Inspection on 01/02/06 for Northernhay

This inspection was carried out on 1st 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Northernhay 09/01/07

Northernhay 02/06/05

Northernhay 06/01/05

Northernhay 05/07/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Northernhay 11 Bickley Road Bromley Kent BR1 2ND Lead Inspector Lorraine Pumford Unannounced Inspection 14.00 1 February 2006 st Northernhay DS0000006958.V257000.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 Northernhay DS0000006958.V257000.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. Northernhay DS0000006958.V257000.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Northernhay Address 11 Bickley Road Bromley Kent BR1 2ND 020 8295 3757 020 8467 7211 infonorthernhay@aol.com 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) Bromley Autistic Trust Hayley Gilham Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Northernhay DS0000006958.V257000.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd June 2005 Brief Description of the Service: Northernhay is a large, detached Victorian house, which provides accommodation and care for six service users with autism. Hyde Housing Association owns the building and the service provider is Bromley Autistic Trust, which also employs the staff. The house is spacious and has private and communal facilities to meet the service users needs. It has a large enclosed back garden and some off street parking at the front. Northernhay is situated on a main road and bus route leading to Bromley town centre. For people with full mobility, it is within reasonable walking distance of a train station. Northernhay DS0000006958.V257000.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was undertaken by one inspector who was in the home for approximately 3.5 hours. During this time some records were examined and parts of the premises inspected. The manager, staff on duty and service users at home that afternoon also contributed information contained within this inspection report. All Registered Care Homes receive a minimum of two inspections within a 12 months period, as this inspection may not have covered all the “National Minimum Standards” on this occasion, should further information be required it is recommended that a copy of the last inspection report also be obtained. What the service does well: Service users are provided with a clean, comfortable environment suitably furnished to meet their needs. Service users are able to participate in household activities, as well as a number of social and leisure activities. Staff have a clear understanding of service users needs and the action required by them to meet their assessed needs. The home ensures service users receive support from appropriate health care professionals. Staff are given appropriate training to meet the needs of service users. The home has a clearly defined gender policy. The home operates an effective key worker system that provides appropriate support for service users. Northernhay DS0000006958.V257000.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. Northernhay DS0000006958.V257000.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 Northernhay DS0000006958.V257000.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): 1 The Service User Guide must set out clear and accessible information regarding any additional costs to be incurred by the service user. EVIDENCE: In discussion with the manager it was apparent that the issue raised at the previous inspection regarding the service users responsibility for additional costs, i.e. for the purchasing of towels, has still to be addressed. These additional costs must be included in the service users guide Northernhay DS0000006958.V257000.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 Service users right to make decisions is restricted by them not being actively encouraged to participate in managing their financial affairs. EVIDENCE: A sample of money held on behalf of service users was checked against the records and these accounts tallied. At present this information is recorded in a single ledger and staff have responsibly for decanting sums of money into envelopes for service users for specified daily activities i.e. day centres. The envelope or envelopes are handed to service users for that days activity. Discussion took place with the manager regarding developing service users independence and skills with money by each person having their own book to record money being deposited and withdrawn, this would also safeguard service users confidentiality with regards to their money. Depending on the individual service users ability this process would also include service users signing for money rather than staff signing the document on their behalf and handing out the envelopes. Northernhay DS0000006958.V257000.R01.S.doc Version 5.0 Page 10 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): 14,16 The daily routines and house rules help promote independence and individual choice. Service users are able to participate in a number of social and leisure activities. EVIDENCE: Service users have varied opportunities to participate in a range of leisure and social activities. Service users spoke enthusiastically of a forthcoming holiday, which has been arranged by staff. The home operates a key worker system. Staff spoken with were able to provide the inspector with a clear picture of the additional responsibilities this entails and the way in which they provide practical and psychological support to service users. Service users are able to choose if they wish to have a key to their own room, an appropriate lock has been provided for a service user who wanted a key to his room to ensure privacy, however also permits staff to access the room in the event of an emergency. Northernhay DS0000006958.V257000.R01.S.doc Version 5.0 Page 11 The manager stated that service users are responsible for participating in a number of household activities depending on their skills and ability. Discussion took place around the need for this information to be included in the homes Service User Guide. There is a system in place for service users who are able to collect their post unopened from the homes office. Staff assist service users who need assistance with this task. Service users are free to move around the house and grounds as they please, the manager stated service users who are able are encouraged to travel independently within the community and support and guidance is provided by staff when necessary. Northernhay DS0000006958.V257000.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 Personal support is offered in a way that respects residents dignity and privacy and promotes their independence. The health needs of the residents are identified and met, with evidence of multi-disciplinary working taking place regularly. EVIDENCE: Personal support is offered in a way in which residents dignity and privacy are respected and independence promoted. A member of staff spoken with was able to clearly indicate the way in which staff ensure privacy is maintained for service users. Residents are supported by staff to attend routine health care appointments. Health professionals provide specialist support to the home, including speech and language therapy, epilepsy specialist and psychiatric specialists from the Community Learning Disability team. The manager has been liaising with an epilepsy specialist regarding a more appropriate system of monitoring seizures than the present baby listening monitor which compromises service users privacy. Northernhay DS0000006958.V257000.R01.S.doc Version 5.0 Page 13 The relatives of a service user have asked staff to implement a weight loss programme. The manager stated that in the first instance she will prepare the diet sheet, however the community dietician will be involved in the preparation before the diet is implemented. Good interaction was seen between staff and service users. The home has a gender policy and the manager stated that the shift pattern ensured the male member of staff working in a home does not provide personal care to female service users. Staff stated that service users are encouraged to choose their own clothes with guidance provided by staff taking into account the time of year, weather etc. Service users that the inspector met with were comfortable and relaxed and wearing age appropriate clothing. Northernhay DS0000006958.V257000.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 The homes complaints procedure and adult protection policy protect staff and service users in the home. EVIDENCE: The home has a complaints procedure, which meets with the Care Home Regulations 2001. Staff spoken with were aware of the term whistleblowing and were aware of the Trusts policy in relation to this. The Trust has also developed procedures for the protection of vulnerable adults. During the course of the year no complaints have been made to the CSCI regarding the care and service provided at Northernhay. The issue of service users finances were discussed with the manager during the course of the inspection. At present all money due to service users is paid directly to the trust and held in a central account. Each service user receives a personal allowance of approximately twenty pounds per week. The trust retains the fees payable to them and any remainder of the service users benefits. Regulation 20 of the Care Homes Regulations 2001 states that service users money must be held in accounts in their individual names. Northernhay DS0000006958.V257000.R01.S.doc Version 5.0 Page 15 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): 24,28 Service users are provided with a clean, comfortable environment suitable furnished to meet their needs. EVIDENCE: Since the last inspection the lounge, downstairs WC and upstairs bathroom and a service users bedroom have benefited from a sustained programme of redecoration. There has been a change of use of one room, the room previously designated for private conversation is being turned into a bedroom for a service user who experienced difficulty in using the stairs, this change has also been agreed with the fire officer who confirmed the room fit for purpose. The manager is currently arranging quotes with a view to the room being provided with ensuite facilities. At present the communal telephone remains in situ in this new bedroom, this needs to be relocated to a more appropriate place, enabling service users to make and receive calls in private. Northernhay DS0000006958.V257000.R01.S.doc Version 5.0 Page 16 Further discussion took place regarding ensuring service users are provided with a room to meet with guests in private other than their bedroom. The manager stated that discussion was currently taking place regarding the possibility of a conservatory being added to the rear of the property, this would not only enable service users to have additional pleasant communal space but could also be used by service users to make phone calls and meet with guests in private. On the afternoon of the inspection a service users bedroom felt particularly cold, towels placed on the radiator remained damp and unaired, and discussion took place with the manager regarding the need for service users bedroom to be heated so that service users can spend time in their bedrooms in comfort. The manager turned the central heating thermostat up during the course of the inspection to re-dresses this issue. Northernhay DS0000006958.V257000.R01.S.doc Version 5.0 Page 17 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): 35,36 Staff are provided with relevant training to meet the needs of the service users and are provided with appropriate supervison. EVIDENCE: Staff spoken with provided details of training they have received in relation to providing care for service users with autism. Staff stated they felt they were provided with relevant and sufficient training opportunities for their personal development and to improve their knowledge and skills. The staffing matrix regarding training seen at the time of the inspection was out of date. The manager stated this document would be updated and a copy forwarded to the CSCI. Staff spoken with stated they receive regular supervision from senior staff and that the working atmosphere in the home was open and inclusive. Regular staff meetings are held and minutes from these were seen by the inspector. Staff felt their views were taken into consideration by the manager. Northernhay DS0000006958.V257000.R01.S.doc Version 5.0 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 There are relevant health and safety policies and procedures in place to safeguard service users and staff working in the home. The quality assurance mechanisms must be developed further and need to include a copy of the providers monthly audit being forwarded to the CSCI. EVIDENCE: Discussion took place with the manager regarding the need for quality assurance mechanisms carried out by herself to be developed further to comply with the requirement of Regulation 24 of the Care Homes Regulations 2001, this requires the registered person to establish with a view to improving, a system of reviewing the quality of care and service provided by the home. The manager was unable to recall if a monthly audit by a representative of the Trust had taken place recently. The last copy of the registered providers inspection was received by the CSCI in December 2005. These audits should be carried out each month with the findings forwarded to the CSCI. Northernhay DS0000006958.V257000.R01.S.doc Version 5.0 Page 19 The manager stated that the home receives regular visits from members of the service support committee, who provide feedback to the registered provider. Service users and relatives meet with staff informally throughout the year, which provides the opportunity for informal discussion regarding the service provided. There was no written evidence that the Trust had ascertained the views of the service users or their representatives, regarding the care and service provided. The quality assurance procedure should also ascertain the views of relevant health and social care professionals to enable the Trust to measure success in achieving its aims and objectives and to plan and develop the quality of the service provided. Staff spoken with stated they provided references, and CRB/ POVA checks had also taken place. Staff have been provided with job descriptions and a contract of employment. Staff stated they had received a formal induction when commencing work with The Bromley Autistic Trust and had received training specifically in relation to meeting the needs of service user with autism. Training had also been arranged regarding the administration of medication and food hygiene. All Staff hold a current first aid certificates. Records indicate that weekly checks to the fire alarm system take place, and staff receive regular fire safety training including the evacuation of the premises. The accident book was seen to be appropriately completed for both staff and service users. Northernhay DS0000006958.V257000.R01.S.doc Version 5.0 Page 20 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 2 X X X X Standard No 22 23 Score X 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 2 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X 2 X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 3 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X X X X 3 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Northernhay Score 3 3 X X Standard No 37 38 39 40 41 42 43 Score 3 X 2 X X 3 X DS0000006958.V257000.R01.S.doc Version 5.0 Page 21 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 Requirement Timescale for action 30/07/05 2 YA23 3 YA39 4 YA39 5 YA28 17(2)Sch4 Keep a copy of the homes .8 charges including any extra amounts payable by service users. 20(1)(a) The registered person shall not pay money belonging to any service user into a bank account and less (a) the account is in the name of the service user, or any of the service users, to which the money belongs (b)the account is not used by the registered person in connection with the carrying on all management of the care home. 24 The registered person shall establish and maintain a system for (a) for reviewing at appropriate intervals and (b) improving the quality of care provided in the care home. 26(5) (a) The registered provider shall supply a copy of the monthly report compiled to meet this regulation to the CSCI. 16(2)(b) the registered person shall having regard to the size of the care home and the number and needs of service users, provide telephone facilities which are DS0000006958.V257000.R01.S.doc 30/05/06 30/05/06 30/03/06 30/05/06 Northernhay Version 5.0 Page 22 suitable for the needs of service users, and make arrangements to enable service users to use such facilities in private. 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 2 Refer to Standard YA7 YA35 Good Practice Recommendations service users manage their own finances, where support and tuition are needed, the reason for, and manner, of support are documented and reviewed. A training needs assessment is carried out for all the staff team and an up-to-date record of staff training needs is maintained. Northernhay DS0000006958.V257000.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH 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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