Inspection on 24/06/07 for Prudhoe House

This inspection was carried out on 24th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Prudhoe House 05/06/08

Prudhoe House 19/11/06

Prudhoe House 02/02/06

Prudhoe House 08/09/05

Prudhoe House 26/11/04

Prudhoe House 22/07/04

Prudhoe House 09/03/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 Prudhoe House South Road Prudhoe Northumberland NE42 5LB Lead Inspector Glynis Gaffney Key Unannounced Inspection 24, 25 and 29 June and 30 July 2007 13:30 Prudhoe House DS0000000648.V338154.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 Prudhoe House DS0000000648.V338154.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. Prudhoe House DS0000000648.V338154.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Prudhoe House Address South Road Prudhoe Northumberland NE42 5LB 01661 830786 01661 830786 NTAWNT.prudhoe@nhs.net 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) Northumberland, Tyne & Wear NHS Trust Ms Judith Blackburn Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Prudhoe House DS0000000648.V338154.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: There are no additional conditions of registration Date of last inspection 19th November 2006 Brief Description of the Service: Prudhoe House is a registered care home for six people who have learning disabilities, situated within the community of Prudhoe. The home is an attractive listed building and blends in with the local community. It is not recognisable as a care home. The following facilities are available – four single bedrooms and one double room, an assisted bathroom, two toilets, an office/activities area, a lounge and a dining kitchen. There is an attractive garden area to the front of the building. Off street car parking is available. Copies of the home’s statement of purpose and the Commission’s inspection reports were available by request at Prudhoe House. The current scale of charges is between £62.35 and £94.45 per week. Prudhoe House DS0000000648.V338154.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. How the inspection was carried out: Before the visit: We looked at: • • • • • Information we have received since the last visit on the 19 November 2006; How the service dealt with any complaints & concerns since the last visit; Any changes to how the home is run; The manager’s view of how well they care for people; The views of people who use the service & their relatives, staff & other professionals. The Visit: An unannounced visit was made on the 24 June 2007. During the visit we: • • • • • • Talked with one person who used the service, some of the staff, the manager and her deputy; Looked at information about the people who use the service & how well their needs are met; Looked at other records which must be kept; Checked that staff had the knowledge, skills & training to meet the needs of the people they care for; Looked around the building to make sure it was clean, safe & comfortable; Checked what improvements had been made since the last visit. We told the manager what we found. What the service does well: A person living at the home said: ‘I like living at Prudhoe House and I am made very comfortable. I have a work placement and also go on holiday with other service users and staff. (Staff) always listen and understand what I need during the day and night.’ Prudhoe House DS0000000648.V338154.R01.S.doc Version 5.2 Page 6 The families of people living at the home were surveyed as part of the inspection. A selection of comments has been included throughout this report. A family member said: ‘My son depends on (the) carers as he is unable to choose the way he lives. The staff at Prudhoe House do the job well. They also make sure that I am okay getting (my daughter) and I to hospital appointments and anywhere else we need to go.’ No surveys were returned by professionals involved with the service. The manager adopted a positive approach to the inspection process and was willing to engage in a constructive debate. The premises were pleasantly furnished throughout. Each of the bedrooms visited were nicely decorated and furnished. They were also clean and tidy. There were no unpleasant odours present in the building. A resident said that she enjoyed the meals served at Prudhoe House. Staff were kind, respectful, considerate and had developed warm and caring relationships with the people in their care. A resident said that she was very satisfied with the care and support provided by Prudhoe House staff. She felt that staff listened to her opinions and views. People received a good standard of physical care. There was a pleasant atmosphere in the home. Staff communicated with people in a positive manner, building upon their strengths and abilities. People living at the home had access to a separate activities area that contained specialised sensory equipment. The majority of staff had obtained a relevant qualification in care. Each year the Trust requires staff to complete a statement regarding whether they have received any convictions during the previous 12 months. The home had its own transport. The Trust had made arrangements for the home’s financial records and budgetary information to be audited on a monthly basis. What has improved since the last inspection? Following requirements set in the last inspection: Prudhoe House DS0000000648.V338154.R01.S.doc Version 5.2 Page 7 • • • • Peoples’ care plans had been reviewed on a regular basis in line with the National Minimum Standards; The home’s complaints record had been updated to include details of the most recent complaint received by Prudhoe House; Specialist bathing equipment had been provided to make it easier for people to use the bath; Regular visits had been carried out by the provider to assess and monitor the quality of service provided at the home. A new fire system and alarm had been fitted. 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. Prudhoe House DS0000000648.V338154.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Prudhoe House DS0000000648.V338154.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The needs and wishes of each person had been properly assessed before they moved into the home. This meant that staff knew about the needs of each person and what care and support they required. EVIDENCE: The people who live at Prudhoe House had lived there for several years. Each person’s needs had been assessed before their admission into Prudhoe House. This had been confirmed during previous inspection visits to Prudhoe House. The home’s statement of purpose said that people would only be admitted into the service following receipt of a full Social Services needs assessment. Standard two was not fully assessed, as there had been no new admissions into the home since the last inspection visit in November 2006. Prudhoe House DS0000000648.V338154.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Peoples’ care records contained useful guidance and information setting out how their needs should be met. But, they did not cover all of the areas referred to in the National Minimum Standards. This might result in staff not being clear about how to meet each person’s care needs. The arrangements in place for assessing the risks posed to people were generally satisfactory. This meant that people living at the home were protected from unnecessary risks and potential harm. EVIDENCE: The care records of two people living at the home were examined. Each file contained good information about what people could do for themselves, what support they required from staff, and how their needs were to be met in the Prudhoe House DS0000000648.V338154.R01.S.doc Version 5.2 Page 11 home. Although this information had recently been reviewed, the assessments were originally compiled in 1995/1996 when people first moved into the home. The Trust was in the process of introducing a new approach to person centred planning and that most staff had recently undergone training in this area. During the next 12 months, the manager intends to implement the Trust’s new approach to care planning within her home. A variety of care plans had been prepared for each person covering areas such as the management of personal finances, eating and drinking, health care and mobility. But, care plans addressing peoples’ needs in each of the areas referred to in the National Minimum Standards had not been prepared. Staff recognised that taking reasonable risks is an essential part of people’s lives and took steps to support each person to be independent while keeping them safe. During the inspection, staff were observed supporting and encouraging people to make decisions and choices about what they wanted to do. Care records contained some information about what choices and decisions people were able to make. There was no evidence that independent advocates had been used to help identify what support people required to make daily choices and decisions. Peoples’ care plans referred to the use of Communication Dictionaries to help promote better understanding and expression. But, there was no information relating to the use of these tools in the care records examined. Although the person interviewed as part of the inspection arrangements had signed the assessment information held about her, she had not signed her care plans to confirm her agreement with the contents. Other people living at the home were unable to do so due to the significant level of their disabilities. Staff were observed providing physical care in a kind, respectful and sensitive manner. They demonstrated a good understanding of peoples’ needs and had learned to communicate with them in an effective manner. Steps had been taken to minimise the risks faced by people living at the home. General risk assessments had been devised covering such areas as the use of the lease vehicle, safety in the home and the use of the kitchen. All of these assessments had been updated in the last 12 months. In one person’s care records, a moving and handling risk assessment had been completed. But, it had not been updated since January 2006. Other risk assessments had been completed covering the person’s need for support with activities outside of the home and what assistance would be needed in the event of a fire. There was no moving and handling risk assessment in the second set of care records examined. Prudhoe House DS0000000648.V338154.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Suitable arrangements were in place for people to take part in appropriate activities in line with their needs and preferences. Staff and people living at the home had good links within the local community and the arrangements for supporting people to maintain contact with their friends and family were satisfactory. The relationships between staff and people living at the home were good and personal support was provided in such a way as to promote and protect their privacy and dignity. EVIDENCE: Prudhoe House DS0000000648.V338154.R01.S.doc Version 5.2 Page 13 People had been provided with opportunities to develop and maintain important personal and family relationships. Peoples’ care records contained important information about families and friends. During the inspection, a member of staff supported one person to visit their mother in hospital. Another person said that staff supported her to take the daily phone calls she received from her mother in private. The same person also said that staff always made visitors and family members feel welcome. There was clear written guidance for staff regarding how they should respect and safeguard peoples’ right to privacy. Staff supported people to join in meaningful daytime activities. For example, two people attended a local day care facility during the week. For two other people, their daytime care needs were met in-house. Staff said that a timetable of opportunities had been drawn up for each person. A timetable was not available in one person’s care records. Arrangements had been made for people to participate in weekly sensory, musical, aromatherapy and artwork sessions. Staff supported people to make use of everyday community facilities. The home had its own transport. Over a period of three months, one person had visited the Theatre Royal in Newcastle and attended a concert at the Newcastle Arena. A member of staff said that wherever practical, at least one person always participated in the home’s weekly shopping trip. One person said that she was very happy with the opportunities she had been given to go to work and follow her chosen hobbies and leisure interests. People had opportunities to mix with people who did not have disabilities through the use of what the local community had to offer. Most people living at the home required some degree of assistance with eating and drinking. Peoples’ assessments contained information about how their needs for support with eating and drinking should be met. For example, one person’s assessment included reference to the need to promote healthy eating and maintain their current weight. There was also reference to the need to involve a dietician where necessary. Care plans covering peoples’ needs for assistance with eating and drinking had been devised. The Home’s menus were varied and indicated that people were offered a healthy and nutritious diet. Alternatives were available and healthy eating was encouraged. People were encouraged to assist with the food shopping and, where appropriate, the preparation of meals. Because of the size of the kitchen/dining area staff took their meals after people living at the home had eaten theirs. One person said that they were very happy with the food served at the home. Prudhoe House DS0000000648.V338154.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for monitoring and meeting peoples’ health care needs were satisfactory. This meant that people received the health care and support they needed. The arrangements for the administration and recording of medication were also satisfactory and protected people from potential harm. EVIDENCE: Staff spoke knowledgeably about how peoples’ health care needs were met. Each person had a detailed health care assessment that had been recently updated. Generally, people had been provided with regular access to dental, optical, chiropody, and where required, more specialised health care. Peoples’ continence care needs had recently been assessed. It was identified that one person had not received dental or optical health care in over two years. Staff said that they had received training in meeting peoples’ health care needs. Prudhoe House DS0000000648.V338154.R01.S.doc Version 5.2 Page 15 The deputy manager said that arrangements had recently been made for two staff to complete a course in diabetic care. A person using the service said that she felt well cared for. Three relatives who returned surveys said that the home ‘always/usually’ sought to manage and improve peoples’ health care needs. Support plans had been put in place that set out how peoples’ personal care needs were to be met. For one person this covered the assistance they required with bathing, personal hygiene and dressing. Three relatives who returned surveys said that the home ‘usually/always’ respected individuals’ rights to privacy and dignity. The Trust had prepared a detailed medication policy. Local procedures setting out how medication was to be handled within the home were in place. A sample of peoples’ medication records was examined and these were generally satisfactory. A record of medicines received into the home had been kept. All medicines were safely locked away. Staff administering drugs were observed removing medication from a storage cupboard and taking it into the kitchen to administer. This practice had not been risk assessed. There were no people administering their own medication, or taking controlled drugs, at the time of the inspection. All staff had received training in the safe handling of medicines. Three relatives who returned surveys said that medication was ‘usually/always’ well managed. Prudhoe House DS0000000648.V338154.R01.S.doc Version 5.2 Page 16 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 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Suitable systems were in place for handling complaints and for protecting people from abuse. This meant that peoples’ views, and those of their representatives, were listened to and acted upon, and people were protected from abuse and neglect. EVIDENCE: The home had a complaints procedure. This was not available in a format that could be easily understood by any of the people living at the home. Various leaflets explaining how the Trust’s complaints procedure operated were available on request. One person said that if she was unhappy with anything that happened in the home she would tell her mother or a member of staff. Other people were unable to comments on how complaints were handled by the home. Neither the home, nor the Commission, had received any complaints since the last inspection. Three relatives who returned surveys said that the home ‘usually/always’ responded appropriately if concerns were raised. All staff had received training in the protection of vulnerable adults. This is now part of the regular core training for staff. Policies and procedures for the protection of vulnerable adults were in place. There had been no incidents that Prudhoe House DS0000000648.V338154.R01.S.doc Version 5.2 Page 17 had required a referral in line with these procedures. One person told the inspector that she felt safe and secure living at the home. Prudhoe House DS0000000648.V338154.R01.S.doc Version 5.2 Page 18 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 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The arrangements for keeping the home clean and tidy were satisfactory. The standard of the accommodation, décor and furniture and fittings was generally satisfactory and provided people with a comfortable place to live. There was not sufficient space to enable staff to provide support in an appropriate way to people who needed it when eating. EVIDENCE: The home provided a pleasant and safe place to live. A tour of the premises revealed no hazards. Peoples’ bedrooms were attractively decorated and furnished. There was one shared bedroom. Privacy screening had been provided. Staff had ensured that each bedroom was different and reflected the needs and personalities of the occupant. The layout and design of the home enabled people to live together in an ordinary domestic environment. The Prudhoe House DS0000000648.V338154.R01.S.doc Version 5.2 Page 19 home was well lit, warm, clean and tidy. There were no unpleasant odours. Maintenance and redecoration had been carried out at regular intervals. At the time of the inspection, a new fire system was being fitted. Although people had access to a sensory room, this area also housed the home’s office and filing systems. Cleaning materials and other potentially hazardous substances had been safely stored. The Deputy Manager said that he thought the Department of Health Infection Control checklist had not been completed. The home had been adapted to meet the needs of the people living there. A range of specialist aids and equipment had been provided. For example: • • • The assisted bathroom had been fitted with grab rails and a ceiling hoist; An electric seat was available to help lift people off the floor following a fall; There was a lift giving people level access to all parts of the building. The kitchen was clean and tidy and a new dining table and chairs had recently been purchased. But, space was limited making it difficult to provide appropriate support to people who needed it at meal times. For the whole of the teatime meal a member of staff had to both stand and crouch whilst supporting someone to eat their meal. Staff told the inspector that staggered meal times had once been tried to reduce the number of people in the kitchen. They said this had not worked. The home was originally registered by the local authority on the understanding that a combined kitchen dining room would be sufficient to meet the needs of the people living at Prudhoe House. Since that time, the National Minimum Standards and the Care Homes Regulations have been introduced and implemented. Staff said that people living at the home would benefit from a walk-in shower that would give them a choice when bathing. A relative who returned a survey said that another bathroom and a bedroom would further improve the service. Prudhoe House DS0000000648.V338154.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was a satisfactory programme of regular and structured staff supervision. This meant that staff were properly supervised, received support and guidance in meeting the needs of people living at the home. There was a competent team of staff who had access to a range of training opportunities. This meant that people were being cared for by staff that had had relevant training in meeting their care needs. EVIDENCE: The provider had a recruitment and selection policy. A sample of staff personnel records was examined. There was evidence that: • Criminal Records Bureau Disclosure checks had been carried out for each member of staff and two written references had been obtained; DS0000000648.V338154.R01.S.doc Version 5.2 Page 21 Prudhoe House • • Staff had completed an application form and updated their Rehabilitation of Offenders statement on an annual basis; Each member of staff had been given a contract of employment and had received induction training. Staff were observed communicating with and supporting people in a caring, respectful and helpful manner. A sample of rotas was checked. A minimum of two staff had been rostered on duty throughout the working day. On occasions, extra staff had been scheduled on duty. Staff said that this enabled them to support people to use community facilities, participate in trips out and attend social events. One member of staff who sleeps over at the home covers the nighttime period. Most of the people who live at the home have profound support needs and some also have physical disabilities. One person has epilepsy and another requires the use of a wheelchair and assistance with moving and handling. During the inspection, a member of staff was observed accompanying a resident to visit their mother in hospital. This left the remaining member of staff to monitor, support and assist the four people who had stayed behind. An examination of a sample of rotas showed that there had been occasions during the previous week, when one member of staff had been left to care for four residents, whilst the other care worker drove two people to their day care placement. Staff said that depending on who had been left behind in the building, assistance might be required with using the toilet or mobilising. The inspector was advised that should the lone worker find it necessary to carry out such tasks, the remaining residents would be left unattended, albeit for short periods of time. Staff said that they felt it was not good practice to leave a lone worker in the building to care for residents, even when there were fewer people in the home. There was no risk assessment that specifically addressed the risks associated with leaving one member of staff, whether in the home or in the community, to care for people with such profound support needs. However, there was no evidence during the inspection that people had been neglected or put at risk as a consequence of the home’s staffing arrangements. Staff from other homes had covered shortfalls in the rota. turnover of staff. There was a low Only one person was able to complete a survey. In her response, she said that – ‘I can do most things at Prudhoe House when there are enough staff on duty.’ This person also said that she felt well treated by staff and got on with everyone. Three relatives who returned surveys said that care staff had the skills and experience to meet the needs of people living at the home. The majority of staff had obtained a relevant qualification in care. Staff that had completed a care qualification had covered equality and diversity issues as part of this training. There was a programme of training for staff that included Prudhoe House DS0000000648.V338154.R01.S.doc Version 5.2 Page 22 regular updates of core training. The training programme for 2007 – 2008 included Equality and Diversity and Person Centred Planning. Arrangements were in place to ensure that staff updated their statutory training in key areas on an annual basis. The deputy manager said that documentary evidence of training attended was not always in place as staff usually kept their certificates. The manager maintained an overview of the dates on which each member of staff received supervision. In 2007, each person had received two supervision sessions. These records were not checked during the inspection. Prudhoe House DS0000000648.V338154.R01.S.doc Version 5.2 Page 23 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 and 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The manager provided a clear sense of leadership, involved staff in the management of Prudhoe House, and demonstrated a commitment to providing people with good quality care. This meant that people lived in a home which was run and managed by a person who was fit to be in charge, was of good character and able to discharge her responsibilities fully. There were suitable arrangements for keeping peoples’ money and valuables safe. This meant that people living at Prudhoe House could be sure that their money and financial interests were being safeguarded. EVIDENCE: Prudhoe House DS0000000648.V338154.R01.S.doc Version 5.2 Page 24 The manager is a registered nurse with significant experience of working with people who have learning disabilities and managing a community home. She also had a relevant management qualification. All of the people living at Prudhoe House had their money managed on a dayto-day basis by the home. Each person had their own separate purse in which their money was kept. Peoples’ money was securely stored. Two staff signatures had been obtained for money spent on behalf of people living at the home. Receipts had been obtained for money spent. Peoples’ financial records and the home’s general financial records were independently audited on a monthly basis. Internal systems had been developed to monitor the quality of care provided in the home. For example: • • • • Provider monitoring visits had been carried out on a regular basis. The documentation used by the Trust to monitor the quality of its services had recently been expanded to address a wider range of quality issues; Quality questionnaires had been sent to peoples’ relatives in 2006. Generally, positive responses had been received; Two working groups had recently been set up to review the Trust’s approach to care planning and documentation used, and how it ensures equality and diversity within the services provided; Arrangements had been put in place to monitor staff performance. This enabled the Trust to support staff to attain core skills and relevant knowledge. Professionals having regular contact with Prudhoe House, as well as the home’s staff, had not been consulted about how well the home was meeting its objectives. A range of health and safety records was examined. There was an inspection of the premises during which no hazards were identified. The home had a current gas safety certificate. The lift had been serviced on at least two occasions in the last 12 months. Electrical appliances had been safety checked. There was an up to date fire risk assessment. A new fire alarm system had recently been fitted. However, the following concerns were identified: • • • Documentary evidence confirming that all of the home’s hoisting equipment, and electronic bed, had been serviced on at least two occasions in the last 12 months was not always in place; Staff had not participated in fire drills at the frequency stipulated by the local Fire Authority; The home’s legionella risk assessment had not been reviewed during the last 12 months; DS0000000648.V338154.R01.S.doc Version 5.2 Page 25 Prudhoe House • • A number of fire doors had been propped open to make it easier for people with limited mobility to walk freely around the building; The home did not have a current periodic inspection report for its electrical installations. Prudhoe House DS0000000648.V338154.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 2 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 2 X Prudhoe House DS0000000648.V338154.R01.S.doc Version 5.2 Page 27 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 YA6 Regulation 15 Requirement Ensure that: • Steps are taken to implement the Trust’s new approach to care planning within the home; Each individual’s Person Centred Plan (PCP) covers all of the areas referred to in the National Minimum Standards for Younger Adults; The PCP devised is in a format that can be understood by the person to whom it refers, wherever this is possible. Timescale for action 01/12/08 • • 2. YA24 23(2)(f) A qualified person should carry 01/01/08 out an assessment of the kitchen environment to ensure that it meets the needs of the people living there. 01/04/08 Action should be taken to improve the kitchen environment in line with the findings of any assessment conducted. 3. YA24 23(2)(f) Prudhoe House DS0000000648.V338154.R01.S.doc Version 5.2 Page 28 4. YA33 18 Carry out and implement a risk 01/01/08 assessment that takes into account the needs and capabilities of the people living at the home. The assessment must include strategies to minimise any risks identified as a result of leaving only one member of staff in the building. Ensure that documentary 01/12/07 evidence of any relevant qualifications and training undertaken by staff is obtained. Ensure that: • Documentary evidence is available within the home confirming that: * All hoisting equipment (and the electronic bed) have been serviced every six months; * The home’s electrical systems have been inspected on a periodic basis; • Staff participate in at least two fire drills each year; • Extra risk assessments are completed in the following areas: preventing falls from first floor windows; managing the risks associated with hot surfaces such as radiators; • Fire doors are not propped open. Review other methods for holding fire doors open that comply with the fire regulations. 01/12/07 5. YA35 7, 9 & 19 6. YA42 13(4) 7. YA42 23 Ensure that all staff take part in 01/12/07 at least two fire drills every 12 months. (The timescale for complying Prudhoe House DS0000000648.V338154.R01.S.doc Version 5.2 Page 29 with this requirement expired on 12/03/07) RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA6 Good Practice Recommendations A nationally recognised approach to person centred planning should be adopted for use within the home. Use the Person Centred Plan (PCP) process to explore what choices and decisions each person living at the home can make. Provide people with access to an independent advocate to assist in the development of their PCP. (Refer to: ‘The Watching Brief’ by Assist – advocacy guidance for people with high support needs or significant barriers to communication. Email: h.boon@bild.org.uk) Where appropriate, review Communication Dictionary. 2. 3. YA24 YA30 Provide a walk-in shower facility. Complete the Department of Health Infection Control checklist for Care Homes. Test the home’s water systems for the presence of Legionella on a six monthly basis. Review the home’s legionella risk assessment each year. 4. YA39 Ensure that staff, and professionals who have contact with the home, are surveyed about their opinions regarding how well Prudhoe House meets its objectives. peoples’ need for a Prudhoe House DS0000000648.V338154.R01.S.doc Version 5.2 Page 30 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 © 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 Prudhoe House DS0000000648.V338154.R01.S.doc Version 5.2 Page 31 - 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. 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