Inspection on 24/02/06 for North View (21)

This inspection was carried out on 24th February 2006.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

North View (21) 13/07/09

North View (21) 14/07/08

North View (21) 28/06/07

North View (21) 11/07/06

North View (21) 16/09/05

North View (21) 02/09/04

North View (21) 21/05/04

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 HOME ADULTS 18-65 North View (21) Jarrow Tyne And Wear NE32 5JQ Lead Inspector Gillian McCabe Unannounced Inspection 24 th February 2006 10:00 North View (21) DS0000000259.V260689.R01.S.doc Version 5.0 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 North View (21) DS0000000259.V260689.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 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. North View (21) DS0000000259.V260689.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service North View (21) Address Jarrow Tyne And Wear NE32 5JQ 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) 0191 420 0125 0191 483 8857 www.unitedresponse.org.uk United Response Mrs Pauline Gallagher Care Home 6 Category(ies) of Learning disability (6), Physical disability (6) registration, with number of places North View (21) DS0000000259.V260689.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: 21 North View is a registered care home owned by United Response. It provides accommodation with personal care and support for up to six men and women aged between eighteen and sixty-five who have learning difficulties. Some service users may also be physically disabled or have a sensory impairment. Nursing care cannot be provided. The property is a detached purpose built two-storey house, which stands in its own grounds. It has an accessible garden and patio, and blends in well with neighbouring houses. It has six single bedrooms, all located on the ground floor, a shared living room and a separate dining room and newly refitted kitchen. Staff accommodation is on the first floor. Within walking distance of Jarrow town centre, the home is close to local shops, Churches, pubs and a range of leisure facilities. It enjoys very good public transport links. North View (21) DS0000000259.V260689.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 seven hours and thirty minutes during one full day, and was a scheduled unannounced inspection. As the inspection was unannounced the views of service users, relatives and other visitors to the home were not gathered before the inspection. The inspector met with all service users throughout the day, time was also spent with some service users observing their life in the home. The majority of service users were out at various places during the inspection. Time was spent speaking with four members of staff about the running of the home and the support and training they receive to enable them to do their jobs. Time was also spent with the manger discussing her role and the running of the home. As part of case tracking two service users files were read, service users contract/statement of terms and conditions, service users health records, activity plans, the homes menus, fire log records and the homes policies and procedures. A sample audit of the homes procedures for administering, storing, receiving and disposal of medications was carried out. A tour of the home was carried out looking at the standard of accommodation on offer and the plans for maintaining a safe living and working environment. What the service does well: What has improved since the last inspection? The manager has reviewed the homes medication systems for administration, receipt and disposal of medicines and now carries out a weekly audit of medication to ensure no mistakes are being made. The manager has successfully completed an NVQ Level IV Award in ‘Care’ North View (21) DS0000000259.V260689.R01.S.doc Version 5.0 Page 6 The manager has reviewed the homes fire risk assessment. 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 View (21) DS0000000259.V260689.R01.S.doc Version 5.0 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 North View (21) DS0000000259.V260689.R01.S.doc Version 5.0 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): The home does not at present have a completed statement of purpose that is accessible for service users at 21 North View. EVIDENCE: The home’s statement of purpose and service user guide has not at present been developed to include all of the information required by regulation. This is an outstanding requirement since May 2004. It is important that service users have access to this information as it informs people about the overall service provided, which will assist in helping individuals to decide if it’s the right place for them to live. The manager discussed and gave the inspector a sample of the statement of purpose that is currently being developed using written words and pictures. The type of information included in the new format includes details of how to make a complaint, details of support that is available and details of activities inside and outside the home. The manager has recently reviewed the way in which service user contracts are produced. The new contracts are being developed using written words and pictures. All service users should have a copy of the contract providing information regarding fees that may be payable for things like activities, transport costs, furnishings or holidays etc, as service users may not be aware of any additional costs due to them. Once the newly developed contracts have North View (21) DS0000000259.V260689.R01.S.doc Version 5.0 Page 9 been produced, they should be signed by service users, family members or an advocate to say that they agree with the terms and conditions of the home. North View (21) DS0000000259.V260689.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 Service Users assessed needs are reflected in individual support plans within individual plans of care however some areas of need, such as pressure care would benefit from a more detailed support plan. This would ensure consistency and clear guidance for members of staff. EVIDENCE: All service users have good individual support plans in place developed by the person’s key worker. As part of case tracking two service users files were looked at, and each plan showed a lot of detail and covered a broad range of a person’s care needs. Each plan highlights service users abilities, strengths and preferences, as well as areas of need. Staff confirmed that plans are regularly evaluated to reflect any changing needs, goals or aspirations. One person’s plan indicated that the person might need support from staff to monitor pressure areas however, a plan was not in place to show how this support would be given. It was clear from observations and discussion with staff that appropriate interventions are carried out to support service users. However these good practices are not always reflected in evaluations or reviews of care plans. It is North View (21) DS0000000259.V260689.R01.S.doc Version 5.0 Page 11 vital that information in support plans is specific to ensure the correct amount of support is always given. Service users plans are now reviewed on a regular basis. However some outcomes of reviews would benefit from being recorded more descriptively. Some evaluations were written in the same context. For example, ‘no change, continue with care plan’. North View (21) DS0000000259.V260689.R01.S.doc Version 5.0 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13,15,16 & 17 Service Users are assisted to lead fulfilling and active lifestyles by accessing a wide range of community facilities and having regular community presence. Service users receive healthy, nutritious and balanced meals in pleasant surroundings. All meals are prepared to meet the individual needs of each person. EVIDENCE: Service users are promoted and supported to follow their own lifestyles and maintain contacts with their friends. Friends and family members are encouraged to visit the home at any time throughout the day and service users will invite visitors to their own room or to communal living areas such as main lounge or dining area. The manager and staff encourage service users to develop and maintain appropriate friendships inside and outside the home. Service users are offered an excellent choice of home cooked, healthy and nutritious meals. Meals are served in the homes dining room, which is nicely decorated and benefits from plenty of space to enable staff and service users to sit together and enjoy their meals. North View (21) DS0000000259.V260689.R01.S.doc Version 5.0 Page 13 Staff and service users plan the homes menu on a weekly basis. Staff usually purchases shopping on a weekly basis, staff confirmed that some service users like to go to the supermarket to help with the weekly shop. The staff at North view also consider the recommended daily allowance of fruit and vegetables when planning meals as well as taking into account healthy eating options. The manager and staff have developed a food file with service users that contain pictures of meals and food items that are on the menu. This would benefit from being developed to include a wider range of pictures of food items, as this will assist service users who are unable to express themselves verbally, to choose meals they like. The manager and staff confirmed that mealtimes are flexible to suit individual lifestyles however people generally like to stick to the same routine and have breakfast, lunch and dinner around the same time each day. Snacks and refreshments are available at any time throughout the day and staff will support service users with any preparation that is required. Examples of main meals on the menu, Leek and potato pie with Gammon; Chicken Kiev, potato wedges and sweet corn. North View (21) DS0000000259.V260689.R01.S.doc Version 5.0 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19. Standard 20 assessed as a previous requirement. Service users have their personal care needs clearly outlined within their case files; health care needs are identified and suitable arrangements are in place to ensure they are promoted and met. EVIDENCE: All service users have physical and emotional health needs recorded and monitored by a ‘Health Action Plan’. These plans give details of where medical intervention may be needed or has happened previously. The plan gives details of health professionals involved in the person’s health care for example G.P’s, Dentists, Opticians, Chiropodist’s, Community Nurses and Specialist Consultants. Records of visits carried out to various health professionals are detailed, and up to date information regarding any health care the person is currently receiving is clearly recorded. The manager and staff confirmed that appointments would be made with various healthcare professionals when necessary and healthcare professionals would visit the home if requested. This ensures a persons health needs are regularly monitored. The last inspection highlighted some unsafe medication practices and the manager has reviewed the homes medication systems for administration, receipt and disposal of medicines. A sample audit of the homes procedures for administration, disposal and storage of medication was carried out. Records North View (21) DS0000000259.V260689.R01.S.doc Version 5.0 Page 15 were completed in full and signed appropriately. The manager now carries out a weekly audit of medication to ensure no mistakes are being made. North View (21) DS0000000259.V260689.R01.S.doc Version 5.0 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): All key standards assessed at previous inspection. Standard 23 assessed as a previous requirement. The home’s ‘whistle-blowing’ policy needs to be reviewed to ensure that all staff are made aware of the procedure they need to follow if they have any concerns about service user’s well being. EVIDENCE: All staff at North view have attended ‘Protection of Vulnerable Adult’ (POVA) training offered by South Tyneside Council. This ensures that staff are aware of the procedure to be followed if they have concerns about a persons well being. All staff are issued with guidance under the General Social Care Council code of Conduct upon commencement of post however, United Response’s ‘whistleblowing’ policy needs to be updated to notify staff that they must always report any bad practice, in line with their duty of care under the General Social Care Council (GSCC) code of conduct. The policy at present does not inform staff of the need to share information with the local authority adult protection co coordinator so thorough investigations can be carried out with all relevant professionals involved. North View (21) DS0000000259.V260689.R01.S.doc Version 5.0 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): All key standards assessed at previous inspection. 24 were inspected as a previous requirement. Service users live in comfortable and pleasant surroundings. EVIDENCE: Some minor repairs were highlighted at previous inspection. The lounge carpet needed cleaning and the thresh strip replacing. The manager has had the lounge carpet cleaned however the carpet is not meeting the needs of service users. The carpet has stretched but is unable to be refitted. The manager and staff have consulted with service users via service user meetings to discuss changing the carpet. A good quality laminate flooring is going to be purchased by the end of March 2006. North View (21) DS0000000259.V260689.R01.S.doc Version 5.0 Page 18 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 & 35 Members of staff receive regular training opportunities that ensure service users are appropriately supported and protected by competent and qualified members of staff. EVIDENCE: North View benefits from a stable and competent staff team who have a good knowledge of service users needs. All staff have completed mandatory training courses, including Infection Control, Fire Training however, the manager does not carry out three monthly and six monthly Fire safety and instruction training. The manager confirmed that all staff are trained in Safe Handling of Medicines, Equality and Diversity, Food Hygiene. The majority of support staff have completed NVQ in Level II and some have completed NVQ Level III. The manager confirmed that staff are regularly provided with training opportunities to help them to better understand the needs of service users at North View. North View (21) DS0000000259.V260689.R01.S.doc Version 5.0 Page 19 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): 39 & 42 The manager of the home is experienced and competent to run the home, which ensures service users rights and best interests are always promoted. Staff training and the homes policies aim to protect service users welfare, however the health and safety of service users is not always protected. EVIDENCE: The home’s manager Mrs Pauline Gallagher strives to provide good leadership and guidance to the staff team. She is always keen to develop her existing skills and share her knowledge and experience with the staff team. This ensures that service users are offered an excellent amount of care and support. She is well experienced to work at a senior level and has a Diploma in Management of Care Services and the Registered Manager’s Award, and has recently been successful in completion of an NVQ 4 in ‘Care’. Staff confirmed that the manager is very approachable and supportive and commented that they enjoy working at the home. Observations showed that the manager has established good relationships with the service users and staff at 21 Northview. North View (21) DS0000000259.V260689.R01.S.doc Version 5.0 Page 20 All staff have received statutory training in health & safety matters, including Fire Safety, Infection Control and Emergency First Aid however, three month and six month Fire Safety instructions are not carried out. It is vital that all staff receive three monthly and six monthly training in fire prevention and procedures to ensure the health, safety and welfare of residents and staff. The manager has recently liaised with the Fire Safety Team to assist with the development of a full fire risk for the home. Water temperatures in the kitchen and toilets were tested and measured in one instance to be 58 degrees centigrade, which is too high. Also measurements in one toilet were too low. An immediate requirement notice was issued to the Manager for these matter to be put right immediately. The manager contacted a plumber on the day of inspection and confirmed that these matters would be addressed the following day. The home has external agencies that carry out checks periodically on things like emergency lighting and fire extinguisher checks. This ensures that environment and pieces of equipment remain safe and intact. A service user survey is carried out on a yearly basis and the purpose of the questionnaire is to gather service users views about the home they live in and the service that is provided. Service users and their relatives are able to make suggestions about how the home and service might be improved. The information is gathered and analysed to determine areas of good or poor practice. The information is fed back to members of staff to highlight what they are doing well and also to look at ways of suggestions for improving the service where necessary. North View (21) DS0000000259.V260689.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 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 2 X X 2 Standard No 22 23 Score X 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X X LIFESTYLES Standard No Score 11 X 12 4 13 X 14 X 15 X 16 4 17 Standard No 31 32 33 34 35 36 Score X 3 X X 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 North View (21) Score X X 3 X Standard No 37 38 39 40 41 42 43 Score 3 X X X X 2 X DS0000000259.V260689.R01.S.doc Version 5.0 Page 22 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 YA1 Regulation 4&5Schedule 1 Requirement The statement of purpose and service user guide must be developed to include all of the information required by regulation. They must be made available to each person in a suitably accessible format TIMESCALE OF MAY 2004 NOT MET Timescale for action 30/06/06 2. YA1 17(2)Schedule Service user 4 contracts/statement of terms and conditions of placement must be revised to clearly show a breakdown of the home’s charges and what users can expect in return for their fees. United Response staff may not represent service users for the purpose of entering into contracts with the company. TIMESCALE OF MAY 2004 NOT MET 30/06/06 3. YA6 14(2)15 (2(b,c) Written evidence must be kept to show how each service users support-plan is evaluated and updated to DS0000000259.V260689.R01.S.doc 30/06/06 North View (21) Version 5.0 Page 23 reflect changing needs and circumstances. Risk management documents must be evaluated in the same way. TIMESCALE OF MAY 2004 NOT MET. 4. YA6 14(2)(b) The Registered Manager should further develop careplanning guidance in relation to pressure care needs of a specific service user. The home’s ‘whistle-blowing’ policy must be amended in line with GSCC code of conduct requirements. TIMESCALE OF FEBRUARY 2005 NOT MET. The lounge carpet requires refitting or replacing. The registered person must make adequate arrangements for staff to receive suitable training in fire prevention and to ensure by means of fire drills and practices at prescribed intervals that everyone is aware of the procedure to be followed in the case of a fire, including the procedure for saving life 30/05/06 5. YA23 13 (6) 30/05/06 6. 7 YA24 YA42 23 (2)(b) 13(4) 23 (4) 30/06/06 24/02/06 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 YA6 Good Practice Recommendations Following care plan reviews where ‘no change’ in a user’s DS0000000259.V260689.R01.S.doc Version 5.0 Page 24 North View (21) needs has been found and plans have remained the same, information should be recorded to evidence staff judgments. North View (21) DS0000000259.V260689.R01.S.doc Version 5.0 Page 25 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 North View (21) DS0000000259.V260689.R01.S.doc Version 5.0 Page 26 - 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!