CARE HOME ADULTS 18-65
Park View (15) Hetton-le-hole Houghton Le Spring Tyne And Wear DH5 9JH Lead Inspector
Mr Clifford Renwick Unannounced Inspection 6th October 2005 10:00 Park View (15) DS0000015787.V250713.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 Park View (15) DS0000015787.V250713.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. Park View (15) DS0000015787.V250713.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Park View (15) Address Hetton-le-hole Houghton Le Spring Tyne And Wear DH5 9JH 0191 520 8570 0191 520 8570 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) S.E.L.F. Limited Mrs Barbara Murray Care Home 8 Category(ies) of Learning disability (8), Mental disorder, registration, with number excluding learning disability or dementia (2) of places Park View (15) DS0000015787.V250713.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Category MD is for current residents only Date of last inspection 9th May 2005 Brief Description of the Service: The home is registered to provide personal care for 8 adults under the age of 65 years, it does not provide nursing care. Any health needs are addressed by the use of community health services. It specifically offers services for adults with a learning disability who are ambulant and are able to manage the stairs in the building. It cannot provide accommodation for people who are physically disabled.The house is semi detached and stands in its own grounds in what could be described as being in the centre of Hetton le Hole. It is only a short walk to the local shops. The busy shopping parade at Hetton, which has a range of facilities, including a swimming baths, is within easy reach.The building is 2 storeys in construction and has bedrooms on both the ground and first floor. Its design and layout ensures that it blends in with the neighbouring houses and there are no features that would indicate that it provides a residential service. The house was originally an older persons home which following conversion was developed into two residential homes for people with a learning disability. The adjacent house is also owned by the same company and offers a similar service. The house like the adjacent has its own entrance and separate staff team and registered manager and is run independently.There is a large enclosed rear garden and patio area and parking which is shared between the 2 homes. Park View (15) DS0000015787.V250713.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 6 hours and was carried out as part of the statutory twice-yearly inspection process by the Lead Inspector and another inspector. Most areas of the premises were viewed and care records were examined as well as records that related to health and safety and new staff employed in the home. Discussion took place with the staff on duty on the morning shift and also with the staff on the changeover of shift in the afternoon. Discussion also took place with all 8-service users. Inspectors spent time observing staff practices and they also joined in some of the activities with service users and this included having lunch with them. The judgements made are based upon the evidence available at the time of the inspection. What the service does well:
The home continues to provide consistent support to service users whereby they are always encouraged to be involved in how the service is delivered. The staff team continue to be motivated and enthusiastic about the work and are positive towards undergoing regular training. A good range of activities continue to be provided in and outside of the home and service users are able to take part in activities, which they not only enjoy but also assist them in developing new skills. The evidence available in the home confirms that service users are continuing to develop a range of skills, which assists them with their personal development and daily living skills. Discussions with service users confirmed that staff provides them with a happy and comfortable place to live. Another positive attribute of this service is the vibrant atmosphere that is created between the staff and service users and a good level of humour and rapport is always present. Park View (15) DS0000015787.V250713.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. Park View (15) DS0000015787.V250713.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 Park View (15) DS0000015787.V250713.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): 2 Each service user’s care needs are assessed prior to their move to the home, and periodically thereafter. This helps ensure that each service user’s needs are met at the home and inappropriate admissions avoided. EVIDENCE: Examination of service users files confirmed that assessments are ongoing and compiled by staff in order to ensure that any changing needs are addressed as part of the care planning process. A key worker system has been implemented and key workers are updating records on a monthly basis and compile a report, which would reflect any changes, and whether any additional actions are required. Some development and updating is now required with the homes assessment document and this was discussed with the manager. Park View (15) DS0000015787.V250713.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): 6, 9, 10 Practices at 15 Park View follow those recommended within the National Minimum standards and ensure that service users can live as independent lifestyle as possible. Service users assessed needs are reflected within their individual plans of care. These provide guidance for staffs’ care practice. Confidentiality is maintained by staff at all times and this is supported by appropriate polices and procedures which ensure that service users best interests are always taken into consideration. EVIDENCE: The staff have a very in depth knowledge of the people using the service and their needs. Service users discussed their service user plan and were aware of what they were for. Some service users need a little more staff involvement at the moment and they are aware of why a more prominent staff presence was needed. Some minor amendment is required to a risk assessment for one service user in order to demonstrate changes in the care plan. Staff again handled difficult situations sensitively and well. The majority of service users are aware that their personal information will only be shared on a need to know basis and staff have discussed with service users what the term
Park View (15) DS0000015787.V250713.R01.S.doc Version 5.0 Page 10 confidentiality means. Those service users who because of their learning disability needs can not comprehend such an abstract concept as confidentiality, have been made aware that staff keep their service user plans safe and this will be recorded as a limitation. Service users actively make decisions about their lifestyles and staff assists them to achieve their goals. Service users were eager to share developments in their lives and how they had been involved in these changes. Individuals are very aware of the routines of the house and why they are in place. However at times staff need to re-evaluate the structure to ensure it has flexibility and allows people to develop their problem-solving skills. Park View (15) DS0000015787.V250713.R01.S.doc Version 5.0 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, 16 Service users are encouraged to reach their potential and often exceed what was expected of them. EVIDENCE: Over the day a wide range of activity was completed. Service users are encouraged to make decisions about how they spend free time and participate in the day. The service users at 15 Park View prefer more structure to their day and this was evident in how the routines are developed. Service users said that the ‘staff were their friends’ and an easy rapport has developed between all. The atmosphere in the home was very welcoming and relaxed. Service users said they felt that they had really developed since moving to the home. It was evident that all of the service users had made positive developments. Some service users who have been unable to communicate effectively using speech were starting to form meaningful sentences. The local library has been running a craft course and service users discussed the presentation ceremony they attended for completing the first 10-week course. Service users were keen to inform inspectors about the second course that has now started and on Monday how they made elephants. Service users
Park View (15) DS0000015787.V250713.R01.S.doc Version 5.0 Page 12 said that they went out to the local shops with staff and used local amenities. On the day of the inspection one of the service users went shopping with staff and this was a positive experience for the service user who showed inspectors what he had purchased. Some service users have restrictions imposed on them as a condition of their terms and conditions of residence of going out and the distance they can travel. These service users were very clear as to what the expectations were in relation to travel. They said that staff were helping them to develop their skills and recognise when certain behaviour might pose a problem for them or others. Park View (15) DS0000015787.V250713.R01.S.doc Version 5.0 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): 19 Service users health care needs are identified and arrangements are made to help ensure they are promoted and met. Staff will also advocate, or seek additional advocacy support, to ensure that each service users’ rights of access to health care services and treatment are met. EVIDENCE: Examination of service users case files confirmed that good records are in place, which demonstrate how individual health needs are met. One service user who has experienced major health problems has been well supported by staff throughout her illness and also has the additional support of a named nurse. Good use is made of all NHS services and service users are encouraged and supported by staff when attending outpatient appointments. Two service users have been following a healthy eating diet and as a result have lost a significant amount of weight of which they stated that they were pleased with. A community nurse visits the service twice daily to support a service user who has diabetes and a good rapport has been established between the nurse and the service user and also the staff. Park View (15) DS0000015787.V250713.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 There are satisfactory procedures in place that protect the service users from abuse. EVIDENCE: Policies and procedures are in place that deals with the protection of vulnerable adults and since the last inspection these have been extended. All but two of the staff have received appropriate training in the use of these procedures and the manager has carried out training as a lead officer and is responsible for ensuring that staff are supported in this area of work at all times. Discussion was held with the manager about the need to ensure that when policies and procedures are revised to include the date of the revision as this will link into the homes quality assurance system. Park View (15) DS0000015787.V250713.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): 30 The home is homely, comfortable, and clean and provides service users with a safe and well-maintained environment in which to live. EVIDENCE: Close circuit television cameras have been installed to the external grounds and entrance of the home and also the adjacent home in order to enhance the security systems currently in place. Discussion with the manager confirmed that decoration is to be carried out to ground floor bathroom and also the staircase and consideration is being given to changing the settees in the lounge. The building is good decorative order considering the heavy use that is made of it and if anything only the kitchen is possibly in need of refurbishment over the next 12 months. This was discussed with the manager who was receptive to the advice that was offered. Park View (15) DS0000015787.V250713.R01.S.doc Version 5.0 Page 16 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): 34, 35 A competent staff team supports Service users, and the staff team have worked hard to ensure that in excess of 50 of them are qualified to NVQ level 2 in care, or higher. Recruitment processes are robust and rigorous and this ensures that service users are protected at all times. EVIDENCE: Two new staff have commenced work in the home and examination of their personnel files confirmed that all information required by regulation had been obtained during the recruitment process. The two new staff have been enrolled on NVQ Level 2 training and all other staff have undergone NVQ training at varying levels. The manager has recently achieved the registered managers award and NVQ Level 4. Park View (15) DS0000015787.V250713.R01.S.doc Version 5.0 Page 17 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): The manager continues to demonstrate that she is a hardworking and an experienced leader who has successfully developed the service and improved the health, welfare and lifestyle opportunities for service users. All required policies and procedures are in place which help staff and the manager run the home efficiently and for the benefit of service users. EVIDENCE: Discussion with the manager confirmed that the homes policies and procedures are under review and being developed to reflect current changes. Staff polices and procedures relating to their employment have already been revised and implemented. Service minutes now contain a photographic record of who attended the meetings and this assists in making these more easily understood by service users. At the time of the inspection senior staff from the home and the adjacent service were undergoing training in equality and diversity and this training was being delivered by a representative of Bishop Auckland college. All care staff have been registered to complete this training.
Park View (15) DS0000015787.V250713.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X 3 3 Standard No 24 25 26 27 28 29 30
STAFFING Score X X X X X X 4 LIFESTYLES Standard No Score 11 4 12 X 13 X 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X X X 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Park View (15) Score X 4 X X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X 3 X X DS0000015787.V250713.R01.S.doc Version 5.0 Page 19 No 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 YA6 Regulation 14, (2), (b) 15 Requirement The homes assessment document must continue to be developed as advised during the inspection. Minor amendments to the risk assessment and care plan as identified and discussed during the inspection must be addressed. Timescale for action 31/03/06 2 YA6 31/01/06 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 2 Refer to Standard YA40 YA24 Good Practice Recommendations Consideration should be given to ensuring the date of revision is entered on to the policies and procedures as they undergo revision. Consideration should be given to refurbishing the kitchen within the next 12 months and replace cupboards which are now showing signs of wear. Park View (15) DS0000015787.V250713.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection South of Tyne Area Office Baltic House Port of Tyne Tyne Dock South Shields NE34 9PT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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