Inspection on 22/05/06 for Northmead House

This inspection was carried out on 22nd May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Northmead House 19/07/07

Northmead House 20/12/05

Northmead House 18/08/05

Northmead House 23/11/04

Northmead House 25/06/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Northmead House 3 Northmead Puriton Bridgwater Somerset TA7 8DD Lead Inspector Sally Murphy Unannounced Inspection 22nd May 2006 09:15 Northmead House DS0000042169.V290515.R01.S.doc Version 5.1 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 Northmead House DS0000042169.V290515.R01.S.doc Version 5.1 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. Northmead House DS0000042169.V290515.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Northmead House Address 3 Northmead Puriton Bridgwater Somerset TA7 8DD 01823 423126 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) Somerset County Council (LD Services) Ms Clare Lois Marks Care Home 10 Category(ies) of Learning disability (0), Physical disability (0) registration, with number of places Northmead House DS0000042169.V290515.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Registered for up to 10 persons in category LD who may have a concurrent physical disability. Registered for respite care placements only. Date of last inspection 20th December 2005 Brief Description of the Service: Northmead House is a large detached house situated in the village of Puriton. The home provides respite care for adults who have a learning disability. Appropriate adaptations have been provided within the home to meet service users needs. There is an enclosed garden at the rear of the property. Northmead House is run by Social Services. Lorraine Hartley has recently been appointed as Manager, and is in the process of applying to become the Registered Manager for the home. The Responsible Individual for the service is Mr David Dick. Northmead House is registered with the Commission for Social Care Inspection to provide respite care for up to ten people who have a learning and those that also have a concurrent physical disability. Northmead House DS0000042169.V290515.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was completed as part of the planned programme of inspection. The inspection was unannounced and was completed by two Inspectors over one day. The previous inspection was announced, and was completed on 20th December 2005. On the day of the inspection there were five service users residing at the home. During the course of the visit service users, staff members and the Manager were spoken with. Care practice was also observed, records examined and a tour of the premises was made. What the service does well: What has improved since the last inspection? What they could do better: Northmead House DS0000042169.V290515.R01.S.doc Version 5.1 Page 6 Six requirements have been made as a result of this inspection. These relate the completion of food and fluid charts, storage of prescribed creams, environment issues within one service user room, staff training and the disposal of clinical waste. A requirement has also been made stating that the Manager submit an application to CSCI to become the Registered Manager for the home. 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. Northmead House DS0000042169.V290515.R01.S.doc Version 5.1 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 Northmead House DS0000042169.V290515.R01.S.doc Version 5.1 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, 2 & 3. Quality in this outcome area is good. Service users and their families are provided with relevant information regarding the home. Appropriate assessments are completed to ensure that the home will be able to meet service users’ needs. EVIDENCE: The home has a Statement of Purpose and Service User Guide that provide details of the services and facilities provided at Northmead House. The Service User Guide is also available in Somerset Total Communication. The home has an Admissions procedure. The Manager ensures that an assessment of need is completed prior to any service user receiving respite care at the home. Due to the nature of the service, the home sometimes receives emergency placements. Northmead House DS0000042169.V290515.R01.S.doc Version 5.1 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): 6, 7, 8, 9 & 10. Quality in this outcome area is good. The home has developed an appropriate care plan for each service user. Service users are encouraged to exercise choice and participate in all aspects of life within the home. Service users are supported in taking risks. Records relating to service users are stored securely and appropriately maintained. EVIDENCE: Care plans are maintained for each service user. Two care plans were examined in detail. Care plans included a photograph of the service user, and provided information regarding service users needs, daily routines and preferences. Individual risk assessments had been completed for each service user, including risk assessments relating to the use of bed rails, (where appropriate). Those care plans seen had been regularly reviewed and updated. The Manager plans to further develop care plans at the home. Northmead House DS0000042169.V290515.R01.S.doc Version 5.1 Page 10 Service users are encouraged to exercise choice, and independence is promoted. Service users spoken with stated that they enjoyed participating in tasks within the home, and that they are consulted regarding the meals and activities provided. The home operates a Key Team system to ensure that the home continues to meet the needs of each service user accessing the service. There is a notice board in the hallway displaying who will be on duty each day. Staff will support service users in managing their finances where required. Financial records were examined for two service users. All entries had supported by receipts and two staff signatures, and the monies held tallied with the records maintained. All records relating to service users are stored securely, and may be accessed by service users at their request. Northmead House DS0000042169.V290515.R01.S.doc Version 5.1 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): 11, 12, 13, 14, 15, 16 & 17. Quality in this outcome area is good. The home offers service users opportunities to engage with peers, access appropriate leisure activities, and exercise choice. Service users rights and responsibilities are respected. Service users are offered a choice of menu, and stated that they enjoyed the meals provided. EVIDENCE: Service users are supported in developing and maintaining daily living skills. Staff from the home will assist service users in continuing to access social and educational resources that they would normally attend, during periods of respite care. Northmead House DS0000042169.V290515.R01.S.doc Version 5.1 Page 12 On the day of the inspection, three service users were accessing day services. One service user went shopping with a staff member and a further service user returned home following a period of respite care. Staff spoken with confirmed that service users access local facilities including day centre, shops, supermarkets, and local church. Staffing levels are varied in response to service users needs, and daily routines. At present there is a limited range of in-house activities available. The Manager has advised that a donation of £300 has recently been received from the local church and that this will be used to purchase items such as a karaoke machine, disco lights and barbeque. The Manager also plans to install a pool table, and to further increase the range of social activities being offered at the home. As a respite service, staff have frequent contact with service users family members, when service users arrive and leave the home. Care plans provide details of service users personal and family relationships. Service users rights and responsibilities are respected. One care plan seen included a service user agreement, outlining their rights and wishes. Some service users accessing the service have an advocate. The home has a menu that provides a balanced and nutritious diet. Staff confirmed that they are aware of the likes and dislikes of service users. A food and fluid chart had been maintained for one service user, however on some occasions no entry had been made therefore it was not clear whether the meal had been refused, or the dietary intake not recorded. On the day of the inspection, breakfast time was relaxed and unhurried. Service users were supported with their choices and timing. The home has a file, which lists all service users snack preferences. The Manager advised that she plans to review the menu for evening meals so that service users who have received a cooked meal at lunchtime whilst at day services, will be able to choose a snack, should they prefer. Northmead House DS0000042169.V290515.R01.S.doc Version 5.1 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): 18, 19 & 20. Quality in this outcome area is good. Service users are provided with appropriate assistance to meet their personal care needs. The home supports service users in accessing healthcare services. The home has a medication policy. Medication Administration Records had been appropriately maintained. EVIDENCE: Service users are provided with support to undertake personal care tasks as required. The level and type of assistance is specified within their care plan. Service users receive assistance from a member of the same gender wherever possible. Staff support service users in accessing healthcare services and ensure that specialist advice is sought as necessary. Staff are provided with medication training. Due to the nature of the service provided, there are a number of admissions and discharges from the home. Northmead House DS0000042169.V290515.R01.S.doc Version 5.1 Page 14 This is an area which requires close attention, and staff have worked hard to ensure that clear records are maintained of all medication entering and leaving the home. Currently medication is stored securely in each service users’ room. This is under review and the home may choose to hold medication centrally. On the day on inspection an external cream was found within a bedroom that was being occupied, which belonged to a service user who had previously received respite care at the home. Medication Administration Records were examined for two service users, and each and been appropriately maintained. Northmead House DS0000042169.V290515.R01.S.doc Version 5.1 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): 22 & 23. Quality in this outcome area is adequate. The home has a complaints procedure and policy relating to the Protection of Vulnerable Adults. EVIDENCE: The home has a complaints procedure, which is also available in Somerset Total Communication. Information is also provided on the notice board regarding service users rights. There have been no complaints received by the home or CSCI since the last inspection. It is recommended that the home obtain a copy of the video produced by Somerset County Council, entitled ‘I want to make a complaint’, so that service users may be more aware of this procedure. The home should also develop a complaints and compliments log. The Inspectors saw a Thank You card received from one service user. The home has appropriate policies relating to the Protection of Vulnerable Adults and whistleblowing. Northmead House DS0000042169.V290515.R01.S.doc Version 5.1 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): 24, 25, 26, 27, 28, 29 & 30. Quality in this outcome area is good. The home has been decorated and furnished to a good standard. Appropriate adaptations have been provided. The home has sufficient communal areas and bathrooms to meet service users’ needs. The home was found to have a high standard of cleanliness. EVIDENCE: Northmead House is a large detached property situated within the village of Puriton. Service user accommodation is provided over two floors. A passenger lift is available. Communal space comprises of a lounge, quiet room, large dining room and kitchen. There is an enclosed garden at the rear of the property that is accessible to wheelchair users. Service user rooms are single occupancy, and all but one have en suite facilities. Rooms 1 & 2 on the ground floor have overhead hoists fitted. Service users rooms have been decorated to a good standard. Service users are able to bring possessions with them into the home. Northmead House DS0000042169.V290515.R01.S.doc Version 5.1 Page 17 There are two assisted bathrooms and one wet room at the home, and additional toilets close to communal areas. Since the last inspection, the staff sleeping-in room on the ground floor and one first floor service user room have been swiched uses. The Registered Person must ensure that the wardrobe is secured, radiator guarded and the room re-decorated before this room is occupied by a service user. During the tour of the premises it was also noted that the window in room 9 does not close properly, and that the fabric on the sofa has started to split and will require replacement within the re-furbishment programme for the home. The laundry and kitchen areas were clean and well organised. Appropriate hand washing facilities had been provided for staff throughout the home. The home had been maintained to a high standard of cleanliness. The Registered Person must review the procedure for disposing of incontinence pads to ensure that they comply fully with guidelines relating to clinical waste. Northmead House DS0000042169.V290515.R01.S.doc Version 5.1 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): 31, 32, 33, 34, 35 & 36. Quality in this outcome area is adequate. Staff are experienced and provide a good standard of care. Staffing levels are appropriate to meet service users’ needs. Staff have not been provided with regular opportunities to attend training. Staff receive appropriate support and supervision. EVIDENCE: Duty rotas are maintained. Staffing levels vary according to the number of service users receiving support and their dependency levels. The Manager advised that they plan to complete a staff training needs analysis, and develop a plan to meet these needs. During the examination of staff training records it was found that some staff required updated Food Hygiene training, and that further training was required in relation to the specialist needs of their service user group, such as the administration of rectal diazepam. Northmead House DS0000042169.V290515.R01.S.doc Version 5.1 Page 19 One staff recruitment file was examined which included evidence of a POVA First check and enhanced CRB disclosure being obtained. Staff spoken with confirmed that they had received appropriate support and regular supervision. Northmead House DS0000042169.V290515.R01.S.doc Version 5.1 Page 20 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, 38, 39, 40, 41, 42 & 43. Quality in this outcome area is good. The home is well run. There is a relaxed and open atmosphere within the home. Appropriate actions have been taken to promote the health and safety of staff and service users. EVIDENCE: Lorraine Hartley has recently been appointed as the Manager at Northmead House. At the time of the inspection she had only been in post for a period of six weeks. Lorraine has spent time reviewing practice, and plans to focus on the development of care plans, and staff training at the home. Staff and service users spoken with stated that the Manager was approachable, and that they felt listened to. Regulation 26 visits are conducted on a monthly basis. Northmead House DS0000042169.V290515.R01.S.doc Version 5.1 Page 21 The home has appropriate policies and procedures in place to safeguard vulnerable service users. All records relating to service users are stored securely in accordance with the Data Protection Act 1998. Somerset County Council provides appropriate Employers Liability insurance. Fire safety records were examined. Fire equipment is serviced and tested as required. There are notices displayed in each room in Somerset Total Communication that provide details of the actions to be taken in the event of a fire. All staff members had been provided with updated fire safety training. Equipment servicing records had been appropriately maintained. On the day of the inspection, one item within the fridge had not been dated, and was disposed of by a staff member. Hazardous substances had been stored securely and were not accessible to service users. Northmead House DS0000042169.V290515.R01.S.doc Version 5.1 Page 22 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 X 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 3 29 3 30 2 STAFFING Standard No Score 31 3 32 1 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 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 2 3 3 3 3 3 3 Northmead House DS0000042169.V290515.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA17 Regulation 17 (1) Sch 3 (m) Requirement Where food and fluid charts are in use, these must be completed in full to ensure that the service users’ nutritional intake may be appropriately examined. Timescale for action 23/06/06 2. YA20 13(2) Prescribed external creams 23/06/06 belonging to a service user, must not be available within another service users’ room. The Registered Person must ensure that the wardrobe is secured, radiator guarded and the room re-decorated before this room is occupied by a service user. The window in room 9 must be repaired to ensure that is closes fully. 21/07/06 3. YA24 13(4) (a) 4. YA30 16 (2) (k) The Registered Person should 18/08/06 review the procedure for disposing of incontinence pads to ensure that they comply fully with guidelines relating to clinical waste. A staff training needs analysis DS0000042169.V290515.R01.S.doc 5. YA32 18 (1) (c) 18/08/06 Page 24 Northmead House Version 5.1 must be completed, and a plan be developed to ensure that staff receive updated training in mandatory course, and specialist training, such as the administration of rectal diazepam which relate to the needs of their service user group. A copy of the training analysis and plan must be forwarded to CSCI. 6. YA37 8 (1) (a) The manager must submit an application to CSCI to become the Registered Manager for the home. 21/07/06 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 YA22 Good Practice Recommendations The home should obtain a copy of the video produced by Somerset County Council, entitled ‘I want to make a complaint’, so that service users may be more aware of this procedure. The home should develop and maintain a complaints log. Northmead House DS0000042169.V290515.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Northmead House DS0000042169.V290515.R01.S.doc Version 5.1 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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