Inspection on 19/07/05 for North House

This inspection was carried out on 19th July 2005.

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

Other inspections for this house

North House 06/09/06

North House 19/12/05

North House 04/10/04

North House 03/08/04

North House 19/02/04

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

CARE HOME ADULTS 18-65 North House 126-128 Northampton Road Market Harborough Leicestershire LE16 9LR Lead Inspector Keith Charlton Unannounced 19 July 2005 09:30 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. North House C51 C08 S1719 North House V233014 190705 Stage 2.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service North House Address 126-128 Northampton Road Market Harborough Leicestershire LE16 9LR 01858 432751 01858 466916 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) Mrs Willamina Vert, 128 Northampton Road, Market Harborough, Leicestershire, LE16 9LR Ms Linda-Marie McCoy CRH 12 Category(ies) of MD Mental Disorder - 12 places registration, with number of places North House C51 C08 S1719 North House V233014 190705 Stage 2.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: No Additional Conditions of Registration Date of last inspection 4th October 2004 Brief Description of the Service: North House is a 12-bedded residential home for people with mental health needs. The home has been open for 18 years and is situated within 10 minutes walking distance of the centre of Market Harborough. The home has ten single bedrooms and one double. One of the single bedrooms has ensuite facilities. There are two lounges (one smoking and one non-smoking), two dining rooms, and two kitchens (one of which is for service user training purposes). At the rear of the home is a conservatory, which looks out over the home’s gardens. North House C51 C08 S1719 North House V233014 190705 Stage 2.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced Inspection. The Home’s Registered Manager was on duty. Planning for the Inspection included reading the Pre-Inspection Questionnaire and a positive Comment Card returned by a Social Worker, which stated that, the care provided is good. There have been no recent complaints received regarding the home. The Inspection took place between 9.25 and 14.50 and included a tour of the building, inspection of records and direct and indirect observation of care practices. The Inspector spoke to eight residents, two members of staff and the Registered Manager. One resident stated, ‘‘Staff are friendly to me and have time if I have a problem. I could not be in a better home’’. What the service does well: What has improved since the last inspection? North House C51 C08 S1719 North House V233014 190705 Stage 2.doc Version 1.30 Page 6 A secure system for the storage of Service Users money has been established. Service Users records now include a photograph of the individual Service User. 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. North House C51 C08 S1719 North House V233014 190705 Stage 2.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 North House C51 C08 S1719 North House V233014 190705 Stage 2.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) These National Standards were assessed in the previous Inspection Report. EVIDENCE: - North House C51 C08 S1719 North House V233014 190705 Stage 2.doc Version 1.30 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 standard(s) 6,7,9 The Registered Manager promotes the individual needs and choices of service users. EVIDENCE: Of the two Service Users case tracked the care plans were seen to have been developed based on Social Work Care Management Assessments and assessments conducted by North House, which involved the Service User. These were seen to include aspects of personal, social and health care needs; Care plans had regular reviews every six months. A staff member spoken with said that care staff are asked to read service users Care Plans. Service Users said they had access to the care plans and that they were able to contribute to them. Service users are encouraged to make decisions and choices on a daily basis and are expected to maintain a level of independence in the home. For example, if they are capable, of washing and ironing, or making their own hot drinks. This was documented in the individual care plans. North House C51 C08 S1719 North House V233014 190705 Stage 2.doc Version 1.30 Page 10 Some service users were under the impression that they had to be up by 9.00am or they would miss breakfast and this is also the impression given by the Statement of Purpose. The Registered Manager said this was not the case and will arrange to speak to service users on a one to one basis to ascertain preferred times and then record this in the Care Plans. Service users said they could stay up late and watch TV if they wished, they could self medicate if they are safe to do so and they could have more baths or showers if they wanted. The Statement Of Purpose and Service User Guide informs Service Users of advocacy services. Risks associated with Service Users activities of daily living were also recorded and the Registered Manager said these were to be reviewed shortly as not all were relevant now – e.g. one Care Plan stated a risk in relation to a service user’s behaviour towards other service users which has not been an issue for some time. Assessments identified the hazard, the degree of risk and specified the action to be taken by staff to minimise the risk. North House C51 C08 S1719 North House V233014 190705 Stage 2.doc Version 1.30 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 standard(s) 17 The standard of the food provided to service users is high, and appreciated by them. EVIDENCE: All service users said that they thought the food was very good and that it was home cooked, ‘not out of a packet’. The cook was spoken to and she was very enthusiastic about her job of providing tasty food to service users. Lunch served was beef casserole, with potatoes and vegetables, followed by steamed lemon pudding with custard. This looked attractive and smelled very appetising. Dessert was tasted and found to be very tasty. Alternatives were said to be available by service users and the cook confirmed this. Food records showed a variety on foods. The Registered Manager is to arrange for the breakfast choice to be recorded. Service users asked said they did not want any other meals. One service user has chosen to go on a diet and the staff are supporting her to do this. North House C51 C08 S1719 North House V233014 190705 Stage 2.doc Version 1.30 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 standard(s) 19 Service users health care needs are met. EVIDENCE: Service users said that if they are not well the staff make sure they can see GPs. One service user said that he had been injured in the past but the staff were helping him make progress. Care plans indicated that Service Users were registered at a local health centre, registered with local dentists, visited by a chiropodist every six weeks and have annual eye checks from a visiting optician. One Service User was seen to have a specific medical condition, which in the main controlled by medication and the care plan now provides staff with sufficient information to manage the identified needs as required by the last Inspection Report. North House C51 C08 S1719 North House V233014 190705 Stage 2.doc Version 1.30 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 standard(s) 22 Service users feel that their concerns would be speedily acted upon. EVIDENCE: Service users are encouraged to raise any concerns they may have at Residents’ Meetings and North House has a system for recording and monitoring informal complaints. Service Users spoken to confirmed that they knew how to complain and would feel confident that their concerns would be taken seriously and actioned by staff. No formal complaints have been received by the home during the last twelve months. During the inspection, the homes formal complaints policy was viewed and generally found to meet the criteria listed under National Standard 22. However, exceptions included being totally clear of the right of the complainant to complain to the Commission for Social Care Inspection first rather than to the Registered Manager, and taking out the reference to the ombudsman which is not now relevant. The Registered Manager said this would be altered. North House C51 C08 S1719 North House V233014 190705 Stage 2.doc Version 1.30 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 standard(s) 24 Facilities are homely, clean and comfortable. The Registered Manager needs to ensure they are safe at all times as some fire doors were wedged open. EVIDENCE: Service Users spoken to confirmed that the premises were well maintained and comfortable and they were kept clean by staff and service users. A tour of the premises was conducted that included viewing the communal areas and the individual accommodation of the Service Users. The home comprises two sitting rooms, one smoking, one non-smoking, two dining areas and a conservatory. All were seen to be safe, comfortable, bright, cheerful, airy, clean and free from offensive odours. Furnishings, fittings, and equipment were seen to be domestic in nature. It was noted that at the end of landings on the first floor by service users bedrooms these areas were not well lit and it is therefore recommended that additional main lights be installed. There were wedged open fire doors to a lounge and the kitchen. The water temperature to a bath measured 49.2c – the National Standard is close to 43c. North House C51 C08 S1719 North House V233014 190705 Stage 2.doc Version 1.30 Page 15 There are no radiator covers to protect service users from scalding – the Registered Manager said that they were only currently needed for one service user on the ground floor so this service user ‘s bedroom and communal radiators on the ground floor need to have covers installed. North House C51 C08 S1719 North House V233014 190705 Stage 2.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,34 Staffing levels meet required standards. Service users need to be fully protected by the home’s recruitment practice. EVIDENCE: North House has a Registered Manager, a Senior Carer; eight care assistants, a cook and a maintenance man. The duty rota evidenced that two care staff are on duty during the day; two in the evening and at night there is one waking member of staff and another member of staff on call. Service Users spoken to during the inspection confirmed their satisfaction with the staffing arrangements at North House. Criminal Records Bureau checks are now sought by the Registered Manager though there was evidence that recruitment practices need to be tightened to ensure that before commencement staff must have two written references and a Protection of Vulnerable Adults First check. North House C51 C08 S1719 North House V233014 190705 Stage 2.doc Version 1.30 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 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) 40 Service users monies are securely kept. EVIDENCE: It is now the case that North House has established a secure system for the storage of Service Users money which only the Registered Manager and deputy Manager have access to. There are records of service users finances – the Registered Manager is to ensure that all transactions are sighed by a staff member and a service user or two staff members if service users refuse to sign. North House C51 C08 S1719 North House V233014 190705 Stage 2.doc Version 1.30 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x x Standard No 11 12 13 14 15 16 17 x x x x x x 4 Standard No 31 32 33 34 35 36 Score x x 3 2 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 North House Score x x x x Standard No 37 38 39 40 41 42 43 Score x x x 3 x x x C51 C08 S1719 North House V233014 190705 Stage 2.doc Version 1.30 Page 19 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 34 Regulation 18 Requirement Recruitment practices need to be tightened to ensure that before commencement staff must have two written references and a Protection of Vulnerable Adults First check. A service user ‘s bedroom and communal radiators on the ground floor need to have radiator covers installed. The water temperature to a bath measured 49.2c – the National Standard is close to 43c and this needs to be followed. Fire doors must not be wedged open unless they have approved devices installed. Timescale for action 19/7/05 2. 24 13 15/10/05 3. 24 13 15/7/05 4. 24 13 15/7/05 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 24 Good Practice Recommendations At the end of landings on the first floor by service users bedrooms these areas are not well lit and it is therefore recommended that additional main lights are installed. C51 C08 S1719 North House V233014 190705 Stage 2.doc Version 1.30 Page 20 North House Commission for Social Care Inspection Newland House, First Floor Campbell Square Northampton NN1 3EB 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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