CARE HOME ADULTS 18-65
Newfield View 6/8 Gleadless Avenue Sheffield South Yorkshire S12 2QH Lead Inspector
Paula Loxley Unannounced 14 June 2005 13:00-17:45 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. Newfield View J55 S2988 Newfield V230016 140605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Newfield View Address 6/8 Gleadless Avenue Sheffield South Yorkshire S12 2QH 0114 281 0818 0114 281 0818 Newfieldview@hotmail.com Mrs Mandy Billard Mr Clifford Billard Mrs Mandy Billard PC Care home only 8 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) Category(ies) of LD Learning Disability registration, with number of places Newfield View J55 S2988 Newfield V230016 140605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 10 January 2005 Brief Description of the Service: The home is a large domestic style detached house located in an attractive residential area in the south east of the city, situated close to local amenities and public transport. Newfield View is currently registered to provide 24 hour care for 8 younger adults with a learning disability. The home consists of 6 single bedrooms and 1 double room and all rooms have been decorated and furnished to a high standard. Two bedrooms have en-suite facilities provided and each room has been individually personalised by the service user. Several areas of the home have recently been redecorated and refurbished to a high standard and this has ensured that the home is well maintained, welcoming and homely. During the last year a new heating and fire alarm system have been installed and the home has been completely rewired. Since the last inspection a porch has been built onto the front doorway and the driveway has been paved. There is a large, private and attractive rear garden and this is well stocked and maintained. A greenhouse,lighting, outdoor seating with sun parasols in addition to garden ornaments and potted plants had also been provided. Newfield View J55 S2988 Newfield V230016 140605 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place from 1:00 pm to 5:45 pm. As part of the inspection process seven service users and three staff, including the manager, were spoken to. A number of records were examined and several areas of the building were inspected. The inspector was pleased to note that throughout the inspection staff interacted positively and sensitively with each service user who were obviously comfortable and at ease in the company of staff. The inspector would like to thank service users, the manager and staff for their commitment to the inspection process. What the service does well:
The home is homely, friendly and welcoming. Service users said they loved living at the home where they were well cared for by staff whom they referred to as ‘their family’. All areas of the home were clean and well maintained to a high standard and service users had been consulted regarding any redecoration or refurbishment. Service users were able to visit the home for trial periods and full detailed assessments had been completed prior to their admission. Service users were only admitted once it had been determined that the home could meet their needs and that all service users currently living at the home were happy with the arrangements. Care plans were in the process of being redeveloped within a ‘Person Centred Plan’ (PCP) format and the manager and staff had attended training on these to support them with this process. Service users are actively involved in the development of their care plan and in the running of the home. Service user meetings were held regularly and service users confirmed that they were able to talk to the manager and staff whenever they wished if they had any ideas or concerns. The personal and health care needs of each individual had clearly been identified and the manager and staff had worked positively and proactively to ensure that they addressed these needs. All service users attended a wide variety of social and leisure activities and these were based very much on the personal preferences of each individual. Staff interacted well with each service user and it was obvious from discussions with service users that staff had developed positive and respectful relationships with them. Newfield View J55 S2988 Newfield V230016 140605 Stage 4.doc Version 1.30 Page 6 Newly recruited staff had completed detailed induction training and staff and service users had been involved in the recruitment and selection of new staff. Records were in the main well ordered and up to date and the manager was keen to ensure that any issues found were addressed. The manager and staff had completed a range of training courses and were committed to developing this further. Quality assurance systems were in place and the manager had completed regular internal audits of the service to ensure that the home were continuing to meet or exceed the standards. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Newfield View J55 S2988 Newfield V230016 140605 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Newfield View J55 S2988 Newfield V230016 140605 Stage 4.doc Version 1.30 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4 and 5. A detailed service user guide and statement of purpose had been produced and these clearly provided service users with the necessary information regarding the services and facilities provided by the home. Service users individual needs had been fully assessed prior to their admission, and they had moved into the home once it had been agreed that the home could meet their needs. Service users were able to have informal introductory visits to the home and at the time of their admission had been provided with a contract containing the relevant information. Newfield View J55 S2988 Newfield V230016 140605 Stage 4.doc Version 1.30 Page 9 EVIDENCE: The statement of purpose and service user guide had been updated and they contained all of the required information. Copies were available and the manager confirmed that they would be available in alternative formats should the service users request this. Both documents were explained and read out to service users on a regular basis. Detailed full needs assessments had been completed by the referring social worker for two service users recently admitted to the home. Their families had been involved in the assessment process as appropriate. The manager confirmed that service users were only admitted to the home once they were sure that they could meet their needs. Service users said that they had been involved in discussions regarding new admissions and had been able to give their views of how they got on with the individual concerned. Service users were able to visit the home for informal tea visits and overnight stays prior to their admission if they wished. Service users confirmed that this helped them to get to know everyone at the home and made them feel less anxious. Records checked confirmed that service users families had been very involved in decisions regarding the arrangements. An up to date contract/statement of terms and conditions had been provided to service users and signed copies were retained on individual files. These clearly detailed the fees, including any extra charges, and the services and facilities provided by the home. Newfield View J55 S2988 Newfield V230016 140605 Stage 4.doc Version 1.30 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 standard(s) 6, 7 and 8 Service users individual needs were regularly assessed and reviewed. Care plans were being updated within a ‘Person Centred Plan’ (PCP) format and as these had not been fully completed staff had not recorded all of the relevant information relating to each individuals goals and the action taken. Service users were encouraged and supported by staff to make decisions and they were provided with formal and informal opportunities to participate in the day-to-day running of the home. Newfield View J55 S2988 Newfield V230016 140605 Stage 4.doc Version 1.30 Page 11 EVIDENCE: Care plans were in the process of being updated to ensure that they covered all of the relevant sections and clearly detailed each individual’s needs and preferences relating to all aspects of their care. Service users were involved in this process and formal reviews had taken place, with service users, their families and social workers invited to attend. The new format once completed will include the individual’s aims and choices in relation to each aspect of their life. Care plans detailed the gender of staff that they wished to support them with their personal care. Service users were aware of their care plan and that they could have access to it when they wanted. Several daily recordings did not detail the support provided by staff to meet each individuals needs and as a consequence of this it could not always be confirmed that each individuals needs had been met. Service users said they thought the manager and staff listened to their views, ideas and concerns and that they could discuss these in service user meetings that were held every six weeks or individually with their key worker, care staff or the manager. The minutes confirmed they had talked about menus, holidays, outings, the home and new staff. They said they could talk to staff about anything and that staff were their family. Observations confirmed that staff were attentive and supportive and that positive relationships had been developed with each service user. The manager stated that they would also be included in their six monthly probationary review and service users said that they enjoyed being able to do this. Service users had completed questionnaires on their views of the service provided and these were available. Newfield View J55 S2988 Newfield V230016 140605 Stage 4.doc Version 1.30 Page 12 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) 11, 12, 13 and 16. Service users were able to maintain and develop their social, emotional, communication and independent living skills. Service users were provided with regular opportunities to engage in appropriate activities, based on their personal preferences. Service users had varied weekly activity programmes and all service users had developed and maintained links with their local community. The daily routines were flexible and promoted individual choice and independence. Newfield View J55 S2988 Newfield V230016 140605 Stage 4.doc Version 1.30 Page 13 EVIDENCE: Service users said that staff encouraged and supported them with their chosen activities in the home and in the local community. They stated that they could use public transport, which included the bus or the tram, or travel in the minibus provided by the home. All spoken to confirmed that staff encouraged them to be independent and that they helped with household chores including the preparation of meals and the cleaning of their rooms. The current daily activities included work placements at local charity facilities, attendance at college for creative arts, sport or drama, attendance at a number of local day centres, gardening, cookery, woodwork and needlework. Service users said they liked how they spent their time and if they wanted to do anything different they would discuss this with the manager or at their review meetings. Two service users were noticeably more positive and outgoing and this appeared to be because of their increased social and leisure activities. One service user said he was particularly enjoying his drama course at a local college and he was happy that staff had supported him with accessing and attending this. All service users said they could choose what they wanted to do and who they wished to spend time with whilst they were at the home. Staff observed were respectful and attentive to the needs of each individual with whom they had obviously developed positive relationships. Service users confirmed that they had a key for their own room and that they could entertain their visitors their if they wished. Newfield View J55 S2988 Newfield V230016 140605 Stage 4.doc Version 1.30 Page 14 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 and 19. Service users received individual personal support that promoted their privacy, dignity and independence. The healthcare needs of service users had been regularly assessed and reviewed and the appropriate action had been taken to ensure that needs were met and that each service user was supported as required. Procedures were in place to closely monitor the health and personal care of each service user. Newfield View J55 S2988 Newfield V230016 140605 Stage 4.doc Version 1.30 Page 15 EVIDENCE: Observations and discussions with service users and staff confirmed that each individual’s personal care needs had been identified and met. Preferences regarding personal care routines, and the gender of staff they wished to support them with this, had been recorded. Service users were well dressed and each had their own preferred choice of dress, hairstyle and appearance. Two service users said they enjoyed shopping for clothes and having their haircut. Any specialist equipment required had been provided and the levels of support required by each person had been regularly reviewed. This ensured that their needs in relation to dignity, choice and independence were met. Staff had provided advice and guidance to service users regarding healthy eating. One service user said she felt much better now she was eating healthy and she was proud of the weight she had lost and the clothes she could now wear. Measures were in place to ensure that any issues relating to weight, medication or other health problems were identified and dealt with as a priority. As a consequence of this one service user had their medication reduced and one had a full health check with the appropriate medical specialists. Discussions with the manager and records checked confirmed that any potential problems had been dealt with quickly and therefore all service users healthcare had been positively promoted. Service users said they were fit and well and were reassured by the support provided by staff with appointments and medical consultations. Newfield View J55 S2988 Newfield V230016 140605 Stage 4.doc Version 1.30 Page 16 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. The homes complaints procedure was clear, accessible and contained the necessary information. Staff had a good understanding of the procedure and timescales involved. Service users were aware that they could complain. The complaints record was available within the home. EVIDENCE: The complaints procedure was available for service users, their relatives and staff. The manager confirmed that this would be available in alternative formats should this be requested. Service users said that they knew that they could complain if they were not happy about anything and that they felt able to discuss any issues or concerns that they may have with the manager and staff. They confirmed that staff were always available and that they were encouraged to talk about anything that troubled them or caused them anxiety. Service user meetings were held regularly and minor issues were discussed, and the appropriate action taken, before the issues had chance to develop into more serious concerns. The complaints record confirmed that no complaints had been made during the last twelve months. Newfield View J55 S2988 Newfield V230016 140605 Stage 4.doc Version 1.30 Page 17 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 and 30. All areas of the home seen were clean, homely and comfortable and provided safe access for service users. Effective cleaning routines were in place and the home had the appropriate policies and procedures to ensure the control of infection. The registered providers were keen to ensure that the home was well maintained and could meet service users individual needs. The home is welcoming and attractively decorated and furnished. Newfield View J55 S2988 Newfield V230016 140605 Stage 4.doc Version 1.30 Page 18 EVIDENCE: Since the last inspection a porch had been built onto the front doorway of the home. The manager confirmed that once the internal decoration has been completed, service users will use this entrance to access the home. Service users said they were very happy with the extension and confirmed that they had been consulted regarding any changes or redecoration. Staff and service users had met to discuss the cleaning routines that were needed to ensure that the home was hygienic and well maintained. Service users helped with a variety of household tasks and they confirmed that they were able to choose which tasks they wished to help with and that staff supported them with this if required. All communal areas had been recently redecorated to a high standard and new settees had been provided for the dining conservatory. Service users said they could choose where they wished to spend their time and that they had enough room to do the things they wanted. CCTV cameras had been fitted to entrance areas as part of the homes security measures and service users confirmed that this made them feel safe at the home. Staff confirmed that all equipment was in good working order and that it had been serviced as required. Newfield View J55 S2988 Newfield V230016 140605 Stage 4.doc Version 1.30 Page 19 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, 34 and 35. Service users were effectively supported by care staff that had a range of skills and experience. The home had the appropriate recruitment policies and procedures in place although not all of the required information was available on one staff file and therefore the protection of service users could not be ensured. The home had a training and development plan and all staff had completed a range of training relevant to their role. Newfield View J55 S2988 Newfield V230016 140605 Stage 4.doc Version 1.30 Page 20 EVIDENCE: Staff were aware of the needs of individual service users and they confirmed that the homes communication systems enabled them to support service users. Staff files and discussions with the staff and the manager confirmed that all staff had completed detailed induction training. Staff were approachable and sensitive to the needs of service users and were able to communicate effectively with each person. Staff had completed training on NVQ in care and this had ensured that more than 50 of the staff team were qualified to level 2. The manager confirmed that staff were awaiting funding to commence training on level 3. Training records confirmed that since the last inspection staff had also completed training on fire safety, challenging behaviour, PCP’s and medication. Staff recruitment files checked were well-ordered and contained most of the required information. New staff were confirmed in post following receipt of two written references, a satisfactory CRB check at the enhanced level and a health declaration. Application forms, interview assessments, job descriptions and codes of conduct had been retained on staff files in addition to full details of induction and additional training. One staff file did not have the induction training sheets signed off and the educational and employment history on the application form was incomplete. As a consequence of this should there be any gaps in the CV these will not have been checked. Newfield View J55 S2988 Newfield V230016 140605 Stage 4.doc Version 1.30 Page 21 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 and 41. Service users benefited from a home that is well run by the registered manager. Service user surveys had been completed and service users had regular opportunities to discuss and feedback their views of the service provided by the home. Records were in the main up to date and well ordered to ensure the best interests of service users although minor omissions were noted on the staff rota and with service user finance records. Newfield View J55 S2988 Newfield V230016 140605 Stage 4.doc Version 1.30 Page 22 EVIDENCE: The registered manager has a wealth of experience of caring for people with a learning disability in a care setting. She has successfully completed the registered managers award and is due to commence NVQ level 4 training in care in the near future. Discussions confirmed that she is committed to further training for herself and all members of the staff team. The manager had a job description that clearly defined her roles and responsibilities and staff were aware of her role. She is committed to ensuring that the home maintains and develops their high standards of care, she had completed regular internal audits on all aspects of the service provided by the home. Service users confirmed that they could see the manager when they wished and they said that she was very approachable and supportive. Feedback was being sought on a regular basis from service users, their families and social workers and other professionals involved with each individual. The manager confirmed that their views via questionnaires would be available within the home. Records were securely stored as required and those checked were accurate and up to date and in good order. Staff and service users confirmed that they had access to the appropriate records as required. Staff rotas needed amending to include the start time of all shifts and service user finance records had not been signed by the manager to confirm that they had been audited. Newfield View J55 S2988 Newfield V230016 140605 Stage 4.doc Version 1.30 Page 23 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 4 3 4 3 3 Standard No 22 23
ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 2 4 4 x x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 3 4 3 x x 4 x Standard No 31 32 33 34 35 36 Score x 3 x 2 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Newfield View Score 3 4 x x Standard No 37 38 39 40 41 42 43 Score 2 x 4 x 2 x x J55 S2988 Newfield V230016 140605 Stage 4.doc Version 1.30 Page 24 Are there any outstanding requirements from the last inspection? NO 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 YA6 Regulation 17 Requirement Care plans must be fully completed to ensure that the individuals support needs and goals are clearly recorded. Daily recordings must include details of the support/assistance provided by staff to facilitate service users needs. Staff recruitment files must include all of the required information. Staff rotas must detail the start time of all shifts. The manager must sign to confirm that service users finance records have been audited. Timescale for action 30/09/05 2. YA6 17 30/09/05 3. 4. 5. YA34 YA41 YA41 19 17 17 31/07/05 31/07/05 31/07/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA37 Good Practice Recommendations The registered manager must complete NVQ level 4 training in management and care, or equivalent by 2005. Newfield View J55 S2988 Newfield V230016 140605 Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection Ground floor, Unit 3 Waterside Court Bold Street Sheffield, S9 2LR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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