Inspection on 10/08/05 for Prospect House

This inspection was carried out on 10th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Prospect House 12/12/06

Prospect House 09/03/06

Prospect House 16/02/05

Prospect House 15/09/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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

CARE HOME ADULTS 18-65 Prospect House Woodlands Avenue Goole East Yorkshire DN14 6RU Lead Inspector Ros Sanderson Unannounced 10 August 2005 10:30 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 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 Stationary 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. J53_J04_S19710_Prospect House_V236047_100805_Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Prospect House Address Woodlands Avenue, Goole, East Yorkshire, DN14 6RU Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01405 761026 01405 720112 Humberside Independent Care Association Limited Mrs Wendy Beck Care Home 24 Category(ies) of Learning disability (24) registration, with number of places J53_J04_S19710_Prospect House_V236047_100805_Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 16/2/05 Brief Description of the Service: Prospect House is situated in a residential area on the outskirts of Goole. The home provides care and accommodation for up to twenty four younger adults who have a learning disability. Prospect House is owned and operated by Humberside Indepenent Care Association Ltd, a not for profit organisation. The accommodation is split into four separate units each having their own lounge, kitchen, dining area and bathroom facilities. Each unit accommodates six service users and the units on the first floor are serviced by a passenger lift. Service users have been encouraged to personalise their own bedrooms. The home is situated conveniently for local facilities including shops, hairdressers and the local hospital. The town centre is within walking distance and there is also easy access to local public transport. J53_J04_S19710_Prospect House_V236047_100805_Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over one day and lasted six hours including preparation time. The inspection process included looking at the service users accommodation, meeting service users and staff and inspecting records of service users. What the service does well: What has improved since the last inspection? What they could do better: During the inspection an aggressive incident was witnessed between two service users. The manager must make sure that all service users are protected at all times and that any incident affecting service users health and welfare are addressed and recorded appropriately. The manager must also ensure that any such incidents are reported to the correct authorities. J53_J04_S19710_Prospect House_V236047_100805_Stage 4.doc Version 1.40 Page 6 At the last inspection a requirement was made that the chains be removed from the bathroom doors allowing service users access at all times. The chains were still in place and service users were observed undoing them theirselves and so having access. It is required that these chains be removed and so reducing any restrictions for service users. Chains should only be used where a risk assessment has been completed and their use is a control measure to reduce identified risks. 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. J53_J04_S19710_Prospect House_V236047_100805_Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection J53_J04_S19710_Prospect House_V236047_100805_Stage 4.doc Version 1.40 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 standard(s) 2 Service users needs and aspirations are fully assessed before admission and this ensures that they and their representatives can be assured that these will be met. EVIDENCE: Service user plans show that full needs assessment are carried out by the home for all prospective service users. This is in addition to any assessment generated from the care management team. The assessment forms the basis for formulating the care plans once service users take up residence. The assessment is completed where possible with the full co-operation of the service user. There is provision in the document for the service user or their representative to sign to indicate their involvement and agreement with the assessment. J53_J04_S19710_Prospect House_V236047_100805_Stage 4.doc Version 1.40 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 standard(s) 6&9 Service users are able to exercise choice and control in their lives through involvement and participation in the care planning process. EVIDENCE: Service users are fully involved in the drawing up of care plans and this helps to ensure that the plans are relevant to individual service users. The plans are partly in pictorial format to aid service users understanding. The home operates a key worker system and all service users are made aware of whom their key worker is. Everybody that is involved with the service user is detailed within the care plan including relatives, advocates, where appropriate, social workers, key workers, and health professionals. Their details are recorded and the service user is aware of how to contact them if needed. There was evidence in the plans that they are reviewed regularly and everybody taking part including the service user signs the reviews. This is evidenced with signatures. The key workers also evaluate the plans on a monthly basis with the cooperation of the service user and this ensures their continuing participation in the care planning process. J53_J04_S19710_Prospect House_V236047_100805_Stage 4.doc Version 1.40 Page 10 On the day of the inspection many service users were out at day centres and other social events. The plans identified what the service users liked to do on a day-to-day basis and the details in the plans showed that the staff assist in helping service users maintain their social lifestyle within a risk assessment framework. Service users spoke about how they were looking forward to a forthcoming holiday. J53_J04_S19710_Prospect House_V236047_100805_Stage 4.doc Version 1.40 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 standard(s) 12&17 Service users take part in activities that they have chosen. Service users are provided with a choice of nutritionally sound food. EVIDENCE: The care plans showed that individual service users preferences regarding activities are recorded. These activities are encouraged by staff who help the service user to continue to be able to participate in chosen activities. Staff constantly introduce new ideas and recent events held in the home included a cheese and wine party. Service users attend local day centres and have the opportunity to further their education in areas such as communication and literacy. Some of the service users had received certificates to recognise their progress. All service users have the opportunity to go on holiday each year and are accompanied by staff. On each unit there is a ‘visual menu’ that service users have access to at all times. It clearly identifies what food is available at each mealtime with the aid of a photograph. Service users have contributed to the planning of menus by suggesting alternatives at their meetings. The food provided is varied and well balanced. J53_J04_S19710_Prospect House_V236047_100805_Stage 4.doc Version 1.40 Page 12 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 standard(s) 18 Service users are provided with support from staff in a way that promotes their choice and independence. EVIDENCE: The care plans that were looked at showed that individual routines, likes and dislikes of service users had been discussed and recorded. The plans identify how service users would like to be supported in their daily routines and staff spoken with were clearly aware of the individual needs of the service users. Routines in the home are flexible allowing the service users to exercise choice and control in their lives. The plans clearly identify healthcare needs of service users and equipment sought to help service users live as independently as possible. Evidence was seen of individual specialised equipment in the service users rooms. Aids and adaptation were also seen around the home to ensure the collective needs of service users are met. The care plans showed involvement of other healthcare professionals where needed including a dietician. Staff were very clear about advice given by the professionals. Staff were observed interacting with service users in an appropriate manner and in a way that encouraged the service users to express opinions and take an active part in conversations. J53_J04_S19710_Prospect House_V236047_100805_Stage 4.doc Version 1.40 Page 13 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 standard(s) 23 Service users are not always protected. EVIDENCE: Policies and procedures are in place to safeguard service users from abuse and staff are aware of these. All staff receive training in Protection of Vulnerable Adults procedures. However during the inspection an incident was witnessed between two service users where one was seen to be aggressive towards another in a way that could cause physical harm. The records showed that this had happened before and on one occasion in previous months had been reported to the local Social Services and the Commission for Social Care Inspection. Not all of the incidents had been recorded in each service users daily records and not all incidents had been reported. Social Service officers have now been informed about all incidents. The manager is required to follow the procedures laid down in the multi agency policy for the protection of vulnerable adults and fulfil her responsibilities under the Care Standards Act 2000. The manager is also required to arrange urgent reviews of the needs of each service user involved and copies of the review documents must be sent to the Commission for Social Care Inspection when the home receives them. J53_J04_S19710_Prospect House_V236047_100805_Stage 4.doc Version 1.40 Page 14 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 standard(s) 24&30 Prospect House is a clean and pleasant place in which to live. EVIDENCE: Prospect House is purpose built and therefore offering easy access for people who may have a disability. Most rooms are single occupancy and those service users who share a room have chosen to do so. There are no offensive odours in the home and it is clean and bright with good natural ventilation. The situation of the home allows service users easy access to local amenities. Service users are encouraged to personalise their rooms and each room is individual to that service user. All equipment provided in the home is of good quality and regularly serviced. There was evidence of personal protective equipment for staff and staff confirmed that they receive training in infection control. There are still chains on bathroom doors in order to prevent access to service users. However during the inspection service users were observed undoing the chains and gaining access. Service users should have access to all areas of the home within a risk assessment framework. In one instance access was restricted as the bath was out of order and awaiting parts so restricting service users in this case was justified. J53_J04_S19710_Prospect House_V236047_100805_Stage 4.doc Version 1.40 Page 15 The laundry facilities in the home are situated away from food preparation areas and equipment provided allows staff to wash laundry at appropriate temperatures. There are adequate hand washing facilities in the laundry. J53_J04_S19710_Prospect House_V236047_100805_Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 Service users are supported by well trained, enthusiastic staff. EVIDENCE: All staff employed at the home have undergone vigorous recruitment and selection procedures. The home only employs staff that they have received two written references or and received a satisfactory CRB check for. All staff attend a block induction week at the companies headquarters and until this is complete the staff work under supervision. Each member of staff has a training plan and this ensures that all mandatory training is completed and current. The organisation also provides training for staff that is relevant to the service user group including understanding dementia and managing challenging behaviour. Staff spoken with were enthusiastic about their roles and knowledgeable about the service users. J53_J04_S19710_Prospect House_V236047_100805_Stage 4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 The health of the service users is protected and to ensure the safety and welfare of service users continue the requirements in this report must be met. EVIDENCE: All safety certificates relating to servicing and checking of equipment in the home are current. The registered manager ensures that all staff receive mandatory training at the required intervals and this ensures that only safe working practices are employed in the home. Fire safety training is carried out four monthly for night staff and six monthly for day staff. Fire safety notices are posted around the home. All risk assessments, both generic and specific to service users are complete and reviewed on a regular basis. It was noted at the inspection that not all incidents affecting the well being of service users had been reported to local Social Services Department and under regulation 37 of the Care Standards Act 2000. A requirement was made that J53_J04_S19710_Prospect House_V236047_100805_Stage 4.doc Version 1.40 Page 18 all incidents affecting the well being of service users are reported to CSCI under Regulation 37 and in the case of adult protection, the local authority. J53_J04_S19710_Prospect House_V236047_100805_Stage 4.doc Version 1.40 Page 19 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 ENVIRONMENT Score x 1 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 x x x x 3 Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 x x x Standard No 37 38 39 40 41 42 43 Score x x x x x 1 x J53_J04_S19710_Prospect House_V236047_100805_Stage 4.doc Version 1.40 Page 20 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 23 Regulation 13(6) Requirement To ensure each service users needs are being met the registered manager must arrange urgent reviews for each of the service users involved in the incident witnessed during the inspection. Copies of the review reports must be forwarded to the Commission for Social Care Inspection All incidents leading to serious injuries to service users or any incident that affects the well being or safety of any service user must be reported to the Commission and in the case of adult protection issues to the Local authority. The registered person must ensure that service users have access to all bathrooms and that the chains are removed. Risk assessments must be in place where control measures are in use to control risk. Timescale for action 17/9/05 2. 23 &42 37(1(c,e)) On receipt of this report and maintained thereafter. 3. 24 23(2(j)) On receipt of this report and maintained thereafter. J53_J04_S19710_Prospect House_V236047_100805_Stage 4.doc Version 1.40 Page 21 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 Good Practice Recommendations J53_J04_S19710_Prospect House_V236047_100805_Stage 4.doc Version 1.40 Page 22 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. 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