newby Drive Residential Care Home Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score X X X X X 3 x DS0000021471.V263897.R01.S.doc Version 5.0 Page 19 No 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. Standard Regulation Requirement Timescale for action 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 YA6 YA20 Good Practice Recommendations The manager should encourage all service users to sign all parts of the service user plan. The manager should consider storing medication records alongside the medication to be given Newby Drive Residential Care Home DS0000021471.V263897.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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