Inspection on 31/01/06 for Newsome Road

This inspection was carried out on 31st January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Newsome Road 15/10/08

Newsome Road 08/10/07

Newsome Road 14/02/07

Newsome Road 23/08/05

Newsome Road 02/11/04

Newsome Road 27/04/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Muston Road (70)

Grayling

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

CARE HOME ADULTS 18-65 Newsome Road 35&37 Newsome Road Newsome Huddersfield West Yorkshire HD4 6NH Lead Inspector Alison McCabe Unannounced Inspection 31st January 2006 3:30 Newsome Road DS0000026325.V271245.R01.S.doc Version 5.1 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 Newsome Road DS0000026325.V271245.R01.S.doc Version 5.1 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. Newsome Road DS0000026325.V271245.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Newsome Road Address 35&37 Newsome Road Newsome Huddersfield West Yorkshire HD4 6NH 01484 667866 01484 667747 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) Bridgewood Trust Limited Mr George Lockwood Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Newsome Road DS0000026325.V271245.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd August 2005 Brief Description of the Service: 35/37 Newsome Road is a care home providing accommodation and personal care for up to five younger adults with learning disabilities. It is run by the Bridgewood Trust, a voluntary organisation specialising in the care of people with learning disabilities. Yorkshire Housing Association owns the premises. The home is located in a residential area close to the centre of Huddersfield. It consists of two adjoining houses of the same style as those in the area. The houses provide accommodation for two service users and staff sleeping in room in one house, and accommodation for three service users in the adjoining house. Accommodation is provided on two floors in both houses. The premises have enclosed well-maintained gardens to the rear. Newsome Road DS0000026325.V271245.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted between 3.30pm and 7.30pm by one inspector. The inspector had the opportunity to meet with some service users, a support worker, the registered manager and residential services manager. The inspector had limited time with service users as most had chosen to spend time alone in their bedrooms after the evening meal. A sample of service user and staff records were examined as part of this inspection. The findings of the inspection are generally positive. Service users spoken to all reported being happy at the home and, when asked, did not report to have any concerns or complaints. What the service does well: What has improved since the last inspection? What they could do better: Individual care plans and risk assessments need to be more detailed so that staff are clear about how to meet service users’ needs and protect them from harm. Newsome Road DS0000026325.V271245.R01.S.doc Version 5.1 Page 6 For those service users who present challenging behaviour, there must be clear behavioural management plans so that staff have clear guidance about how best to support service users. The arrangement of staff working alone needs to be reviewed to ensure that all risks are considered and minimized where necessary. Staff need to be given the opportunity to attend more training to ensure they have the skills necessary for the job. The registered manager needs to continue making progress towards achieving the Registered Managers’ Award. 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. Newsome Road DS0000026325.V271245.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Newsome Road DS0000026325.V271245.R01.S.doc Version 5.1 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 the following standard(s): 2 Service users’ needs are assessed prior to them moving into the home. EVIDENCE: There have been no new admissions to this home since 1998. Those service user files that were examined contained community care assessments that were completed prior to service users being admitted. Newsome Road DS0000026325.V271245.R01.S.doc Version 5.1 Page 9 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 Individual care plans and risk assessments do not contain sufficient detail about identified needs and risks. Service users are supported to make decisions about their own lives. EVIDENCE: The Bridgewood Trust has introduced a revised care planning system that is due to be implemented in full by the end of February 2006. In preparation for this, all service users at Newsome Road have been involved in completing a personal support plan assessment with their keyworkers. This information will then be used to inform the new care plan. The manager reported that he anticipated meeting the implementation deadline set out by the provider. The care plans currently in place do not address the service users’ needs in all areas, and this will therefore be reassessed at the next inspection visit. Service users spoken to, and the manager, confirmed that service users are supported to make decisions about their lives. Examples include choosing where to go on holiday, choosing meals and activities. Information about advocacy services was available in the home. Newsome Road DS0000026325.V271245.R01.S.doc Version 5.1 Page 10 The manager reported that risk assessments would be reviewed as part of the new care planning system. It was noted that a number of identified risks relating to service users had not been assessed and steps to minimize risks had not been discussed or agreed. This was discussed with the manager and residential services manager at the time of inspection. It is positive that the manager and staff at the home encourage service users to live as independent a lifestyle as possible, however the home’s risk assessment and risk management strategies need to improve. A requirement has been made in respect of risk assessment. Newsome Road DS0000026325.V271245.R01.S.doc Version 5.1 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): 12,16 Good support is offered to service users to enable them to participate in valued and fulfilling activities. Service users’ rights are respected at this home. EVIDENCE: Service users are supported to participate in valued and fulfilling activities. Service users attend a range of educational facilities, work placements and day services. This is in addition to a busy leisure and social schedule. The staff team respects service users’ rights and responsibilities. Service users were observed to choose when to be alone or in the company of others. Service users have unrestricted access to all areas of their home with the exception of the staff sleeping in room. The manager was observed to encourage a service user to ring the doorbell before entering the adjoining house and to wait to be invited in before entering. Some service users have a key to the house having been assessed as able to manage this. Staff were observed to interact appropriately with service users. Newsome Road DS0000026325.V271245.R01.S.doc Version 5.1 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 Personal support plans do not contain sufficient information so that staff are clear about how to support service users. Service users are supported in having their healthcare needs met. EVIDENCE: Personal support plans are in the process of being developed for those service users who cannot easily communicate their needs and who require support in this area. Although the manager reported that service users can choose when to go to bed, get up, have meals etc, these activities are often less flexible due to planned activities, college placements or work. The manager reported that some service users require support in planning appropriate bed times, meal times etc, taking into account the planned activities for the evening or next day. There was evidence in the records examined that service users receive additional specialist support when required, for example, community nurse, psychologist, psychiatrist. All service users are registered with a GP and there was evidence in records that service users are supported to attend a range of healthcare appointments, for example dentist, hospital, GP and optician. The personal support plan assessments recently completed with service users includes healthcare needs and requirements. Newsome Road DS0000026325.V271245.R01.S.doc Version 5.1 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Service users are not always adequately protected from the risk of harm. EVIDENCE: A satisfactory adult protection procedure is in place and all staff have received training in this area. At the time of inspection, the inspector was notified of a recent incident where a service user had been hurt by a fellow service user. The inspector was concerned that no actions had been agreed to minimize the risks in future and communication between the staff team following the incident was reported by staff to be unsatisfactory. This issue was raised at the last inspection, and in order to protect service users, the manager must address this matter. The manager assured the inspector that risk assessments would be completed considering the recent incident, and that staff would be meeting in the near future to discuss behavioural management strategies. It was noted that a few days prior to the inspection, an agreed intervention had been implemented with a service user in an attempt to reduce episodes of challenging behaviour. In addition to this, staff need to have clear guidance about how to respond to incidents of challenging behaviour. This must be included as part of the individual service user plan. Newsome Road DS0000026325.V271245.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: Not assessed on this occasion. Newsome Road DS0000026325.V271245.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Service users are supported by a stable staff team, although a review of the staffing levels is necessary. Good recruitment practice is evident at this home. The staff team do not always receive adequate training. EVIDENCE: There have been no changes in the staff team at this home since the last inspection. There has been no turnover in staff for several years and agency staff are not used. The staff team is made up of the registered manager and two support staff; staff work alone for the majority of the time. Some concerns were raised during the inspection about lone working. Recently one staff member was supporting four service users in the community when an incident occurred resulting in the staff member phoning for additional support from the area manager. Whilst effective back up systems were implemented, the staffing levels need to be reviewed in light of this incident. This was discussed with the manager and residential services manager at the time of inspection and a recommendation has been made in respect of this. As the staff have all worked at the home for several years, they have a good knowledge and understanding of the service users’ needs; good communication with service users was evident. Regular staff meetings take place and minutes of these meetings are kept. Newsome Road DS0000026325.V271245.R01.S.doc Version 5.1 Page 16 Staff recruitment records were examined as part of this inspection and were found to contain the required documentation. Staff training records were examined and it was noted that staff had received very little training in 2004 or 2005. None of the staff had received the recommended five training and development days. The manager explained that some of the training had been cancelled for various reasons; this was reflected in the records. It was noted that several areas of training had been received years’ previously, for example, the last movement and handling and protection training a staff member had received was in the summer of 2003. It is essential that staff receive regular training to ensure that they are aware of changes in legislation and current good practice. It was recommended at the last inspection that staff receive training in autistic spectrum disorder as this is relevant to some service users living at the home. This has not been received although the manager reported that it was imminent. The manager explained that he had completed emergency aid training in July 2005, however there was no evidence in the records to confirm this; records of training need to be kept up to date. One staff member has completed the LDAF induction and foundation and one staff member and the manager are qualified to NVQ level two in care. Newsome Road DS0000026325.V271245.R01.S.doc Version 5.1 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): 37,42 Service users live in a well run home. Although the registered manager does not have the required qualifications, he is working towards achieving this. Service users’ and staff safety is not always protected in all areas. EVIDENCE: The registered manager is qualified to NVQ level two in care and is currently working towards the Registered Managers’ Award. Progress in achieving this award has been very slow with only three units signed off in eighteen months; this is due to a number of unforeseen circumstances. The registered manager must continue working towards this award to achieve it as soon as possible. It is essential that the manager also undertakes periodic training and development in order to update and maintain knowledge and skills; a record of training should be kept. Records regarding health and safety matters were in good order. There was evidence in the records that the required checks and maintenance of safety equipment is carried out. The fire alarm is tested weekly as required, and staff Newsome Road DS0000026325.V271245.R01.S.doc Version 5.1 Page 18 are now recording which point has been tested as required at the last inspection. As previously discussed in this report, a review of staffing levels is necessary to consider the safety of service users and staff and the development of clear strategies is necessary to enable staff to safely and effectively manage potential incidents of challenging behaviour; this should be completed as part of the service users’ care plans and risk assessments. Newsome Road DS0000026325.V271245.R01.S.doc Version 5.1 Page 19 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 X 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 X 23 1 ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 1 3 X 1 X LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 X 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 1 3 X X 2 X X X X 1 X Newsome Road DS0000026325.V271245.R01.S.doc Version 5.1 Page 20 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 YA6 YA18 Regulation 15 1 2 bcd 12(1)(b) Requirement A current individual care plan that includes personal support plans must be in place for all service users accommodated at the home. This must be kept under review. Identified risks to service users must be assessed and appropriate action taken to minimize identified risks. Agreed behavioural management strategies must be developed and implemented where necessary. Timescale for action 28/02/06 2 YA9YA42 13(4) 28/02/06 3 YA23YA42 13(6) 28/02/06 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 YA32 Good Practice Recommendations A review of staffing levels should be conducted considering the current needs of the service users. DS0000026325.V271245.R01.S.doc Version 5.1 Page 21 Newsome Road 2 YA35 All staff should receive a minimum of five days training per year. It is recommended that all staff receive training in Autistic Spectrum Disorder. Newsome Road DS0000026325.V271245.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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