Inspection on 05/07/06 for No. 1 Northbourne

This inspection was carried out on 5th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

No. 1 Northbourne 30/01/09

No. 1 Northbourne 31/08/07

No. 1 Northbourne 20/09/05

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 Sam Doku Key Unannounced Inspection 5th July 2006 10:00 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.V301677.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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.V301677.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service No. 1 Northbourne Address Durham Road Low Fell Gateshead Tyne & Wear NE9 5AR 0191 4914643 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) www.c-i-c.co.uk Community Integrated Care 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.V301677.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th September 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.V301677.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was a key inspection and was carried out in one day by one inspector. The inspection was unannounced and commenced at 10:08 a.m. and took place on the 5 July 2006. There are currently 4 people living in the home. The process of inspection involved: • A visit to the home to look at the day-to-day management and care provided. These included interviews with the acting manager, discussions with staff, discussions with service users, examination of care plans, risk assessments, staff files, fire safety records, medication systems and other health and safety records. There were discussions with individual service users to find out from them how they find the care that is provided in the home. There were discussions with the manager, and other staff and a tour of the building. • • Before the date of the inspection, survey questionnaires were sent to the service users. Two responses were received. The comments for the two respondents were very positive about the home and the care provided. The observations of staff practices and procedures, examination of documents and records and discussions with staff and management contributed to the inspection findings. The atmosphere in the home was friendly, relaxed and comfortable throughout the time of the inspection. Service users appeared cared for and comfortable with the staff. Service users were able to express their views to the inspector without staff presence. The interviews with service users, care staff and visitors showed that the care provided is of good standard. What the service does well: The home delivers a good quality service allowing service users to exercise a great deal of choice and independence. The staff are highly motivated and offer a service that is on the whole consistent with the expressed wishes of the service users. Service users have great deal of control over their lives. The staff support service users to lead active and fulfilling lifestyles. Service users engage in No. 1 Northbourne DS0000007431.V301677.R01.S.doc Version 5.2 Page 6 social and recreational activities of their choice. Service users regularly go into town to do their shopping and to engage in other social activities. The cultural and religious needs of the service users are fully met. The home encourages regular visits to the home by the local vicar. One service user is supported to attend church service at his local church on Sundays. The home provides extra staffing when the needs of the service users require extra staff input in order to meet specific care need. The staff are good at supporting service users to remain in touch with the friends from other establishments. 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.V301677.R01.S.doc Version 5.2 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.V301677.R01.S.doc Version 5.2 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): 3, 4,5. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Care practices promote individual aspirations, which have been assessed and identified through care plans with the individual’s involvement. This ensures full participation by the service users thus promoting choice and independence. The home supports and encourages pre-admission visits to the home by prospective service users and their relatives. This ensures that useful information about the home and the care that is provided is obtained at hand first hand during the visit. EVIDENCE: Full assessments have been carried out by the social worker and copies being made available to the manager before admissions are arranged. The home carries out their own assessments of the individual in their own setting to make sure Northbourne has the necessary skills and facilities to meet their need before offering a place. These arrangements ensure that the social No. 1 Northbourne DS0000007431.V301677.R01.S.doc Version 5.2 Page 9 worker, the home, the prospective service user and the relatives are confident that the home is able to support and care for the person before they move in. A visiting relative commented on these arrangements as good practice and that she found it helpful and made it easier for them to decide on the home as their preferred choice. In the most recent admission to the home, preadmission visits were arranged for the service user to see the place for herself and to meet the service users who currently reside in the home. This made the transition from one residential establishment to another less traumatic for her. No. 1 Northbourne DS0000007431.V301677.R01.S.doc Version 5.2 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, 10. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Care plans set out the care needs of each service user and suitable arrangements are in place which meet the service users social, emotional and physical healthcare needs of the service users. Service users are treated with respect and dignity which has enhanced their self confidence and self-esteem thus empowering them to determine the way they are looked after. EVIDENCE: The service users care plans set out their care needs and action plans for meeting their needs. The care plans are regularly reviewed updated to reflect changing care needs and for meeting them. Records show that the healthcare needs of the service users are fully met. The home continues to maintain record of contacts with healthcare professionals, including GPs, psychiatrist, chiropody service, dentist, optician and other healthcare services. Entries in the report books provide evidence that the No. 1 Northbourne DS0000007431.V301677.R01.S.doc Version 5.2 Page 11 home continues to engage the services of community nurses where necessary. This ensures that the service users rights to proper healthcare are being safeguarded by the home. Relatives and service users confirmed that their healthcare needs are met through the arrangements for them to have access to healthcare facilities. Service users confirmed that they are treated with respect and dignity. Practices observed during the inspection confirms the views held. This has created a sense of empowerment amongst the service users which was evident in the way that they interacted with the staff. There are suitable arrangements in place for the storage and administration of medicines in the home. All the senior staff have received appropriate training in the administration of medicines. The drugs administration system was examined and there were no discrepancies. This ensures that the health and welfare of the service users are promoted by the good drug administration system operated by the home. No. 1 Northbourne DS0000007431.V301677.R01.S.doc Version 5.2 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, 15. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. There is positive ethos amongst the staff group to involve the service users in community activities, thus giving them a sense of belonging, respect and some element of control over their lives. The home provides the care and support that allows the service users to maintain their way of life and to exercise choices. Service users are provided with varied and nutritious meals that meet their health and social needs. EVIDENCE: The care needs of the service users are clearly identified and methods of addressing those needs are stated. This ensures that all staff are aware of the care needs and follow the same care regime which ensures consistent service for the service users. There is evidence of service users’ religious and recreational needs being fully met thus meeting their religious and spiritual needs. Service users confirmed that they enjoy the activities organised for them, including visit to the home by the local vicar. No. 1 Northbourne DS0000007431.V301677.R01.S.doc Version 5.2 Page 13 Two service users commented on the opportunities available to them to visit the local shopping centre to shop for clothes and to go have meals out. Another service user commented on the arrangements to visit friends and to go to clubs at night where organised social activities are available. He also describe the current arrangements being made for him to travel abroad by plane. He described these arrangements as excellent and feels this has enhanced his quality of life. Two visiting relatives commented on the opportunities for service users to experience social outings and in-house social activities. One service user stated that the staff continue to support her to visit the local shops. A visiting relative and the local vicar stated that they are able to visit at anytime convenient to them and were very appreciative of this level of flexibility. Service users confirmed that the daily routines are organised flexibly to take account of individual likes and dislikes. Service users cited meal times and bed times as examples of such flexibility. The service users stated that although there are set times for meals, they can have their meals at separate times or in their room if they wish. This allows individuals to make positive choices about some aspects of their routines. Examination of past menus indicate that the home provides wholesome and nutritious meals for the service users thus promoting good health. The menus provide evidence of varied and nutritious meals. Service users were extremely complimentary of the food and confirmed that they are provided with good choice and that there is always plenty of food for them. Two service users stated that they are never disappointed with the food provided and there is always plenty to eat. No. 1 Northbourne DS0000007431.V301677.R01.S.doc Version 5.2 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, 18. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The company’s complaints procedure is robust and it is implemented by the home in a way that protects service users from abuse. EVIDENCE: The home has in place a satisfactory policy and procedural guidance on abuse and staff are aware of how to use the ‘Whistle Blowing’ policy should this become necessary. The Service User Guide and Statement of Purpose have summaries of the complaints procedure. These are also in pictorial form and copies are available to service users and their relatives, thereby providing the opportunity for them to complain if they wish. Service users confirmed that any concerns or complaints they may have would be treated seriously with the view to safeguarding their welfare. Suitable training on protection of vulnerable adults (POVA) has been provided for the staff working in the home. The staff who were spoken with showed good understanding of the POVA procedures and showed awareness of the need to protect service users from all forms of abuse. No. 1 Northbourne DS0000007431.V301677.R01.S.doc Version 5.2 Page 15 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, 26. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The home provides accommodation and equipment that meet the needs of the service users. The home is clean and maintained to good standard thus ensuring the welfare and safety of the people who live and work there. EVIDENCE: Northbourne is a home designed to accommodate a small group of older people, some of whom may have mobility problems. Access into and within the home is good and meets the needs of those service users who have mobility difficulties or have use of walking aids such zimmer frames or wheelchairs. There is specialist bathing facilities to promote independent use by those who are capable of doing so. All the bedrooms and toilets have suitable lock on the doors. This provided the opportunity for service users to remain independent and to enjoy good levels of privacy. No. 1 Northbourne DS0000007431.V301677.R01.S.doc Version 5.2 Page 16 The home is close to local shops, other amenities, and to local transport routes. Staff support service users to visit the local shops. Those service users who have had such support expressed their gratitude for the opportunity to continue to visit the local facilities. Window restrictors have been fixed to all windows and all radiators have suitable coverings which ensures security and safety for the service users. Checks of hot water at randomly selected bathrooms confirmed that hot water did not exceed 43°c. thus protecting the service from accidental injuries. The home has written policies and procedures relating to safe handling of hazardous materials for staff to follow. The manager indicated that staff have had training in health and safety, infection control and food hygiene but the training record show that most staff are due for refresher training in these areas. The home was noted to be clean and free from offensive odour. This enhances the self-esteem of the service users. The laundry machines have facilities for sluicing and washing foul linen at very high temperature to avoid the spread of infection. No. 1 Northbourne DS0000007431.V301677.R01.S.doc Version 5.2 Page 17 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, 30. Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. The dramatic reduction in the use of bank staff, has impacted positively on the service users and in the management of the home. The home maintains sufficient staffing levels to meet the needs of the service users. However, not all the staff have had the necessary mandatory training to better equip them for their role as carers. The good recruitment procedures in the home safeguard the safety and welfare of the service users. EVIDENCE: Past staff rotas showed staffing levels being consistently maintained. Staff confirmed that the home has maintained the appropriate staffing levels which ensure that care needs of the service users are met. Service users and relatives also indicated that there are always sufficient staff on duty to meet the needs of service users. The home continues to place emphasis on training the care staff to NVQ Level 2 or above. The manager confirmed that five out of the eight staff have NVQ level II. Staff who have had NVQ training spoke of how the training had boosted their confidence in their care practices for the benefit of the service users. No. 1 Northbourne DS0000007431.V301677.R01.S.doc Version 5.2 Page 18 Staff stated that they have had training in moving and handling, first aid, fire safety training, food hygiene, challenging behaviour management, falls prevention and protection of vulnerable adults awareness training. However, the pre-inspection information relating to staff training indicated that staff training in fire training, first aid, moving and handling, health and safety and infection control are not up to date. Staff need refresher training in these areas to promote the safety and welfare of the service users in their care. It was also noticed from the staff training records that induction training is not organised in a way that ensures accountability. It was not evident who the trainer/mentor was and the documentation was not signed or dated. The process which was meant to be done over a six months period were completed in a matter of days. Such practices undermine the competence of the staff which if not addressed would impact negatively on the quality of the care provided. Staff confirmed that individual supervision arrangements are taking place with staff but this is not at the frequency to meet the national minimum standard. The records of the most recently appointed staff were examined. These contained evidence of good recruitment procedures being followed. This ensures that the service users are protected from possible abuse from people who would be deemed as not suitable to work with vulnerable people. No. 1 Northbourne DS0000007431.V301677.R01.S.doc Version 5.2 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, 33, 35, 38. Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The management approach in the home is geared towards involving service users in most aspects of the running of the home and also in the way they are looked after. This has created a sense of empowerment with the service users and enhanced their self-esteem. The system for managing the service users monies is good and protects them from financial abuse. The detailed organisational policies and procedures health safety and welfare are adhered to by the staff which protects the welfare of the service users. EVIDENCE: No. 1 Northbourne DS0000007431.V301677.R01.S.doc Version 5.2 Page 20 A new manager has recently been appointed from her position as the previous acting manager of No. 1 Northbourne Care Home. The staff indicated that the new manager runs the service in a way that benefits the service users. They commented that she has positive relations with them and the service users. Similar comments were also made by service users and relatives. Details in the service users files indicate that the system for managing the personal allowances for service users is good. Receipts for purchases made on behalf of service users are available on individual files. Withdrawals or payments made on behalf of service users are counter-signed by the service users, their relatives or staff member. The company has produced detailed Health and Safety policies and copies of these were made available for inspection. These cover policy areas such as fire prevention and Care of Substances Hazardous to Health (COSHH). The records indicated that the staff have had training in food hygiene, fire precaution, moving and handling and first aid. This kind of training ensures that the staff maintain safe working practices which safeguard the safety and wellbeing of the service users. All portable appliances have been tested. All the servicing records that were examined were up to date. These included fire fighting equipments, servicing of hoists, water treatment, electrical installation and gas servicing. Up to date servicing and maintenance of these services and equipments ensure a safe environment for the service users and the staff who work there. No. 1 Northbourne DS0000007431.V301677.R01.S.doc Version 5.2 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 X X 3 3 3 N/A 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 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X 3 X X 3 No. 1 Northbourne DS0000007431.V301677.R01.S.doc Version 5.2 Page 22 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 OP28 Regulation 18(1)(a) Requirement All staff must have appropriate training so that they have the skills on which to base their care practice. All must received properly structured and executed induction training. Timescale for action 01/10/06 2 OP30 18(1)(c)(i ) 15/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations No. 1 Northbourne DS0000007431.V301677.R01.S.doc Version 5.2 Page 23 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.V301677.R01.S.doc Version 5.2 Page 24 - 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. 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