Inspection on 12/01/07 for Putney House

This inspection was carried out on 12th January 2007.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Putney House 06/03/06

Putney House 08/11/05

Putney House 09/02/05

Putney House 14/10/04

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 Putney House 47 Scarborough Road Bridington East Yorkshire YO16 7PE Lead Inspector Sarah Sadler Unannounced Inspection 17th January 2007 09:15 Putney House DS0000044926.V326974.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 Putney House DS0000044926.V326974.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. Putney House DS0000044926.V326974.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Putney House Address 47 Scarborough Road Bridington East Yorkshire YO16 7PE 01262 674818 F/T 01262 674818 putney@learningdisabilitiesprovider.co.uk 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) Putney House Limited *** Post Vacant *** Care Home 18 Category(ies) of Learning disability (18) registration, with number of places Putney House DS0000044926.V326974.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 6th March 2006 Brief Description of the Service: Putney House occupies two premises on the one site and is situated on the outskirts of Bridlington, with local amenities that are accessed readily by service users. Accommodation is provided over two floors, with wheelchair access at the rear of the building. There is no passenger lift. The home has a private garden for service users and there are car-parking facilities. A mini-bus is provided for service users who contribute towards the cost of this facility. Putney House Limited owns the home. The fees for the home range from £330 to £1100 per week, with additional charges for example, for toiletries. Putney House DS0000044926.V326974.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key unannounced inspection was undertaken as part of the routine programme of inspections. It commenced at 09.00 and was completed at 16.00 on the 12 January 2007, with a previous one-day’s preparation. The registered person, unregistered manager and one staff member assisted the inspector throughout the day. The service users assisted with the inspection. There were no visiting health professionals or residents’ representatives present on the day of the site visit. A tour of the premises was undertaken and residents’ files and other records were examined. This included pre-inspection material provided by the unregistered manager. Comment cards were sent to service users, relatives and professionals. No responses were received. What the service does well: The residents spoken with on the day of the visit all confirmed that they were happy in the home. Service users attend a variety of activities and choose what they want to do, meeting their social needs and retaining their right to choice. Families and friends are welcomed into the home, with people being supported to maintain contact and relationships. Peoples individual health needs are documented and they are supported to attend any necessary medical appointments, this ensures that their health needs are met. People are able to complain and staff are trained in adult protection; this helps protect service users from abuse. The service is run to meet the specific needs of people with Prader Willi syndrome and the care plans and service user documentation reflect that this is taken into account both in the planning and meeting of needs. Putney House DS0000044926.V326974.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: The statement of purpose and service user guide have not been amended to reflect recent changes within the home. This does not allow potential service users a full picture of the home prior to moving in. The manager has not applied to be registered with the CSCI; registration is a requirement as it is unlawful to manage a service without being registered. The electrical wiring and emergency lighting certificates were not up to date at the time of the visit. A requirement letter was later issued to the registered person and appropriate actions were taken. However the registered person must ensure that, to protect service users, the health and Safety checks within the home are kept up to date at all times. Please contact the provider for advice of actions taken in response to this Putney House DS0000044926.V326974.R01.S.doc Version 5.2 Page 7 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. Putney House DS0000044926.V326974.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 Putney House DS0000044926.V326974.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): 1,2 Quality in this outcome area is adequate . This judgement has been made using available evidence including a visit to this service. Service users are provided with some but not all of the necessary information to enable them to make decisions about living in the home. However, the home does assess their needs to ensure that these can be met. EVIDENCE: There is a statement of purpose and service user guide available within the home. This provides potential service users and their representatives with some information regarding the home and the services offered. However, the registered person explained that recent changes to the home have not yet been incorporated into these documents to update them. Without this information potential service users cannot make an informed decision when choosing their home and support they will receive. All of the service users have resided in the home for some time. Each of the files examined included a very comprehensive Person Centred Plan (care plan), which describes in detail the needs of the service user. This has been Putney House DS0000044926.V326974.R01.S.doc Version 5.2 Page 10 developed from the initial assessments of the service users and allows the carers a full picture of the individual’s needs and how these should be met. Putney House DS0000044926.V326974.R01.S.doc Version 5.2 Page 11 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 good. This judgement has been made using available evidence including a visit to this service. Service users are able to lead their lives, as they would wish, including risk taking; they have a plan of care to support them with this. EVIDENCE: People spoken with were happy living in the home, with the staff team and with the level of support that they receive. Each person has an individual care plan called a Person Centred Plan. These plans are reviewed within the home, with documents reflecting that this review is planned for on a weekly basis. Examination of the files and discussion with the unregistered manager evidenced that, although these reviews may take place, some of the paperwork has been mis-filed and so is not currently available. Further discussion with them manager reflected that this was Putney House DS0000044926.V326974.R01.S.doc Version 5.2 Page 12 actually available within the home. This will be re-addressed at the next site visit. This information provides staff with the details of any changes in care needs and assists them to fully monitor this; it also provides a baseline from which to complete the next review. Annual reviews do take place; these involve the individual service user, their representative from the placing authority, staff from Putney House and possibly a family member. These reviews include feedback from a comprehensive written report produced by the home and allow the service user to participate in a decision making process relating to their care. When asked service users confirmed that they are able to choose what to do and to make their own decisions. The inspector observed that service users choose what activity to undertake and whether to spend time in their own room or to sit with others in the communal areas. Service user notes reflected that people participate in a variety of activities both within the home and the local community. When asked the one staff member interviewed confirmed that people decide to what activities to undertake and which toiletries to use. Service user files included copies of risk assessments that are comprehensive and cover many areas of their lives, for example, bathing and cooking. The risk assessments describe the individual risks, and how these will be managed to help prevent injury, and are also regularly reviewed to ensure that they contain up to date information, reflecting the current amount of risk. A staff member confirmed that people are supported to take risks, for example, to boil the kettle. The registered person confirmed that work is continuing to make polices and procedures available ion different formats so that service users can easily access and read these. Putney House DS0000044926.V326974.R01.S.doc Version 5.2 Page 13 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): 12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are able to undertake leisure activities of their choosing and maintain contact with friends and family. EVIDENCE: Service user records reflect that service users undertake a variety of activities, these include going to local adult education classes, trips out on the minibus and visiting family. They also include activities within the home, such as computer work, playing electronic games, knitting, watching TV and DVD’s and playing board games. Service users confirmed that they were happy with the support provided and in living in the home. Putney House DS0000044926.V326974.R01.S.doc Version 5.2 Page 14 Service user records again contained information relating to the contact that service users have with family and friends. Service users are able to telephone relatives and to receive calls; they also spend time away from Putney house visiting relatives. Service users confirmed that their relatives are able to visit them anytime. Service users were observed to be able to choose when to spend time alone or with others, with unrestricted access to the communal areas of the home and garden, reflecting their right to choose where to spend their time. All but one of the service users has a specific medical condition which affects the diet they are able to have. This is managed very carefully within the home and people have set diets within a rotational menu with the correct foods provided. Service users confirmed that they like the food provided. Putney House DS0000044926.V326974.R01.S.doc Version 5.2 Page 15 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): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are happy with the support they receive, and have their health and medication needs met. EVIDENCE: Service users confirmed that they like the support they receive from the staff team, stating that they “like the staff” and that “the staff are nice”. Service users are supported to maintain their level of health. Service user records included detailed notes of their medical needs. Any appointments to health professionals were recorded with the need for and outcome of the visit. Specific medical needs were recorded within the care plan and monitoring records were used as needed. The service users are supported by the staff team to receive any prescribed medicines. There is a medication procedure within the home and medicines are stored appropriately. There is not a medication fridge as there are currently no medicines needing to be stored at a set temperature. Putney House DS0000044926.V326974.R01.S.doc Version 5.2 Page 16 Records are kept of the receipt of, administration and disposal of all medicines. Putney House DS0000044926.V326974.R01.S.doc Version 5.2 Page 17 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. Service users and their representatives are able to complain and on the whole are protected from abuse. EVIDENCE: The registered person confirmed in the pre-inspection questionnaire and on the day of the visit that no complaints had been received by the home. There is a complaints policy held, which also includes the details of the CSCI should the complainant wish to contact them. Service users spoken with were happy to raise concerns and confident that these would be dealt with by the staff. One concern regarding the sudden death of a service user was referred to the CSCI, this was not founded and no issues were raised from this investigation. The home has a copy of the Local Authority’s policy the Protection of Vulnerable Adults. The member of staff interviewed had attended training regarding this and was clear on the actions she would take should an allegation or situation occur. The correct recruitment procedure to ensure the protection of service users has not been followed regarding Criminal Record Bureau (CRB) checks and this is described in more detail in the staffing section of this report. Service users are supported by the home to manage their finances and due to the individual needs relating to their health condition, are supported with very Putney House DS0000044926.V326974.R01.S.doc Version 5.2 Page 18 clear guidelines regarding the expenditure of their finances. This is to ensure that the monies are spent appropriately and that for example, food is not purchased which would detract from their healthy diet and general health. Records are kept of all transactions, with receipts for expenditures. Putney House DS0000044926.V326974.R01.S.doc Version 5.2 Page 19 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 good. This judgement has been made using available evidence including a visit to this service. Service users live in a comfortable and clean home. EVIDENCE: Service users continue to live in a home that is warm and comfortable. The registered person has recently upgraded and altered some of the accommodation in the one of the buildings into individual bed-sit type rooms and there is a handy person employed within the home for ongoing maintenance. The home has undertaken testing for Legionella in order to meet the requirement that the home meets the Water Supply (Water Fittings) 1999 Regulations. However there was already an assessment in place for this, with the only requirement being that the washing machines had slight adjustments. The registered person confirmed that this work had taken place. This helps to control the risk of infection and maintain individuals health. Putney House DS0000044926.V326974.R01.S.doc Version 5.2 Page 20 The home was clean and tidy throughout. Putney House DS0000044926.V326974.R01.S.doc Version 5.2 Page 21 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 adequate. This judgement has been made using available evidence including a visit to this service. Service users are supported by a well trained staff team, but staff are not always recruited correctly to ensure they are suitable for the job and service users are protected. EVIDENCE: The manager has produced a plan of training for over the next year and the staff team have undertaken a variety of retraining over the previous twelve months. This training included: hoist, risk assessment, Prader Wili Syndrome, diabetes and whistle blowing. The registered person confirmed in the pre-inspection material that all of the staff have attained a National Vocational Qualification (NVQ) in Care at Level 2 or equivalent. Some staff have completed Learning Disability Award Framework (LDAF) training and some staff are currently undertaking this. Putney House DS0000044926.V326974.R01.S.doc Version 5.2 Page 22 Staff records reflected that 2 written references are undertaken on all staff prior to employment. All but one of the staff files included a Criminal Records Bureau (CRB) check to assist in ensuring their suitability for working with vulnerable people. The registered person confirmed that a POVA- first check had not been undertaken prior to this person’s employment and that this was the normal recruitment process. The POVA first check would reflect whether or not an individual has been referred or placed on the POVA list, following an allegation of malpractice, which may prevent them from working with vulnerable people. Checking of this is another way to ensure people are suitable to work with vulnerable individuals. Without a CRB or POVA first check in place the registered person will not be able to ascertain that the potential staff member is suitable to work with vulnerable people and if they consequently commence work, this may place people at risk. Putney House DS0000044926.V326974.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): 37,39,42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users live in a home that is on the whole well managed, but where their health and safety needs are not fully met. EVIDENCE: The unregistered manager has undertaken training and has only to complete one more section to achieve the National Vocational Qualification (NVQ) Level 4 in care, after which she is to undertake training that will meet the requirement for a management qualification to NVQ level 4 in management. Putney House DS0000044926.V326974.R01.S.doc Version 5.2 Page 24 The manager is not yet registered with the CSCI and has not applied for registration. The manager and registered person have not ensured that people are recruited correctly to work in the home. This has not ensured that service users are protected from harm. There is an annual quality assurance check in place, which has not yet been undertaken this year. The registered person confirmed that this system has been developed to include stakeholders and that this will take place this year. The registered person confirmed in the pre-inspection material that all health and safety checks were up to date. Records for fire drills and checks were in place and up to date. There are regular checks for the home and a handyperson is employed to assist with this process. There is a Control of Substances Hazardous to Health (COSHH) file. There was a Landlords gas safety record in place. However there was no up to date evidence that the electrical wiring or emergency lighting were maintained to a satisfactory standard. This was discussed with the registered person at the time of the inspection, who confirmed that evidence of this would be received by the CSCI by 12pm the following day. This was not received and a requirement to complete this was made to the registered person, with a completion date of 23 January, when a faxed response was received from an electrician on this date. Putney House DS0000044926.V326974.R01.S.doc Version 5.2 Page 25 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 2 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 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 2 X 3 X X 2 X Putney House DS0000044926.V326974.R01.S.doc Version 5.2 Page 26 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 YA1 Regulation 4,5,6 Requirement Timescale for action 25/02/07 2 YA34 19 3 Care Section 11. Standards Act 2000 The registered person must ensure that there is an up to date statement of purpose and service user guide available. The registered person 25/02/07 must ensure that staff are safely recruited. A CRB and/or POVA first check must be completed prior to employment. The registered person 25/02/07 must ensure that the unregistered manager applies for registration with the CSCI. 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 YA8 Good Practice Recommendations The registered provider should ensure that policies and procedures are in accessible formats for service users. Putney House DS0000044926.V326974.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 Putney House DS0000044926.V326974.R01.S.doc Version 5.2 Page 28 - 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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