Inspection on 20/09/05 for No. 1 Northbourne

This inspection was carried out on 20th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

No. 1 Northbourne 30/01/09

No. 1 Northbourne 31/08/07

No. 1 Northbourne 05/07/06

No. 1 Northbourne 02/12/04

No. 1 Northbourne 21/07/04

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 HOMES FOR OLDER PEOPLE No. 1 Northbourne Durham Road Low Fell Gateshead Tyne & Wear NE9 5AR Lead Inspector Mr Steve Tuck Unannounced Inspection 3:00 20 September 2005 th X10015.doc Version 1.40 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 No. 1 Northbourne DS0000007431.V250059.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 Older People. 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. No. 1 Northbourne DS0000007431.V250059.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service No. 1 Northbourne Address Durham Road Low Fell Gateshead Tyne & Wear NE9 5AR 0191 487 7242 0191 487 7242 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) Community Integrated Care Mr John Sutherland Care Home 5 Category(ies) of Learning disability (1), Learning disability over registration, with number 65 years of age (5), Physical disability over 65 of places years of age (3), Sensory Impairment over 65 years of age (1) No. 1 Northbourne DS0000007431.V250059.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th May 2005 Brief Description of the Service: Number 1 Northbourne can provide personal care for five people with a learning disability. However nursing care cannot be provided. The home is a purpose built bungalow attached to a care home for older people (Northbourne) but Number 1 Northbourne is run separately by Community Integrated Care although Anchor Trust owns the premises. It is easy for service users to get around the bungalow and all of the necessary facilities are provided including an emergency call system and a bathing and toilet facilities, which have been specifically designed to enable physically frail or disabled people to use them more easily. The home is situated in the Low Fell area of Gateshead and is close to the shops, main bus routes and other facilities. No. 1 Northbourne DS0000007431.V250059.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 4 hours and was a scheduled unannounced inspection. The inspection process involved spending time talking to a number of the people who live in the home as well as the manager and staff. A sample of records were examined including care plans and rotas. A tour of the building took place, which included all communal areas and a selection of service users bedrooms. The inspector was invited to join service users for tea and observations were made of the support the staff offered to service users at this time and throughout the day. The judgements made are based on the evidence available on the day of the inspection. What the service does well: The home supports service users to lead active stimulating and interesting lifestyles. Currently, the home has a competent manager who knows the service users well and is able to successfully direct and demonstrate to staff how service users are to be supported. His friendly approach makes him popular with service users and their families. Service users receive the support that they require from staff to ensure that their personal, physical and emotional health needs are met. Ongoing involvement of other healthcare staff ensures that service users receive the support they need to remain healthy, as they grow older. Service users can choose the food they eat and advice is available to ensure that service they have the opportunity to eat a healthy diet. No. 1 Northbourne DS0000007431.V250059.R01.S.doc Version 5.0 Page 6 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. No. 1 Northbourne DS0000007431.V250059.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection No. 1 Northbourne DS0000007431.V250059.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 A range of information is available which enables service users to make a fully informed choice about where they would like to live. Detailed assessment information is consistently available about perspective service users which confirms that the home can meet service users needs and helps staff to design care plans. EVIDENCE: Although there have bee no new admissions to the home since the last Inspection, there is a comprehensive Statement of Purpose available and a Service User Guide has been designed using images, which offers a range of information about the services that are provided. The manager confirmed that perspective service users are encouraged to visit the home prior to deciding on moving in permanently. Admission to the home is based upon an individual assessment being completed by both placing social worker and the manager and examination of case files confirmed that for all service users this had been completed. Assessments are reviewed every six months, involve service users families and social workers where these are available and also include details No. 1 Northbourne DS0000007431.V250059.R01.S.doc Version 5.0 Page 9 of agreed risk taking. Records indicate that service users and their representative are fully involved whilst carrying out the assessment and any limitations or restrictions are agreed and included in the terms and conditions of residence. Where service users have temporary admissions to hospital, the manager has demonstrated that before returning, an assessment is carried out to ensure that their needs can be met at the home. And these are reviewed should service users’ needs continue to change. No. 1 Northbourne DS0000007431.V250059.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 8 9 and 10 Staff at the home successfully support service users with their social, health and personal care needs in a way which treats them with respect and promotes their rights and privacy. EVIDENCE: A sample of individual care records was examined and accurately reflected the support, guidance and assistance that staff were offering to service users so that their needs and lifestyle aspirations can be met. The format of service user plans continues to be updated and developed to make them easier to understand and service users are involved in the recording of information about them by including terms such as ‘ my strengths’, ‘my needs’, ‘my risk’. Some service users needs are changing, which require a different approach or action to be developed so that they can be successfully supported and the manager is updating these areas to ensure that up to date information is available. This is particularly important where staff who are new to the home, may not be aware of service users personal history, preference or scope of needs. No. 1 Northbourne DS0000007431.V250059.R01.S.doc Version 5.0 Page 11 Risks including risks from falling are assessed and appropriate action to minimise these is taken. There are records of a good range of measures, which have been put in place to minimise the possibility of harm when service users are taking risks and these are known by all staff. All service users have particular healthcare needs and the manager has demonstrated that he can effectively ensure that these needs are met within the home and also by regularly involving healthcare specialists, for example community and district nursing services, general practitioners and specialist medical consultants. Medication records accurately match the numbers stored in the home and suitable administration practices take place. Staff were noted to carry out their duties in a friendly and respectful way, which forms part of the induction training process for all new staff and is constantly monitored by the manager who works alongside team members. No. 1 Northbourne DS0000007431.V250059.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above 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 14 and 15 Service users are encouraged and supported to lead active lifestyles based on their preferences and choices although for some people the lack of information about their finances may limit their choices. Friendships and relationships with people outside the home are encouraged. The meals provided offer a good balanced diet which contributes to the promotion of healthy eating and service users are involved menu planning. EVIDENCE: Service users have active lifestyles which are supported by staff at the home. Staff were noted encouraging service users to make decisions about opportunities available to them and service users discussed some of the opportunities they had taken up recently for example visits to relatives and days out throughout the summer months. One service user has a car which helps him to gain access a wide range of opportunities. Service users with specific interests are encouraged to pursue them, for example by visits to the cinema and historical sites. Also service users have their own weekly routines for example they are supported to visit their hairdresser or salon not only to style their hair but also to meet with friends. Staff are skilled at subtly supporting service users so that they are not disadvantaged by disability or frailty when taking part in activities. Some No. 1 Northbourne DS0000007431.V250059.R01.S.doc Version 5.0 Page 13 service users have regular contact with relatives, which the manager and staff support. Others have wider circles of friends and social contacts which may involve visits to other areas and this support is successfully co-ordinated by staff. Not all service users receive information about their payments to Community Integrated Care in a format that is suitable for them and would therefore find it difficult to be more involved in the management of their finances. Menus were available which confirmed that a good variety of meals and refreshments are provided to service users and observation at mealtime. Discussion held with service users confirmed that they enjoy the meals that are provided at the home. Where necessary and as identified in the individual assessment, special diets and food supplements are made available and as part of the ongoing process of monitoring health records of weight loss/gain are recorded in service users files. Staff joined service users at mealtimes to offer support and assistance where needed and this made the mealtime a relaxed, unhurried and sociable experience for service users. No. 1 Northbourne DS0000007431.V250059.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 17 and 18 Complaints in the home are handled objectively and openly with the manager and staff encouraging service users, their friends and families to offer comment on the services that are offered. Service users are confident that any complaints made would be acted upon. Robust procedures are in place, which should ensure that service users are protected from abuse. However insufficient staff have had training which could lead to abuse being undetected or unreported EVIDENCE: There have been no complaints about the home since the last inspection. However the manager continues to encourage service users to express their views and opinions about the service and can demonstrate instances where actions have been taken in response to service users preferences. All service users have a copy of the homes complaints procedure, which has been designed using images which makes it easier for service users to get their point across. Discussion with service users indicated that they had no complaints at present but would approach the manager if this occurred and felt confident that he would act on this immediately. When asked all service users indicated that they were happy with the support they receive at their home. All service users are enrolled on the electoral register so that they exercise their choices as citizens in deciding the local and national political leaders. Service users have access to independent peer, group and individual advocacy support and some have accessed these services previously. No. 1 Northbourne DS0000007431.V250059.R01.S.doc Version 5.0 Page 15 The service uses a set of procedures known as POVA (Protection of Vulnerable Adults) to offer protection to service users. Recent experience of the service has demonstrated that these procedures are in place but due to a high turnover of staff at the home, many have not received adequate training. No. 1 Northbourne DS0000007431.V250059.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 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 21 22 23 24 25 and 26 The home is clean, warm and well maintained offering service users a homely and safe environment in which to live. However this is to an extent compromised, as service users cannot control the temperature of the heating in the home. EVIDENCE: All rooms are big enough to meet the needs of service users and although none have en-suite facilities, toilets and bathrooms are near to rooms. Most communal areas and some of the service user bedrooms have been redecorated since the last inspection and a programme of routine maintenance and replacement is in operation. Service users are very proud of their rooms, which have been individually decorated and demonstrate their lifestyles, tastes and interests. New bedroom furniture has been purchased since the last inspection and there are records of regular maintenance and replacements. However two dining chairs are damaged. The home has well designed bathing facilities, which have been specifically designed to meet the needs of service users who currently live at the home. No. 1 Northbourne DS0000007431.V250059.R01.S.doc Version 5.0 Page 17 Hot water temperature was checked to ensure that it was safe for service users to use. The room temperature of the home cannot currently be controlled by staff or service users and planned remedial work has not taken place. Which would enable service users to control the heating in their communal and individual rooms. The staff have a successful cleaning regime and encourage service users to take part in keeping their own rooms clean although this is not compulsory. The home has a fully equipped laundry where systems are in place to ensure that clothes are hygienically cleaned. No. 1 Northbourne DS0000007431.V250059.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 28 29 and 30 Service users are not supported by a consistent and trained staff team who they know and have the knowledge and experience to meet their needs. Insufficient background checks are carried out before staff begin working with service users which therefore does not ensure that they are suitable to be employed. EVIDENCE: Observations made during the inspection and information from staff duty rota’s indicate that satisfactory levels of staffing are maintained and that these are sufficient to meet the needs of service users currently living at the home. However the home currently has two staff vacancies and the majority of staff are not permanently assigned to this home and therefore work irregularly there. This makes it difficult for service users to build positive relationships with the staff who support them and makes it difficult to ensure that the strategies in place to support service users are carried out consistently. Not all of the new staff have received adequate training and only 25 of the staff team have acquired NVQ level 2 in care. Current training plans will not ensure that sufficient staff have NVQ training. Staff recruitment records do not contain sufficient information which demonstrates that they are suitable to work at the home. No. 1 Northbourne DS0000007431.V250059.R01.S.doc Version 5.0 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 32 33 34 35 36 37 and 38 The manager offers clear leadership and direction to the staff team so that they can meet the needs of service users. However he is due to leave the service in the near future. Staff have support from the manager to ensure that they carry out their role effectively but they do not receive sufficient formal supervision to ensure that their care practice meets the needs of service users. Arrangements to ensure that the health safety and welfare of service users and staff are in place and are usually successful. EVIDENCE: The registered manger has considerable experience in a variety of care roles as well as five years’ management experience at this care home. He has completed NVQ in management at Level 4 and also has achieved awards in care practice and training / verification. The responsible individual has verbally informed the Commission that the No. 1 Northbourne DS0000007431.V250059.R01.S.doc Version 5.0 Page 20 manager is leaving within a few weeks of this inspection. Although instruction and support is available from the manager on a day-today basis, staff working at the home have not received sufficient one to one supervision, which would help to identify their training needs and develop their performance. The provider organisation is a not for profit organisation and there is information at the home which demonstrates that the organisation has appropriate financial resources and procedures in place which should enable the home to continue to operate for the benefit of service users. Although some information is now available for some service users about their financial contributions to the provider, it is not yet available to all. On the day of the inspection the home was free from any noticeable hazards. However insufficient fire instruction training had not been carried out so that service users and staff are protected in the event of a fire. No. 1 Northbourne DS0000007431.V250059.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 2 3 2 3 3 3 3 2 3 STAFFING Standard No Score 27 1 28 1 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 3 2 2 2 2 No. 1 Northbourne DS0000007431.V250059.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? Yes 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 OP35OP14 Regulation 12 and 17 Requirement The manager and responsible person must regularly supply account payment information to service users whose benefits they hold in a format, which is clear and understandable. (Previous timescale 1/2/05) The manager and responsible individual must ensure that all staff working at the home have received adequate training which enables them to take appropriate action should they suspect or actually witness abuse. Damaged dining room chairs must be replaced with seating which is suitable for service users. The manager must ensure that the level of heating in rooms may be controlled by service users. (Previous timescale1/2/05) The manager and responsible individual must ensure that a regular/ permanent team of staff is recruited at the home. The manager and responsible individual must take urgent DS0000007431.V250059.R01.S.doc Timescale for action 19/11/05 2 OP18 13 19/11/05 3 OP20 23 19/11/05 4 OP25 23 19/11/05 5 OP27 18 01/12/05 6 OP28 18 31/12/05 No. 1 Northbourne Version 5.0 Page 23 7 OP29OP37 19 8 OP30 18 9 OP31 8 steps to ensure that 50 of care staff have achieved NVQ at level 2. The manager and responsible individual must ensure that all staff have adequate checks carried out which demonstrate that they are suitable to be employed at the home, prior to commencing work. All staff must have appropriate training so that they have the skills on which to base their care practice. The responsible individual must inform the Commission in writing of the changes in management arrangements at the home. 19/10/05 31/12/05 07/11/05 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 OP7 Good Practice Recommendations Care planning arrangements should continue to be updated as service users’ needs change. No. 1 Northbourne DS0000007431.V250059.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection South of Tyne Area Office Baltic House Port of Tyne Tyne Dock South Shields NE34 9PT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI No. 1 Northbourne DS0000007431.V250059.R01.S.doc Version 5.0 Page 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!