Inspection on 09/01/07 for Northernhay

This inspection was carried out on 9th January 2007.

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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Northernhay 01/02/06

Northernhay 02/06/05

Northernhay 06/01/05

Northernhay 05/07/04

Similar services:

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Edenvale

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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 Ann Wiseman Unannounced Inspection 9 January 2007 1:30pm th Northernhay DS0000006958.V315485.R01.S.doc Version 5.2 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.V315485.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 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.V315485.R01.S.doc Version 5.2 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.V315485.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st February 2006 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.V315485.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and the Inspector arrived at 1.30pm shortly before the change of shift at 2pm. On arrival there was one care bank worker on duty and two Service Users at home. Because the manager was not on duty the on-call manager was contacted and within 15 minutes she arrived to make sure the Inspector had access to everything she needed, then left again due to a prior appointment. Shortly after that the afternoon staff arrived. The Inspector stayed until 6pm and was able to talk to all of the Service Users and three staff members and returned to the home at a later date to speak with the Manager and check files that only she had access to. On the second visit the Inspector meet one of the Service User’s Mother. Surveys were sent to Service User relatives and the all replies were positive. Northernhay is comfortable and homely and the atmosphere during the visit was calm and relaxed. Paperwork and records are of a high standard and the office is well organised. What the service does well: What has improved since the last inspection? All of the Requirements made at the previous Inspection have been met or are in the process of being met. The service has a comprehensive quality assurance policy that analyses the information received in detail and makes it available to Service Users and their families. The room where Service Users were able to use of the phone is still being used as a bedroom; cord free phones are now in use so that Service Users can still make phone calls privately. Northernhay DS0000006958.V315485.R01.S.doc Version 5.2 Page 6 Expected additional costs to the Service Users have been included on the licence agreement and care contract. 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.V315485.R01.S.doc Version 5.2 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.V315485.R01.S.doc Version 5.2 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): All of the above standards were examined during this visit. Quality in this outcome area is good. This judgment had been made using available evidence including a visit to this service. All prospective Service Users have their needs and aspirations assessed prior to their moving into the house. EVIDENCE: All six of the Service Users files were examined in detail on this occasion and evidence was seen that their needs and aspirations were assessed and continue to be reviewed. The home has the required policy and procedure in place regarding taking in new Service Users and the Manager has assured the Inspector that the required procedure will be followed with any new Service User that moves into Northanhay. Northernhay DS0000006958.V315485.R01.S.doc Version 5.2 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): All of this area was assessed during this Inspection. Quality in this outcome area is good. This judgment had been made using available evidence including a visit to this service. Service Users are supported to make decisions about their lives and are consulted on the running of the house and it’s daily life. Service Users are allowed to take risks as part of an independent lifestyle. EVIDENCE: The Inspector looked at the Service User files and found that the Care Plans were detailed and cover all aspects of their lives, each Service User has their needs and aspirations reassessed each year at a review meeting. Service Users are included in the reviews and sign them as well as the risk assessments and contracts. The service has Person Centred Plans that are well presented in a style that is easily read. Service Users are given opportunities to make decisions about their lives and day-to-day activities. Northernhay DS0000006958.V315485.R01.S.doc Version 5.2 Page 10 Group discussions are encouraged when a decision that will affect them all is needed and the house has user meetings regularly which are recorded and outcomes are actioned. Risk assessments are done in many areas of the Service Users lives and interventions put in place to enable the Service User to take risks as part of an independent likes. Service User files are stored in the office in a locked filing cabinet and are not left out for others to read. Northernhay DS0000006958.V315485.R01.S.doc Version 5.2 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 the following standard(s): All of the above standards were inspected on this occasion. Quality in this outcome area is good. This judgment had been made using available evidence including a visit to this service. Service Users have the opportunity to attend a day centre and to take part in appropriate leisure activities and engage in the local community. EVIDENCE: Service Users are given the opportunity to attend a day centre although two have chosen not to. Daytime activities are offered to those that stay at home. 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. One Service User who is hoping to live independently is being supported to develop independent living skills, there is s program derived by the Service User and staff with goals identified and progress recorded. He has written his own menu and cooks his own meal, timing it so he can eat with the other Service Users. Northernhay DS0000006958.V315485.R01.S.doc Version 5.2 Page 12 Service Users take part in the local community by shopping, eating out, and use public transport, some of the Service Users travel independently. Holidays are arranged annually and one Service User told the Inspector that he enjoyed planning and going on his holidays. Family contact is supported and encouraged, there is a family support group that meet together at the house, some of the Service Users visit their families homes for overnight and weekend stays. In discussion with staff is was evident that they understand the need to respect and uphold Service Users rights and that they support them to take responsibility for respecting others rights as well as their own. During the Inspection the evening meal was being prepared and it appeared and smelt appetising. The fridge and freezer contained ample quantities of food and the menus that are written in consultation with the Service Users were varied and interesting. An alternative meal is offered on request. Service users are able to choose if they wish to have a key to their own room, appropriate locks are used for those that want a key to ensure privacy, however they also permit staff to access the room in the event of an emergency. The manager stated that service users are responsible for participating in a number of household activities depending on their skills and ability. There is a system in place for service users who are able to collect their post unopened from the homes office. Staff help service users who need assistance with this task. Northernhay DS0000006958.V315485.R01.S.doc Version 5.2 Page 13 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): All of this area was judged during this visit. Quality in this outcome area is good. This judgment had been made using available evidence including a visit to this service. Care Plans detail personal needs, including preferences. All Service Users are registered with their local GP and medication is managed efficiently. EVIDENCE: Care Plans clearly show support needs and note preferences in the way the Service Users want to receive personal care. Evidence was noted in Service Users files that show they receive appropriate medical treatment; there are reports from doctors and hospital appointments and also reports from other health service professionals including speech and language therapy, epilepsy specialist and psychiatric specialists from the Community Learning Disability team. The medication is stored in a cabinet that is kept locked and is secured to the wall, the medication and records were examined and showed no mistakes or omissions. It was highlighted in the last Inspection that a baby listening monitor is used to enable staff the safeguard a Service Users with epilepsy, which compromises service users privacy. Northernhay DS0000006958.V315485.R01.S.doc Version 5.2 Page 14 The Manager undertook to investigate other alternatives. The baby monitor is still in place and this practice must not continue, there are many more appropriate ways that enable staff to monitor seizure activity and finding an alternative will be made a Requirement. Please see Requirement 1 Northernhay DS0000006958.V315485.R01.S.doc Version 5.2 Page 15 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): Both of these standards were examined during this Inspection. Quality in this outcome area is good. This judgment had been made using available evidence including a visit to this service. Complaint procedures are in place and required Protection of Vulnerable Adult Training is given. EVIDENCE: The home has a complaints procedure that meets required regulations. Staff spoken with were aware of the term whistle blowing and are also aware of the Trusts policy in relation to this. The Trust has developed procedures for the protection of vulnerable adults. The complaints procedure is posted in the front lobby and the complaints log was examined, it’s format meets requirement. No complaints have been made to the Commission regarding the care and service provided at Northernhay. The issue of service users finances were discussed with the manager at the last inspection. The practise of all monies due to Service Users being paid directly to the trust and held in a central account is still being used. 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. Bromley Autistic Trust has had difficulty setting up individual accounts for the Service Users who need assistance accessing their money as changes to banking regulations to discourage money laundering has made it almost imposable, the Trust is still searching for a way to comply with this regulation. The Requirement made on this issue at the last Inspection will be restated. Please see Requirement 2 Northernhay DS0000006958.V315485.R01.S.doc Version 5.2 Page 16 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 of these standards have been examined on this occasion. Quality in this outcome area is good. This judgment had been made using available evidence including a visit to this service. Northanhay has a homely aspect, it is furnished to a high standard and is comfortable, is clean and hygienic. EVIDENCE: The house is accessible, safe and well maintained and provides the Service Users with an environment that is homely. There are personal items, photos and ornaments around the home, the furniture is serviceable and comfortable looking and the decoration is in a modern, domestic style that the Service Users have helped to chose. The home has recently had some redecoration done and the curtains are still down in the dinning room, the Manager assured the Inspector that the carpet is going to be replaced in that area and new matching curtains will be bought once it has been done. The large rear garden is easily accessed from the house and is well maintained and attractively landscaped, there is a BBQ and garden furniture available to enable the Service Users to enjoy outside eating. Northernhay DS0000006958.V315485.R01.S.doc Version 5.2 Page 17 The building is maintained in a way that promotes a safe environment. The home is kept clean and hygienic by staff, there is a domestic staff member and there is also some input from the Service Users who are supported to keep their rooms clean and tidy. Northernhay DS0000006958.V315485.R01.S.doc Version 5.2 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): All of these standards have been Inspected during this visit. Quality in this outcome area is good. This judgment had been made using available evidence including a visit to this service. Service Users benefit from a staff team that is competent and effective, the homes recruitment policies and practices are in line with requirement. EVIDENCE: The Inspector was able to view staff records including training records; they reflected that the required recruitment practices were carried out. The home has a training plan and staff training needs are assessed, the last assessment was done in August 06. Training records indicate that the home offers a full and varied training program that includes Health and Safety, First Aid, basic Food Hygiene, Person Centred Planning, Moving and Handling, personal Awareness, Medication and Protection of Vulnerable Adults. The Manager and staff confirmed that supervision is offered regularly. Staff feel that the working atmosphere in the home was open and inclusive. Regular staff meetings are held and the inspector saw minutes from these. Staff felt the manager took their views into consideration in the running of the home. Northernhay DS0000006958.V315485.R01.S.doc Version 5.2 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): All of this area was assessed during this Inspection. Quality in this outcome area is good. This judgment had been made using available evidence including a visit to this service. The Service Users benefit from a home that is well run and can be confident that their views underpin the running of the home. Health and Safety safeguards are in place and checks are carried out regularly. EVIDENCE: The Registered Manager appears to be knowledgeable and able to run the home, she shows a good understanding of the Service Users and their needs. The ethos of the house is obviously geared toward empowering the Service User. The home is well organised and the Service Users benefit from the calm and supportive atmosphere generated by the Manager and staff. A sample of Health and Safety records were tested and found to be in order. This is a large house over three floors with a basement. The second floor has a fire escape protected by a second door that forms a small lobby. The fire Northernhay DS0000006958.V315485.R01.S.doc Version 5.2 Page 20 extinguisher in this area was not attached to the wall and could become trip hazard or be moved out of the area altogether, attention must be given to keeping the house safe so that it conforms with fire regulations. The fire extinguisher must be secured to the wall or kept on a stand designed for that purpose. Please see Requirement 3 The house gives annual quality assurance surveys to the Service Users, their families and also staff members. The information is collated in detail and the outcomes for each question is considered and compared with the previous years survey. 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. Policy and procedures that are to standard are in place and are reviewed regularly, they are stored in the office and are easily accessible to staff. Northernhay DS0000006958.V315485.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 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 Standard No Score 1 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 3 3 3 3 3 3 2 3 Northernhay DS0000006958.V315485.R01.S.doc Version 5.2 Page 22 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 YA19 Regulation 12 Requirement Timescale for action A baby listening monitor is used to enable staff the safeguard a 04/06/07 Service Users with epilepsy, which compromises service users privacy. This practice must not continue, there are many more appropriate ways that enable staff to monitor seizure activity. 20 of the Care Homes Regulations 2001 states that service users money must be held in accounts in their individual names The second floor has a fire escape protected by a second door that forms a small lobby. The fire extinguisher in this area was not attached to the wall and could become trip hazard or be moved out of the area altogether, attention must be given to keeping the house safe so that it conforms with fire regulations. The fire extinguisher must be secured to the wall or on a stand designed for that purpose. 04/06/07 2. YA23 20(1)(a) 3. YA42 13 04/06/07 Northernhay DS0000006958.V315485.R01.S.doc Version 5.2 Page 23 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 Northernhay DS0000006958.V315485.R01.S.doc Version 5.2 Page 24 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. Extracts may not be used or reproduced without the express permission of CSCI Northernhay DS0000006958.V315485.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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