CARE HOME ADULTS 18-65
Percy House 50 - 52 Beaconsfield Street Blyth Northumberland NE24 2DS Lead Inspector
Mary Blake Key Unannounced Inspection 18 and 22nd January 2007 09:30
th Percy House DS0000067157.V293365.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 Percy House DS0000067157.V293365.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. Percy House DS0000067157.V293365.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Percy House Address 50 - 52 Beaconsfield Street Blyth Northumberland NE24 2DS 01670 354815 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) Miss Jenny Locker Ms L Halliday Care Home 12 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (7), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (5) Percy House DS0000067157.V293365.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 1 person with a mental disorder may also have a learning disability Date of last inspection Brief Description of the Service: Percy House provides care to twelve adults with mental health needs. Care is provided from a large, traditional building, which has been modernised but at the same time retains many original features, which adds to the character. The home has single and shared bedrooms, toilets and bathing facilities and a range of comfortable communal areas. The home is situated in the centre of Blyth. Local facilities are accessible by public transport and car and shops and facilities are within walking distance. The fees are £370.45 per week. The service user guide and last inspection report were available within the office. Percy House DS0000067157.V293365.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced, the first of the year and took place over two days. Residents care records, staff records and additional statutory records were examined. Case tracking was undertaken, this involved following the care of individual residents. During the visit the inspector spoke with the manager, proprietor and one care staff. Over the two days the majority of the residents spoke with the inspector in private. 12 resident and 2 relative questionnaires were received prior to the site visit; residents were supported to complete these by relatives and staff. These were very positive. What the service does well:
Residents and staff explained the admission process; this usually includes a visit from the manager. This helps new residents identify their own needs and enables staff to meet their needs during their stay. The service gives good support to enable individuals to make decisions and participate in the running of the home. The service gives good support to enable individuals to maintain and develop personal and family relationships Residents described good relationships with the staff and said they were all polite and helpful. Staff were friendly and relaxed and showed a good understanding of residents needs. Individual care plans have continued to improve. Staff were more involved in planning and evaluating care and the plans this helps staff give residents the care they need. The management overviews these plans and this helps to provide a consistent staff approach. Residents are fully involved with their care plans where able. Meals are varied, well balanced and nicely presented offering good choice and nutritious food at all meals. All of the residents spoken to were pleased with the quality and choice available. The home is staffed with a skilled and consistent staff team giving security to residents. Staff recruitment and training records were clear and concise and contained all relevant information. The vetting process helps protect residents. The staff have a good understanding of residents individual needs and the residents were very complimentary about the staff. More than fifty percent of the staff has undertaken National Vocational in Care level 2 or above as this helps provide a trained staff team. Residents live in a home, which is well run and managed.
Percy House DS0000067157.V293365.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Percy House DS0000067157.V293365.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Percy House DS0000067157.V293365.R01.S.doc Version 5.2 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 & 4 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents have theirs need fully assessed by care staff before admission to the home but this is not always sufficiently documented. Residents have a gradual introduction and opportunity to visit the home. EVIDENCE: Pre-admission assessments are undertaken and reflect the needs of the residents. Generally care plans had good information to ensure that the home can meet the needs of the prospective resident but this had not been sufficiently recorded in respect of mental health needs. The Manager is involved in the decisions and in the majority of instances visits the residents prior to their admission. Residents spoke of visiting the home prior to admission “I came to look around first” “ I came for tea before I moved in” “given all information and staff explained things” “my care manager came with me” and that this was useful to reduce anxiety and make the settling in process easier. Percy House DS0000067157.V293365.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8 & 9 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Residents know that their assessed and changing needs are set out within their individual plan. Residents make decisions and are consulted and participate in all aspects of life within the home. Residents are supported to taken risks as part of their independence but this is not always sufficiently documented. EVIDENCE: On examination of a sample of service users plans these were found to be comprehensive care plan that assists them to become as independent as possible. The Manager had ensured that all recorded information is reviewed and summarised on a monthly basis but this was not consistent and some care plans contained outdated information making the recent information difficult to
Percy House DS0000067157.V293365.R01.S.doc Version 5.2 Page 10 find. It was evident that mental health needs were addressed and residents were assessed and given support from professionals but this was not sufficiently recorded within the care plans. Regular residents meetings are held. There have been no new staff appointed but residents spoke of being involved in the selection process. The manager has good systems to enable residents to share their views and they continue to look at ways of involving residents and improving individualised services. Residents commented “ we meet regularly to discuss how we run our home” “ I can come and go as I like” “I can go to bed when I want to” “I go out everyday to meet friends and do shopping” “I like Percy House” “I am quite a free person” Risk assessments were in place but these need to be recorded in more detail and reviewed at an agreed timescale. Percy House DS0000067157.V293365.R01.S.doc Version 5.2 Page 11 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 & 15 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents have good opportunities for personal development, are part of the local community and are able to take part in appropriate educational, training, social and leisure activities. Residents are supported to have appropriate family and personal relationships Resident’s rights are respected and responsibilities recognised in their daily lives. Residents are offered healthy diet and a relaxed and social mealtime. EVIDENCE: The philosophy of the home is for residents to learn skills and be given support to become as independent as possible.
Percy House DS0000067157.V293365.R01.S.doc Version 5.2 Page 12 Residents have the opportunity to increase their social network and staff support residents to maintain existing friendships and social relationships. Residents have opportunities to participate and learn in a range of settings attending College and training centres. They have opportunities for personal development both in the home and through involvement in a range of community based activities. Residents have the opportunity to use community facilities for leisure activities e.g. cinema, theatre, pub, meals, shopping etc. They are offered the opportunity to experience new activities and leisure pursuits as well as supported where necessary to continue with hobbies and interests. Staff assists and encourage residents to maintain family links and previous friendships, respecting the individual resident’s wishes. Some residents spend time at the family home. In discussion with the residents, manager and staff they confirmed their involvement and choice in relation to visitors. It was observed staff respecting privacy by seeking permission prior to entering individual rooms and interacting well with residents. Residents were observed to move freely around the home and were able to spend time alone. Residents commented on the quality and choice of food available. Fresh fruit was available and residents were observed having coffee in a relaxed and social setting. Percy House DS0000067157.V293365.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18 & 19 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents receive personal support the way they prefer and require. Residents physical and emotional health needs are met. EVIDENCE: Residents, who require personal support, are given this in a way that protects their dignity and maximises their independence. It was evident that residents’ individual health needs are identified and residents are supported to access community health services such as general practitioner, district nurse, chiropody, dentist, and optician. All residents have an annual health check. Psychiatric, psychologist and community psychiatric nursing team provides specialist health support. Staff training has been undertaken to provide awareness and additional support for health related needs. There are currently no residents who have any moving and transferring needs.
Percy House DS0000067157.V293365.R01.S.doc Version 5.2 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. 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 feel their views are listened to and acted upon. Residents are protected from abuse, neglect and self-harm EVIDENCE: There have been no recorded complaints. A complaint procedure is in place and displayed around the home. Residents stated that they felt confident that their views would be listened to and acted upon if necessary. “I talk to the staff when I want to make a complaint” Staff have undertaken the one day training on the Protection of Vulnerable Adults. The manager had undertaken the two day course in the Management of suspected abuse. There have been no allegations or cause for concern within the home. Percy House DS0000067157.V293365.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Residents live in a homely, clean, comfortable and safe environment. EVIDENCE: A tour of the building indicated that the premises appeared safe, comfortable, bright and airy, clean and free from odours and generally of a satisfactory standard. Percy House DS0000067157.V293365.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 & 35 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The manager ensures there are adequate numbers of staff on duty that have appropriate skills and experience to care for the residents. The recruitment processes in place protect residents. External and internal training takes place providing residents with a skilled, consistent staff team. EVIDENCE: Staffing rotas showed that there are enough staff are on duty to meet the necessary staffing levels with two staff being on duty at all times during the day. Staff undertake mandatory training, National Vocational Qualifications in Care and other training. This was clarified from the sample of records inspected and discussions with staff. All staff had completed National Vocational Qualification in Care level 2 (NVQ) or over and the home has an induction and training programme for all staff Percy House DS0000067157.V293365.R01.S.doc Version 5.2 Page 17 working in the home. Staff spoke knowledgably about the individual needs of residents. Residents and relatives wrote and spoke positively about staff “the staff at Percy House are very helpful, especially Linda Halliday” “I find the rest of the staff very helpful” Staff recruitment files were examined and were satisfactory and there has been no staff turnover providing a consistent staff team. Percy House DS0000067157.V293365.R01.S.doc Version 5.2 Page 18 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. Resident’s benefit from a well run home with a manager who has developed an open and inclusive atmosphere. Residents’ health, safety and welfare are protected. EVIDENCE: On observations of staff and residents it was evident that they felt confident with the openness and approachability of the Manager. The Manager is qualified and experienced and communicates a clear sense of direction and leadership. The Manager is currently undertaking quality assurance involving working with residents, advocates, supporting professionals and staff to obtain their views
Percy House DS0000067157.V293365.R01.S.doc Version 5.2 Page 19 on the service provided. Regular meetings had been held for residents, relatives and staff. Quality assurance systems are currently under review. Accidents are recorded effectively with accident analyses being completed and risk preventions being undertaken to safeguard residents. The records examined were secure, up to date and in good order. Health and safety systems are well organised, the building is safe and the management and staff spoke knowledgeably about maintaining and promoting the welfare of the residents. Fire testing and maintenance is undertaken at the given timescales. Percy House DS0000067157.V293365.R01.S.doc Version 5.2 Page 20 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 2 3 3 4 3 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 4 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X 3 3 3 X X X 3 Percy House DS0000067157.V293365.R01.S.doc Version 5.2 Page 21 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 YA2 YA6 YA9 Regulation 14 (1) 15 (2) 4 (b)(c) Requirement The Registered Manager must a) Complete preadmission documentation in relation to mental health needs b) Update all service user plans and remove outdated information c) Provide updated risk assessments for all residents as necessary. Timescale for action 01/03/07 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 Percy House DS0000067157.V293365.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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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