Inspection on 16/05/06 for Park View

This inspection was carried out on 16th May 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Park View 10/11/06

Similar services:

Whitwood House

Whitwood Hall

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

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

CARE HOME ADULTS 18-65 Anchor House 61 Northstead Manor Drive Scarborough North Yorkshire YO12 6AF Lead Inspector Mavis Pickard Key Inspection 16th May 2006 09:30 Anchor House DS0000065531.V294975.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 Anchor House DS0000065531.V294975.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. Anchor House DS0000065531.V294975.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Anchor House Address 61 Northstead Manor Drive Scarborough North Yorkshire YO12 6AF 01628 602003 01628 660905 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) Milewood Healthcare Limited Mrs Veronica Kelly Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Anchor House DS0000065531.V294975.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection This is a newly registered service therefore has no previous inspection. Brief Description of the Service: Anchor House is a detached three-story property in the Peasholm area of Scarborough, North Yorkshire. The house is located close to local shops and Peasholm park and about a mile from the north bay and Marine Parade of Scarborough seafront. The home is regsitered to accommodate up to 6 Adults who have a Learning Disability. Information about the services the home provides are made available to prospective clients and/or their representatives and to placing authorities though the provision of a written Statement of Purpose and Service Users Guide and through CSCI reports. At the time of this report the range of fees are from £1398.00 to £ 2800.00 a week. Additional charges may be made for client’s personal toilet requisites, hairdressing, chiropody, eye care and dental treatment as is required. Anchor House DS0000065531.V294975.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This ‘site visit’ is the first to be undertaken for this service, which was first registered in November 2005. During this site visit 3 out of 4 clients of the service were spoken with along with staff and management of the home. Information has been received both prior to and since the visit from client’s relatives, care managers and a general practitioner who says that they have no concerns about the service the home provides. However a client’s representative said they believe that the service cannot provide the specialist services required but that in general they are satisfied with the support their relative receives from the home’s management and staff. 3 out of 4 clients spoke with during the site visit said that they like living at Anchor House and that staff are friendly and kind. What the service does well: What has improved since the last inspection? This is the first inspection. Anchor House DS0000065531.V294975.R01.S.doc Version 5.1 Page 6 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. Anchor House DS0000065531.V294975.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 Anchor House DS0000065531.V294975.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): 2&3 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The complex needs of prospective clients have not been comprehensively assessed prior to admission to the home, clients and/or their representatives do not know that the service can meet their complex needs. EVIDENCE: The service is registered to accommodate up to 6 adults who have a learning disability. The 4 people presently accommodated have mild to moderate learning disabilities and present with complex needs that include physical disability, aquired brain injury and/or mental health problems. The home’s statement of purpose advises that this is a specialist service, however the manager and staff employed although having experience and knowledge of working with people who have a learning disability have not undertaken specialist training nor do they have the experience of supporting people with such complex needs. The members of the support team spoken with although caring in their approach do not present as understanding the particular needs of all Anchor House DS0000065531.V294975.R01.S.doc Version 5.1 Page 9 individuals nor have they presently access to specialist facilities to support them. It is clear from the examination of pre-admission assessments that the home has generally relied on the care management assessment for information and that the home’s own assessment is basic and limited. Having spoken with the service’s newly appointed service manager she advises that a new more robust pre-admission assessment instrument and system is being implemented which will help the manager to assess more appropriately any prospective client. Anchor House DS0000065531.V294975.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Client’s goals are not reflected in their care plan although in general they present as being consulted on and supported to make decisions about their lives. EVIDENCE: Although during this visit staff and clients were noted to be relaxed in each other’s company and to be taking part in leisure activities throughout the day, records show that there are instances of challenging behaviour and that staff has to adopt restraint routines for some clients. These instances quite frequently reported during the early part of the year have tailed off recently. The reasons given for this are that the client was initially unsettled and anxious when they first came to the home, now this period has passed and they are more relaxed. Anchor House DS0000065531.V294975.R01.S.doc Version 5.1 Page 11 From speaking with management and staff and from the examination of training records it is clear that the use of restraint is a last resort and that the service is robust in its training regarding restraint. The provider and manager are trainers for staff and all people employed receive regular internal and external training. All clients have a care plan however aspirations and goals are not routinely identified. Clients spoken with and observed during this site visit presented as being supported by management and staff to lead a usual and domestic style life. However as yet the service has not been successful in setting up dynamic education or lifestyle plans and goals for clients. This situation is in the main due to the fact that most clients have been accommodated for a relatively short length of time and are still settling into their situation. The service opened in November 2005, which is partway through any educational year, an added frustration when management and staff are searching for opportunities for clients. Staff says that the local area does not have opportunities readily available for the education and lifestyle experiences that may be of interest to clients. Anchor House DS0000065531.V294975.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,15,16 and 17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Clients are provided with a healthy diet, are able to take part in appropriate leisure activities, enabled to engage in personal and family relationships and have their rights and responsibilities recognised. However they are not sufficiently engaged in personal and educational development. EVIDENCE: The service is very new having been open for less than 6 months and most clients have lived at the home for a shorter period than that. The timing of the opening of the service, November 2005 means that educational opportunities locally are limited as it’s provision would mean effectively ‘cutting’ into an academic year. Anchor House DS0000065531.V294975.R01.S.doc Version 5.1 Page 13 It was clear from speaking with clients and their families and from survey Clients who feedbacks that all people accommodated have family contact. moved into the home from the local community also have local contacts outside their immediate family, however most people accommodated are not from the local community and will need time and encouragement to build up local contacts. The management and staff group of the service should be proactive in ensuring that clients have the opportunities to build relationships locally, through leisure and educational opportunities. The management team members advised that they are actively sourcing opportunities for clients. During the visit it was observed that clients and staff have good rapport and that they were taking part in leisure activates together such as ‘football’ and visiting the local open spaces, however it is considered that more support is required to be put into developing opportunities for clients to build their own peer group relationships outside the home. The support staff team undertake cooking; the manager said that clients could take part in this activity with support. From the examination of menus it is clear that clients are provided with a nutritious and varied diet. The dining room at the home is being refurbished and at the time of this visit new floors had been laid and some of the decorating completed. The operations manager said that new dining furniture was to be provided; when this area is complete it will provide a pleasant place to take meals and to use for leisure activities. Anchor House DS0000065531.V294975.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Clients receive personal support to live their daily lives, their physical and health needs are met and are they protected by the homes medication policies and procedures. EVIDENCE: It is not clear that the service is presently equipped to provide the emotional support needed by individuals with complex needs. However staff are beginning to receive training to understand the specialist needs of the clients accommodated. It was discussed with the manager and the operations manager during this visit that it is the intention of the service to build on their present knowledge of the general client group to enable staff to understand the complex needs of clients accommodated and to be able to therefore better support them in every aspect of their lives. Anchor House DS0000065531.V294975.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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Clients and their representative feel that their views are listened to and that clients are protected from abuse. EVIDENCE: The service has an appropriate complaints policy and staff understand that should a complaint be raised this will be dealt with through the service’s complaints procedures. To date records show that there are have been no complaints raised formally with the service. Staff employed are provided with appropriate training in respect to the protection of vulnerable adults. All staff spoken with during this visit evidenced that they understand what constitutes abuse and how they would be expected to deal with any abusive situation that may occur. Anchor House DS0000065531.V294975.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 and 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The furnishings and decoration of the premises are overall poor. The home is clean. EVIDENCE: The premises were until immediately prior to registration used as a small hotel. Management and staff spoken with said that the interior of the premises and furnishings etc were not changed from when the building was a hotel to when it became a care home and clients moved in. Although clients own rooms are furnished in a way that reflect their personality the carpets and décor to some private areas are ‘dated’ and need to be replaced and/or refurbished. The communal areas of the home do not reflect the age and personality of the people accommodated in that the carpets, furnishings and décor have not been upgraded since the home was a hotel. Anchor House DS0000065531.V294975.R01.S.doc Version 5.1 Page 17 The operations manager said that she intends that carpets, curtains and furnishings be replaced or re-covered to reflect the purpose of the home and its client group. The provider is presently undertaking the re-furbishment programme and recently clients moved out for a couple of weeks spending the time in York to allow that this programme could take place. During this time new showers were fitted and some of the decorating was completed. It was noted during this visit that not all en-suite shower areas have sufficient space to allow that the client shower comfortably. Although this time away was not a planned holiday and clients had not made a choice to take a holiday in York all people spoken to say that they enjoyed themselves. Communal areas and some bedrooms are situated on the ground floor other bedrooms on the upper floor. The service presently accommodates 1 client who uses a wheelchair sometimes. There is a portable ‘roll down’ type ramp to facilitate wheelchair access to and from the building. The provider said that it is his intention to apply for 3 further bedrooms presently not in use to be registered by the Commission. It will be required that these areas along with the home in general are refurbished to comply with current legislation before this could be considered. Anchor House DS0000065531.V294975.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): 32,34 and 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The service has robust recruitment polices and procedures that are followed when staff are employed. However staff employed do not presently have the skills and experience to provide the specialist support necessary to meet the complex needs of people accommodated. EVIDENCE: A sample of staff recruitment files were examined, which evidenced that, the service undertakes the checks necessary to ensure that clients are safe. All staff are in receipt of Criminal Records Bureau [CRB] and Protection of Vulnerable Adults [POVA] disclosures before that start work. All people employed have previous experience of working with adults with a learning disability. The service is registered to accommodate adults who have a learning disability, presently the service accommodates individuals who have complex needs and Anchor House DS0000065531.V294975.R01.S.doc Version 5.1 Page 19 have been diagnosed as having physical, psychological and mental health needs as well as mild to moderate learning disabilities. From speaking with the management team, some of the staff on duty during this visit and from the examination of training records available it is clear that staff employed have not undertaken training nor have they experience of supporting people who have such profound and the complex needs. The service’s operation manager confirmed that the manager and staff has started to undertake training in respect to the needs of individuals accommodated and would training that would equip them to provide appropriate support for clients living at the home. It was also discussed that the service seeks professional guidance in respect to ensuring that the specialist needs of clients are being met appropriately. Anchor House DS0000065531.V294975.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): 37,39 and 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home presented as an open and welcoming environment. Client’s health and safety is generally promoted although the premises do currently present some concerns. EVIDENCE: The home operates as a domestic style service that provides a generally safe environment for people accommodated. However because staff does not yet have the skill and experience to meet the complex needs of clients presently accommodated not all aspects of clients welfare are being met. Anchor House DS0000065531.V294975.R01.S.doc Version 5.1 Page 21 Most clients have only lived at the home for a short time and the management team explained that this is the reason that external services that should be in place to support their needs have not been developed. It would normally be expected that prior to people being accommodated in a specialist service, the provision of specialist support services necessary to underpin the care provided within the home for people with such profound and complex needs would be in place. The home has not yet developed a way of self-monitoring and this area will be examined at the next visit to the service. Anchor House DS0000065531.V294975.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 X 2 1 3 1 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 1 25 3 26 3 27 2 28 1 29 X 30 3 STAFFING Standard No Score 31 X 32 1 33 X 34 3 35 1 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 1 3 X 3 X LIFESTYLES Standard No Score 11 1 12 2 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 1 X 1 X X 3 X Anchor House DS0000065531.V294975.R01.S.doc Version 5.1 Page 23 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 YA2 Regulation 14(1)(a) Timescale for action That the registered person 16/05/06 must not provide accommodation to clients unless the needs of the client have been assessed by a suitably qualified or trained person including where necessary state registered health professionals using regulated assessment methods. The registered person must 30/07/06 agree with each service user and/or their representative an individual plan, which may include treatment and rehabilitation, describing the services and facilities to be provided by the home, and how these services will meet current and changing needs and aspirations and achieve goals. The registered person must 30/07/06 ensure that clients with complex multiple disabilities are offered specialist interventions and opportunities by trained staff. Requirement 2 YA6 15(1)(2) 3 YA11 12(1)(b) Anchor House DS0000065531.V294975.R01.S.doc Version 5.1 Page 24 4 YA12 5 YA24 6 YA28 7 The registered person must ensure that staff put into place systems and strategies to help clients to find and keep appropriate jobs, and/or continue their education, training or personal development and take part in valued and fulfilling activities. 23(2)(b)(d) The registered person must forward to the Commission a schedule of refurbishment for the home that will ensure that furniture and furnishings provided have a style and ambience that reflect the home’s purpose. 23(2)(i) The above proposal should include how they intend to provide suitable facilities for clients to meet their visitors separate from their private rooms including a separate smoking area if the home accommodates people who smoke and/or does not have a no-smoking policy. 18(1) (a) The registered person must (c) forward to the Commission a schedule of training that will ensure that current and future staff undertakes necessary training and/or have the skills and experience necessary for the tasks they are expected to do. Including an understanding and knowledge of the disabilities and specific conditions of service users accommodated. 12(1)(b) 30/07/06 30/07/06 30/07/06 30/07/06 8 YA37 10(3) The registered person must 30/07/06 forward to the Commission details of training and/or updating of skills to be undertaken by the registered DS0000065531.V294975.R01.S.doc Version 5.1 Page 25 Anchor House 9 YA39 24 10 *RQN Section 31 of the Care Standards Act 2000. manager with respect to her understanding and knowledge of the disabilities and specific conditions of service users accommodated. The registered person must 30/07/06 implement a quality assurance system to monitor the performance of the home. The registered person is 30/07/06 required to provide an action plan to show how improvements to the service will be made. 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 YA27 Good Practice Recommendations Where shower facilities are provided en-suite these should be of sufficient size to allow that the client shower in comfort. Anchor House DS0000065531.V294975.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 Anchor House DS0000065531.V294975.R01.S.doc Version 5.1 Page 27 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!