CARE HOME ADULTS 18-65
Old Park Road Respite Unit 51 Old Park Road Greengates Bradford BD10 9BG Lead Inspector
Liz Cuddington Key Unannounced Inspection 2nd March 2007 14:40 Old Park Road Respite Unit DS0000046751.V323074.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 Old Park Road Respite Unit DS0000046751.V323074.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. Old Park Road Respite Unit DS0000046751.V323074.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Old Park Road Respite Unit Address 51 Old Park Road Greengates Bradford BD10 9BG 01274 481161 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) Bradford District NHS Care Trust Miss Janet Bosomworth Care Home 6 Category(ies) of Dementia (6), Learning disability (6), Physical registration, with number disability (6), Sensory impairment (6) of places Old Park Road Respite Unit DS0000046751.V323074.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 14th February 2006 Brief Description of the Service: Old Park Road is a Bradford District NHS Care Trust home, situated in the Greengates area of Bradford. The home provides respite care for up to 6 adults at a time who have learning disabilities. There are around forty people who currently use the service. There are enclosed gardens to the front and rear of the house and several steps lead to the front door. On the ground floor there is a lounge, dining room, kitchen, one single bedroom, and a toilet. The other five single bedrooms, the bathrooms and two toilets are on the first floor. The layout of the home makes staying there difficult for people who have restricted mobility. All service users pay £8.76p per night’s stay. Old Park Road Respite Unit DS0000046751.V323074.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. In April 2006 the Commission for Social Care Inspection (CSCI) made some changes to the way in which care services are inspected. Care services are now judged against outcome groups. The inspection report is divided into separate sections for each outcome group, for example ‘Choice of Home’, and ‘Personal and Healthcare Support’. An overall judgement is made for each outcome group based on the findings of the inspection. The judgements reflect how well the service delivers these outcomes to the people who use the service. The judgement categories are “excellent”, “good”, “adequate” and “poor”. The judgements are recorded in the main body of this report. More detailed information about these changes is available on our website – www.csci.org.uk This purpose of this inspection was to assess a selection of the National Minimum Standards for Care Homes for Adults (18-65). The methods I used to gather information included making a visit to Old Park Road, which lasted for 5 hours and 45 minutes. The visit included conversations with residents and staff, case tracking and examining records. Before the visit I sent out questionnaires for residents, their relatives and health and social care professionals to complete. A pre-inspection questionnaire was sent to the home. Since the last inspection a complaint has been received about the effect on the amount of respite care time available because two people were living there for an extended period. The home has resolved this concern satisfactorily, and all the places are now available for respite use. Although there are still areas for development, the home has made significant improvements since the last inspection. I would like to thank the ladies and gentlemen who were staying at Old Park Road when I visited, and the staff, for their welcome and hospitality during the inspection, and for taking the time to talk to me. I would also like to thank the people who completed the pre-inspection questionnaires. All this information is very valuable in helping me to assess the quality of the service. What the service does well:
Before the inspection visit I received three comment cards from Social Services’ staff. They all expressed complete satisfaction with the services provided to their clients. I received ten comment cards from service users and relatives. In their comments they said: ‘It’s a good place’.
Old Park Road Respite Unit DS0000046751.V323074.R01.S.doc Version 5.2 Page 6 ‘Nice meals’. ‘I like all staff’. ‘I like this place and the staff, they are good to me’. Most people said they can always do what they want in the home. They said the staff listen to them and the home is always fresh and clean. The comment cards confirmed that service users and their families received enough information to make a decision, before going to Old Park Road for respite. The care plans show in detail how everyone’s care and support needs are to be met. The staff at the home showed that they understand the physical and emotional health of the people who stay at Old Park Road. The interaction between service users and staff was relaxed and friendly. Staff spent time with service users doing activities or just chatting. The people who stay at the home have a say in the meals that are prepared. The home caters very well for service users who need, for example, to eat hallal meat. Separate cooking utensils are used and hallal meat is purchased. The staff are well trained and the home is managed effectively, with input from service users and staff. What has improved since the last inspection? What they could do better:
In the comment cards I received from service users, one person said they are not always able to go out to town when they want to. One person said they cannot always do what they want during the day or evening and would like more opportunities to go out. Another person said they would like to go out more at the weekend. Old Park Road Respite Unit DS0000046751.V323074.R01.S.doc Version 5.2 Page 7 The manager is looking at ways to improve the social and recreational opportunities for service users, outside the home. There needs to be suitable bathing facilities downstairs, so that people with mobility problems can continue to have respite stays at the home of their choice. The Commission for Social Care Inspection’s details must be included in the home’s complaints information. The service user’s care plans need to be signed by the service user or their representative, to show that they have agreed to the plan. The staff recruitment files must all include evidence that the necessary preemployment checks and information have been obtained. 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. The summary of this inspection report can be made available in other formats on request. Old Park Road Respite Unit DS0000046751.V323074.R01.S.doc Version 5.2 Page 8 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 Old Park Road Respite Unit DS0000046751.V323074.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 & 4 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Pre-admission procedures are thorough and flexible. EVIDENCE: In the care plans I looked at there were Social Services’ assessments of needs, as well as the home’s own detailed pre-admission assessments. The home’s own assessment includes information from staff and the manager, as well as from the service users and their relatives. People are able to visit as often as they wish during the day, before deciding whether or not they want to have overnight stays. A key-worker is allocated to each person before the respite stays begin. Most people stay for short periods, often just for a few days or for the weekend. The home no longer provides any long-term care. Old Park Road Respite Unit DS0000046751.V323074.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The care plans are clear and comprehensive. EVIDENCE: I looked at a number of care plans. They are clear and straightforward and show in detail how each person’s care and support is to be provided. There are assessments in place for all the areas of care and support that each individual needs. Before the care plan is developed the service user and their family are asked to provide some essential information. This includes a ‘pen picture’, personal and social care preferences, medical history and any areas where a risk assessment will be needed. The plan is developed using this information as the basis. All the staff who work with the service user contribute to the plan and agree with them the goals they would like to achieve during their respite stays. The plans contain a lot of information to help staff provide the care and support the service user
Old Park Road Respite Unit DS0000046751.V323074.R01.S.doc Version 5.2 Page 11 needs in the way they prefer. The staff at Old Park Road regularly review the care plans. Daily records are kept of any significant occurrences and risk assessments are in place. Wherever possible they should also be signed by the service user or their representative, usually a relative, to show that they have agreed to the original plan and any changes. Old Park Road Respite Unit DS0000046751.V323074.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users lead a varied lifestyle, following their own preferences, during their respite visits. A wider range of recreational opportunities would be beneficial. EVIDENCE: People are able to choose how they spend their time. During the week service users continue with their usual daytime activities outside the home. Some people commented on the service users’ questionnaires I sent out, that they would like more activities outside the home in the evenings and at weekends. The manager is currently looking at a number of additional social and recreational opportunities outside the home. Service users’ families are involved in the life of the home, as far as possible. Each person who goes to Old Park Road is supported and encouraged to
Old Park Road Respite Unit DS0000046751.V323074.R01.S.doc Version 5.2 Page 13 maintain their independence. Their right to make their own decisions and choices is respected. During the evening of my visit to Old Park Road staff spent their time with the service users in conversation, playing board games and doing jigsaw puzzles. Staff told me that some people like to do gardening, help with the cooking and many enjoy baking. Staff also go out with service users to support them to enjoy shopping trips, visits to the cinema and other activities in the local and wider community. The meals are of a high standard and the menus are nutritionally balanced. The menus are changed to suit service users preferences. Hallal meat is obtained for service users who require it. There is separate equipment in the kitchen for preparing and cooking hallal meals. Old Park Road Respite Unit DS0000046751.V323074.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ healthcare needs are accurately recorded and understood. EVIDENCE: The healthcare needs of each service user are clearly recorded in their care plan and the information is comprehensive. The details included people’s nutritional needs and any specialist healthcare that is required. The staff I spoke with all seemed to understand the emotional and physical healthcare needs of each service user and know how to support the individual. The medication in daily use is securely stored and the recording systems are accurate. Old Park Road Respite Unit DS0000046751.V323074.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and relatives are aware of how to make a complaint. The procedure does not include the Commission for Social Care Inspection’s details. The home has suitable adult protection policies and procedures. EVIDENCE: The returned questionnaires confirmed that people generally know how to make a complaint if they need to. The people I spoke to also said they would know how to raise any concerns, if they needed to. If they wish, service users are also entitled to take a complaint about the service to the Commission for Social Care Inspection, whose details have not yet been included in the home’s complaints information. I was told that at their next policy review the Trust would include this information. This has been required information since April 2002, to comply with The Care Homes Regulations 2001. The home has adult protection and ‘whistle-blowing’ policies and procedures in place that cover the way any concerns or allegations of abuse or poor practice would be handled. Protection of Vulnerable Adults training had been arranged for all staff for early in 2007. Old Park Road Respite Unit DS0000046751.V323074.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The programme of refurbishment has been started and noticeable improvements have been made. EVIDENCE: I made a complete tour of the house and gardens. The back garden is attractive and, I was told, is a very popular place for people to spend time when the weather is suitable. Since the last inspection a number of improvements have been made in the house. The lounge, hallway and the downstairs bedroom have been re-decorated. Some of the other bedrooms have had new carpets fitted. Two new washbasins have been put in and the bathrooms are to have a new bath in one and a level access shower in the other. A new wardrobe has been ordered for one bedroom and the manager and staff are planning further refurbishment throughout the home.
Old Park Road Respite Unit DS0000046751.V323074.R01.S.doc Version 5.2 Page 17 Window restrictors have been fitted and measurements have been taken for new windows. The manager expects them to be fitted within the next few months. The new kitchen units had just been installed when I visited the home. The staff said they are a great improvement. Although the tiling and other finishing touches had not been completed, the kitchen looked attractive and hygienic. There is no downstairs bath or shower room, although there is a toilet and washbasin. The lack of a bath or shower on the ground floor means that the home cannot accept people for respite who are unable to manage the stairs. A downstairs shower room would resolve the problem. The home is clean and hygienically maintained throughout. Old Park Road Respite Unit DS0000046751.V323074.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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff are well trained and employed in sufficient numbers to meet the needs of the service users. The recruitment procedures are satisfactory, but more information needs to be obtained for staff who transfer to the home from within the organisation. EVIDENCE: During my visit I looked at some of the staff recruitment files, which are now kept at the home, and the staff training files. Where full recruitment information was available, the files contained completed application forms and two written references. The files for staff who have worked at the home for some time showed that satisfactory Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) register checks had been obtained. The files for staff transferring from another home in the group did not have all of this information. The manager is to discuss with senior management the frequency that CRB checks are renewed. One I saw was dated from early 2003.
Old Park Road Respite Unit DS0000046751.V323074.R01.S.doc Version 5.2 Page 19 Four of the five care staff have achieved a National Vocational Qualification (NVQ) in care at level 2 and one has also completed the level 3 award. The rotas showed that there are two or three staff on duty when service users are at home. At night there are either one or two staff at the home, depending upon the service users’ needs. There is also a senior manager ‘on call’ during the night. Some of the mandatory training refresher courses for staff were booked for January and February this year, others had taken place in 2006. They include; moving and handling, food hygiene, health and safety, first aid, fire safety and adult protection. The week after the inspection, staff were due to attend training on conflict resolution. Further training is planned for later in the year. All the staff are given supernumerary time to read service users’ care plans and have one to one supervision and personal development meetings with their line manager. Old Park Road Respite Unit DS0000046751.V323074.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is generally safe and well managed. EVIDENCE: The home’s manager is suitably qualified and experienced to manage the home effectively. The staff are clear about their roles and, along with service users, contribute to the way the home is run. The kitchen is clean and hygienic and records of refrigerator, deep freezer and hot food temperatures are kept. The pre-inspection questionnaire confirmed that health and safety checks and tests are carried out regularly, either by the home’s staff or external contractors. Old Park Road Respite Unit DS0000046751.V323074.R01.S.doc Version 5.2 Page 21 On the day of the visit an oxygen cylinder, waiting to be collected by the pharmacist, was being stored in the walk-in cupboard next to the kitchen. This is unsafe. Oxygen cylinders that are not needed must be stored safely until they are collected. The pharmacist’s advice should be sought. Old Park Road Respite Unit DS0000046751.V323074.R01.S.doc Version 5.2 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 X 2 3 3 3 4 4 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 3 25 3 26 3 27 2 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 X 3 X X 2 X Old Park Road Respite Unit DS0000046751.V323074.R01.S.doc Version 5.2 Page 23 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 YA22 Regulation 22(7) Requirement The registered provider must ensure details of the Commission for Social Care Inspection is included in the complaints procedure. (Timescale of 31st October 2004, 31st March 2005, 31st October 2005 & 30th June 2006 not met) The registered provider must provide suitable bathing/showering facilities. (Timescale of 31st March 2006 not met) Wherever possible the service user, or their representative, must agree to their care plan and sign to confirm agreement. All the staff recruitment files must include the necessary documentation, as detailed in Schedule 2 of The Care Homes Regulations 2001. Oxygen cylinders that are not in use must be stored safely at all times. Timescale for action 30/06/07 2. YA27 23(2)(j) 30/06/07 3. YA6 15(2)(c) 30/06/07 4. YA34 19 & Schedule 2 13(2) 30/06/07 5. YA42 31/03/07 Old Park Road Respite Unit DS0000046751.V323074.R01.S.doc Version 5.2 Page 24 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 Old Park Road Respite Unit DS0000046751.V323074.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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