Inspection on 22/05/06 for Red Admiral Court (3)

This inspection was carried out on 22nd May 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 11 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Red Admiral Court (3) 29/05/08

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Blenheim House

Prince Bishop Court

Park View (15)

Craigmore House

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

CARE HOME ADULTS 18-65 Red Admiral Court (3) 3 Red Admiral Court Gateshead Tyne and Wear Lead Inspector Miss Andrea Goodall Key Unannounced Inspection 22 , 26th May, 5th June & 4th July 2006 10:00 nd Red Admiral Court (3) DS0000066171.V293013.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 Red Admiral Court (3) DS0000066171.V293013.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. Red Admiral Court (3) DS0000066171.V293013.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Red Admiral Court (3) Address 3 Red Admiral Court Gateshead Tyne and Wear 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) 0191 4611469 Henshaws Society for Blind People Mr Alan Roger Temple Care Home 6 Category(ies) of Learning disability (6), Physical disability (3), registration, with number Sensory impairment (6) of places Red Admiral Court (3) DS0000066171.V293013.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection N/A. First Inspection. Brief Description of the Service: The property at 3 Red Admiral Court is a large, family house in a modern housing estate that was built in 1990. It has been extended to provide 6 bedrooms that meet the National Minimum Standards for Younger Adults. The home provides 6 places for younger adults with learning disabilities and visual impairments, 3 of whom may also have physical disabilities. Three bedrooms on the ground floor have been designated as suitable for use by people who use a wheelchair. The remaining 3 bedrooms are on the first floor, one of which has an en-suite bathroom. There is also a communal bathroom on the ground floor and another on the first floor. The building also provides a kitchen/dining room and a lounge on the ground floor. There is a small quiet room on the first floor. Henshaws Society for Blind People recognises that this room is restricted to use by residents with good mobility, and this limitation is to be reflected in the homes Statement of Purpose. The building has been assessed by a Mobility Officer to ensure that the facilities provided will meet the needs of people with a visual impairment and a physical disability. There is a large staff office on the second floor. The house is a short walk from some local shops and local transport routes. The current residential fee is £1138.63 per week. Red Admiral Court (3) DS0000066171.V293013.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. 3 Red Admiral Court opened last December, and this report is about the first inspection to this new home. The home did not know about the inspection until a couple of days before. As this was the first inspection, all the standards were looked at to see how the home is working. Although there are a number of things the home has yet to do (such as some records and some staff training) this is because it is a new home. The inspection looked at what its like for the people who live here and found that they are very happy with the house and the support they receive. The inspector visited the home 3 times to find out what it is like. One visit was in the evening so the inspector could have a teatime meal with the 3 people who live here, look at their bedrooms with them, and talk to them about the home. On the other visits the inspector looked at how Henshaws Society for Blind People run the home, and looked at care records, staff records and safety records. The inspector also talked with 2 relatives to see what they think of the home. The 3 young people who live here are called residents in this report. Henshaws Society for the Blind is called HSPB in this report. What the service does well: This home is for people who have a visual impairment and it has lots of equipment to help the residents learn how to do things for themselves, such as cooking and doing their own washing. The house is set out so that residents can get around by themselves so they can choose where they spend their time. Before people move in the home makes sure that it will be the right place for them to live. Staff have training in how to guide people with a visual impairment so that they know the best way to support people. Residents can talk about what they want to do with their lives so that staff can support them. Residents make their own choices about what they do, where they go and what they eat. Some residents are learning how to make their own meals. Staff help residents try different things and to go to different places in the local area like shops, clubs, sports and pubs. Residents have their own meetings to talk about what they want from the home as a group. The house is safe, comfortable and warm. It has 6 different bedrooms and residents can choose what colour and style they want in their bedroom. Red Admiral Court (3) DS0000066171.V293013.R01.S.doc Version 5.2 Page 6 Residents have a key to their own bedroom door so they can keep it private. There are 3 bedrooms and bathrooms on the ground floor that can be used by people who have physical disabilities. All residents said that they like the staff. One person said, Staff are great, I get on with all of them. There are enough staff to help residents go out or stay in if they choose. HSBP make sure that all staff are right for the job and gives them plenty of training. Residents, relatives and staff said that the home is a very friendly place. Residents said that they like living here. What has improved since the last inspection? What they could do better: At this time a lot of the information for the people who live here is only in writing. This information should be put into different ways that the residents can use, such as large print and on cassette tape or CD. The home has tenancy agreements for the people who live here but these have not been signed and it is not really clear if this is the right sort of contract for the home. Again these are not in a form that the residents can use. Care records should show how residents have been involved in setting their own plans, and residents should have information that tells them that their records belong to them. Residents must be given information in a way that they can understand about what to do if they are unhappy with the home. Staff should have training in what to do if they think a resident is being treated badly. HSBP should make sure that the kitchen ceiling is safe. The home should make sure that the very hot water is safe to use by residents. Residents said that some things need fixing – the stiff lock to a bathroom, shelves and coat hooks to one bedroom and the water pressure to the ground floor shower. Staff need training to make sure that the home is kept clean, that food is kept and cooked safely and to know what to do if there was a fire in the night. Red Admiral Court (3) DS0000066171.V293013.R01.S.doc Version 5.2 Page 7 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. Red Admiral Court (3) DS0000066171.V293013.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 Red Admiral Court (3) DS0000066171.V293013.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 & 5. Quality in this area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Potential residents do not have information about the service in a format that meets their needs. Comprehensive assessment and admissions procedures make sure that only those residents whose needs can be met are offered a placement at the home. The home provides a specialist service for people with a visual impairment and learning disability, and staff receive training in this area of need. Residents do not currently have information in a suitable format about their rights and responsibilities whilst staying at 3 Red Admiral Court. EVIDENCE: The home has a Statement of Purpose that gives detailed information about the services, and the aims and objectives of the home. These are given to parents, residents and to professionals involved in the residents’ care. There is a also a Service Users Guide which includes clear information about the service but this is in printed form and so is not in an accessible format for the people for whom it is written. The people who live here have individual methods that support their reading of documents, including large print, IT voice software and cassette tape. However there is currently no information available about the service in these formats. Red Admiral Court (3) DS0000066171.V293013.R01.S.doc Version 5.2 Page 10 HSBP provides specialist services for people with a visual impairment. This new home is one of several similar services for people run by HSBP, mainly sited in Yorkshire. All staff have training in visual impairment awareness so that they have an understanding of how to guide and support the people who live here. One future resident uses some degree of Makaton and home staff have begun to spend time with them to learn the specific signs and context that the person uses this as part of their communication. Prior to their move to this home, the needs of any potential residents are assessed by a multi-disciplinary team to ensure that the persons needs can be met by 3 Red Admiral Court. Those involved in the assessments include the potential resident, relatives, social worker, rehabilitation officer, the home manager and education staff. Reviews are then held after 3 months to ensure that the home is meeting their needs. Given the specialist nature of the service, the home does not accept any emergency placements and this is very clearly outlined in the Statement of Purpose. The 3 people who live here previously attended HSBP College in Harrogate. They moved to the home as soon as it opened in December 2005. As the home was new, building works had only just been completed and staff had just been appointed before they moved in. In this way those 3 residents did not have many opportunities to visit the house and meet with staff. However during discussions with individual residents they said that felt involved in the plans to move here, and said that they felt settled very quickly. There are plans for 3 more residents to move into the home in the next few months. There are greater transitional arrangements in place to support their move to the home. Home staff are spending time at the Harrogate College getting to know them, and potential residents have plans for some visits to the home to make sure it suits them. At this time there are unsigned copies of a tenancy agreement for the 3 people here. It is not clear if the residents have the legal rights (and responsibilities) of tenants whilst they live here. The Manager stated that the tenancy agreements have been verbally explained to the residents. However again there is no statement of the terms and conditions of their residence in a suitable format that meets their communication skills. Red Admiral Court (3) DS0000066171.V293013.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 & 10. Quality in this area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Care plans are still being developed so that they will show the individual aspirations and goals of each person. Residents feel that they are involved in making their own decisions and in the daily running of the house. Residents are supported to lead independent lifestyles that includes taking acceptable risks. Residents do not have information about how to access their own records, and their involvement care planning is not demonstrated. EVIDENCE: At this time care plans are still being developed to reflect the individual goals and progress of each resident, particularly towards their independent living skills. Residents are involved in discussing their care records with key staff but have chosen not to sign them. However in this way the care plans do not show that residents are involved in their own care planning. Residents have not yet been involved in the review of policies and procedures regarding the management of the home. However they are very involved in the day to day running of the house and it is more likely that policies would be Red Admiral Court (3) DS0000066171.V293013.R01.S.doc Version 5.2 Page 12 reviewed to reflect their decisions and choices. Each resident has a Personal Futures Plan that records their own choices decisions for their future. These are kept in the residents bedroom and are to be updated every 3 months. All 3 residents make their own individual decisions and choices about their own lifestyles, occupations, activities, and menus. They also hold their own house meetings where they make group decisions and have recently designed their own code of conduct for sharing their house. It was clear from discussions with residents and staff that residents rights to make their own decisions is respected. All 3 residents are working towards independent living skills, with support, and this can incur acceptable risk taking. There are currently risk assessments in place about these areas such as independent travel, use of kitchen equipment, and contact sports. However these records have not been signed by residents to show their understanding and agreement. There is a brief general statement about keeping records confidentially that staff have to read as part of their induction. However there is no comprehensive protocol at the home that refers to sharing information or 3rd party information. There is no statement in a suitable format for residents to let them know their rights to access their own information and how they may do this. Red Admiral Court (3) DS0000066171.V293013.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 & 17. Quality in this area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The home aims to promote and maximise the daily living skills of the people who live here. Residents have fulfilling, purposeful daytime occupations. Residents are supported to use all local community facilities, and enjoy a range of suitable activities. Residents keep in contact with family members and have opportunities to meet others at social and leisure events. Residents are fully involved in choosing menus, shopping, preparing meals with staff support. Meals are nutritious and appropriate for the people who live here. EVIDENCE: The 3 people who currently live here have a visual impairment. All have good comprehension and communication skills. All are working towards greater independent living skills with the support of this service, such as independent travel, cookery and housekeeping skills. It is the aim of some residents to use the home as a stepping-stone towards moving on to greater independent living. Red Admiral Court (3) DS0000066171.V293013.R01.S.doc Version 5.2 Page 14 Residents have been supported to attend a number of daytime occupations that they have chosen. Two residents attend courses at a local college. Two people are involved in a choir at the Sage building. Two use the gym at Gateshead International Stadium where their personal trainer also has a visual impairment. All 3 go swimming and bowling at local facilities. As a result they are out of the home most weekdays. The residents are supported to use a number of local facilities such as shops, cinema, swimming pools and they all use local transport. The house is indistinguishable from surrounding houses on this modern estate and staff stated that there is a good relationship with neighbours. Residents and staff are still sourcing different activities. The homes budget allows for around £35 a week for each resident to use for their chosen leisure activities that are outside of their daytime occupations. If residents preferred, this money could be saved to pay for the resident and support staff for a holiday. This information is not currently outlined in the Service Users Guide. One relative stated that they would prefer to see more inclusion in social clubs and groups for the residents, which they could maintain in the future if they moved to more independent living. The Manager acknowledged the lack of suitable social groups for the young adults who live here, but this will continue to be pursued. Residents said that they have very good contact with their relatives by the home telephone or their own mobile phone, and mostly spend weekends at their family home. Some relatives said that there had been occasions in the past when messages about pick up times had not been passed on between staff. The Manager acknowledged the importance of good communication systems within this developing service. The 3 residents are fully involved in decision-making within the home. They are able to spend time in the lounge or in the privacy of their own rooms at their own choice. Staff were seen to be respectful and supportive of residents preferred daytime routines and decisions. All residents have a key to their own bedroom door, though mostly they tend not to use them. They also tend not to have opportunities to use front door keys. In this way the home may not be promoting them to make the best use of their skills towards future independent living. Residents and staff design a loose weekly menu that they use as a shopping list, but can choose whatever is available within the house for meals. Meals are healthy and nutritious. Red Admiral Court (3) DS0000066171.V293013.R01.S.doc Version 5.2 Page 15 At this time most other main meals are prepared by staff for ease as most people are out of the house all day. One resident is being supported to make their own breakfast. However there are future plans for all residents to have more involvement in preparing main meals. There are recipes and cooking instructions on CD for the residents to use. The inspector joined the 3 people who live here for an evening meal. Residents and staff take their meals together in the kitchen/diner. This is a pleasant and comfortable experience at this time, but is likely to feel cramped when there are 3 more residents and more staff. Red Admiral Court (3) DS0000066171.V293013.R01.S.doc Version 5.2 Page 16 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 & 21. Quality in this area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Residents receive support in the way that they request and require, and can access their own preferred health care services. Future residents may need support with medication so the home is arranging training. There is no policy at the home about the ageing, illness and death of a resident. EVIDENCE: The 3 young men who currently live here are physically fit and all manage their own personal care, such as washing, dressing and bathing. Residents have their own individual daily routines and these are respected by staff. One person does prefer male guidance when using the changing facility at swimming pools and this is also respected. The 3 people who live here are still registered with their own family GPs and dentists in the areas that their parents live. Relatives remain fully involved in arranging and supporting residents to any health care appointments. All 3 receive specialist input from the HSBP Rehabilitation Officer who also provides advice to home staff on specialist equipment. The home currently provides a talking microwave, talking scales, voiced recipes on cassette tape, Red Admiral Court (3) DS0000066171.V293013.R01.S.doc Version 5.2 Page 17 and talking books. There are bump-ons (raised dots and markers) on the washing machine so that residents can identify the different settings. Colour contrasting paintwork and carpets has been used around the home to support any residual vision of the people who live here to help them find their way around. Residents said that they have settled very well and are able to get around the home independently. In this way they can each choose how and where they spend their time in the house. None of the current residents take medication. However a future resident will need support to manage their prescribed medication, and it was stated that training is to be provided for staff in this area of care. The people who live here are young and physically fit. At this time there is no policy at the home to deal with the death of a resident. Clearly healthcare professionals and relatives would make decisions about the palliative or terminal healthcare of a service user in such an event. Red Admiral Court (3) DS0000066171.V293013.R01.S.doc Version 5.2 Page 18 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. Quality in this area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Residents and relatives said that they would feel comfortable about voicing their concerns. However, residents do not have information about the complaints procedure in a suitable format. Staff have had some general training in Protection of Vulnerable Adults but need to have training in the local procedures so that they would know what to do to prevent or report abuse. EVIDENCE: Currently the homes Complaints Procedure is outlined in the printed Service Users Guide. This is not an accessible format for the people who live here. The Manager stated that it has been verbally explained to residents and is discussed at Residents Meetings. However, at all other times, residents do not have this information to hand to refer to independently or in private. All 3 residents have relatives who are very involved in their continuing care. The 2 relatives who took part in discussions stated that they feel comfortable about raising any issues with the Manager. As with any developing service there have been some teething problems that relatives have commented on, but there have been no complaints received from residents or relatives. All staff have had some general training through HSBP in POVA (Protection of Vulnerable Adults) procedures. The Manager is awaiting the local Gateshead Social Services Department to arrange for training in the locally agreed POVA procedures. At the start of this inspection no records of the personal monies of residents were being kept because all 3 men manage their own weekly personal Red Admiral Court (3) DS0000066171.V293013.R01.S.doc Version 5.2 Page 19 allowances. However during discussions with a relative it was apparent that one resident needs some support to record his income and outgoings to ensure that his money is not being lost by him. By the end of this inspection, records and receipts were starting to be being kept to help him keep track of his money. Red Admiral Court (3) DS0000066171.V293013.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 & 30. Quality in this area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Red Admiral Court offers a good standard of accommodation for residents that meets their needs and lifestyles. Residents have the specialist equipment they require to maximise their independence. The home is clean and resident have support to be involved in the household tasks. Some minor premises issues need to be addressed to meet residents requests, and two premises issues need to be reassessed to ensure health & safety. EVIDENCE: The property at 3 Red Admiral Court is a large, family house in a modern housing estate that was built in 1990. It has been extended to provide 6 bedrooms that meet the National Minimum Standards for Younger Adults. The home provides 6 places for younger adults with learning disabilities and visual impairments, 3 of whom may also have physical disabilities. Three bedrooms on the ground floor have been designated as suitable for use by people who use a wheelchair. The remaining 3 bedrooms are on the first floor, one of which has an en-suite bathroom. There is also a communal bathroom on the ground floor and another on the first floor. Red Admiral Court (3) DS0000066171.V293013.R01.S.doc Version 5.2 Page 21 The building also provides a kitchen/dining room and a lounge on the ground floor. These currently allow sufficient room for 3 residents and 2 staff. However both areas are likely to feel very cramped when there are 6 residents and 4 staff. There is a small quiet room on the first floor. Henshaws Society for Blind People recognises that this room is restricted to use by residents with good mobility, and this limitation is to be reflected in the homes Statement of Purpose. The home has an open front garden with easy access from the pavement to the front doors, one of which has a ramp. There is a driveway and sufficient on-street parking. There is a reasonably sized back garden, which is now being tidied up so that residents can make use of it during the summer. The building has been assessed by a Mobility Officer to ensure that the facilities provided will meet the needs of people with a visual impairment and a physical disability. There is a large staff office/sleep-in room on the second floor. In this way the Manager and staff can attend to administrative tasks without the imposing on the residents accommodation. The 3 men who live here chose their own bedrooms before moving here. They are encouraged to choose their own style and colour schemes, and to individualise their bedrooms with their own possessions. Residents make good use of their rooms any time they wish. Modern blinds are fitted to all bedroom windows to support peoples privacy and dignity. All 3 residents said that they were pleased with their accommodation at this home, and particularly their bedrooms. One resident showed the Inspector that the lock to his en-suite is very stiff to operate and the door does not stay closed when unlocked. One resident said that the pressure to the ground floor shower is too forceful. These issues were reported to the Manager for attention. One relative commented that despite repeated requests coat hooks and shelves have still not been fitted in a bedroom. The Manager stated that staff are unable to fit these, and maintenance input will be arranged from Harrogate when there are sufficient premises issues to make such a trip worthwhile. However, this means the resident has been waiting for several months for a simple request. The house is generally well decorated and furnished, comfortable, well equipped, warm and clean. Staff carry out household tasks and residents are involved in cleaning their own rooms with support where necessary. However the Inspector was most concerned with the significant level of movement of the kitchen ceiling when a resident walks across the bedroom floor above. This movement also affects the fluorescent light and there may be a risk of the light covering (and potentially the fluorescent strip bulb) falling Red Admiral Court (3) DS0000066171.V293013.R01.S.doc Version 5.2 Page 22 down from the ceiling. The Manager stated that he had already raised this potential health & safety risk but had been informed by the builders that it was acceptable movement. He is to seek a second opinion. The hot water to the kitchen sink is issued at 62°C, which is scalding hot. The temperature has to be a minimum of 50°C to ensure adequate cleaning, however residents use of the sink as part of their independent living skills is not risk assessed. As with any house that has had extensive works carried out there are some minor issues appearing now, such a fine cracks to fresh plaster and plasterboards nails now exposed. These will be addressed at the end of the first year of operations. Red Admiral Court (3) DS0000066171.V293013.R01.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 & 36. Quality in this area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The staff team is sufficient to provide the level of support required to meet the needs of residents. Staff know their individual roles and responsibilities. Procedures for recruitment of staff ensure the protection of the people who live here. Staff have specific Visual Awareness training, and there are good opportunities for other relevant training. The home falls short of the required number of staff with NVQ qualifications, but staff are to train work towards this. EVIDENCE: The staff team currently consists of the Manager, an acting senior and 4 support workers. All the staff are provided with job descriptions that clearly outline their role and responsibilities in relation to supporting the residents towards improved independent lifestyles and skills. Residents had many positive comments about the staff team. One person said, The staff are great, I get on with them all. Another resident said, I enjoy spending time with the staff, having a chat. All staff are provided with a contract, Induction Pack, HSPB and the General Social Care Council Code of Conduct packs. In this way staff have very clear Red Admiral Court (3) DS0000066171.V293013.R01.S.doc Version 5.2 Page 24 information about what is expected of them in their support of the people who live here. The staffing levels are sufficient to meet the needs of the 3 people who live here. There are least 2 support staff on duty during the day from 8am – 10pm. There is one staff on sleep-in during the night. Staffing levels will increase as new residents move into the home and the Manager is currently recruiting new staff in preparation for this. At this time 2 staff are on sick leave and 2 relief staff are covering their duties. At this time the home does not have 50 of the staff team qualified in NVQ level 2. Currently one staff has attained the NVQ level 2 care qualification, and 2 staff are about to start training towards NVQ level 3. It is acknowledged that this is a new service with a new staff team and it will take some time to achieve this standard. HSBPs recruitment and selection procedures were seen to be clear and thorough. Staff are only employed after satisfactory application, interview, references and Criminal Records Bureau checks have been carried out. This ensures the protection of the people who live here. HSBP provides a comprehensive 5 day induction training scheme in place for all new staff. This includes mandatory health & safety training such as fire safety, first aid and moving & assisting. All staff receive training in Visual Awareness to equip them to know how to guide and support the people who live here. Most staff have also had training in Living Skills Support, to equip them to promote the independent living skills of the people who live here. There is a training plan for the remainder of the year to ensure that all staff receive the required training in health & safety and in NVQ qualifications. It was clear from the training plan and from discussions with staff that HSBP offer good opportunities for staff to develop their skills and knowledge in order to support the people who live here. However there are no individual development and training plan records in individual staff files to record and demonstrate this. At the time of the inspection no staff supervision sessions had been carried out with individual members of staff. However the Manager was to attend training in Supervision and Appraisal, and he and the acting senior are to commence planned supervision sessions in the near future. Red Admiral Court (3) DS0000066171.V293013.R01.S.doc Version 5.2 Page 25 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41, 42 & 43. Quality in this area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Residents benefit from a well run home that has an open, friendly and supportive atmosphere. Residents have the opportunities to be involved in reviewing the service they receive. Policies and procedures are in good order and accessible by staff, although currently not in accessible formats for the residents. The practices of staff ensure the safety of residents, and staff receive training in safety, but fire records have some omissions. HSBP have demonstrated its on-going financial viability, so residents receive a wellorganised service. EVIDENCE: The Manager has prior experience in managing a care home for younger adults with learning disability. He has achieved the Registered Managers Award and is currently training towards NVQ level 4 in Care (he has already attained NVQ Red Admiral Court (3) DS0000066171.V293013.R01.S.doc Version 5.2 Page 26 level 4 in Catering and Hospitality which includes several elements of managing health & safety). In discussions staff stated that the Manager is approachable and supportive. Time was spent observing the good interaction between residents and staff, and there was a friendly, relaxed atmosphere in the home. Relatives said, The staff are very friendly, helpful and welcoming. Relatives commented that the residents are always just as pleased to get back to the home after they have been for weekend breaks. In discussions staff stated that they enjoy working here and that is it a friendly place. Staff were enthusiastic about starting to support people towards more independent lifestyles. Over the past 6 months the Manager has been supported by a Community Services Manager of HSBP who has carried out monthly visits to the home to check on this new services progress and to carry out supervision with the Manager. In the future a locally-based Area Manager will carry out these visits. However at this point HSBP has not submitted the required monthly reports to the CSCI. HSBP is a well-established organisation with a quality assurance system that uses a number of tools to check its services. These include seeking the views of the people who use those services. The home has only been open for 6 months, so HSBP have not yet formally begun to use satisfaction questionnaires to gain the 3 residents views, but will do in the future. The people who live here are very able to express their views about the service they receive, and have begun to have their own monthly meetings, preparing their own agenda, and have also drawn up their own code of conduct. Each resident also had reviews at the end of the first 3 months here so that they could comment on whether they felt the home could meet their needs. In this way residents can make their views about the service known. HSBP have clear policies and procedures, which are accessible to all staff working in the home. Some policies and procedures require staff to sign and read them to ensure that staff have understood their responsibilities. All home records are also accessible by staff for their input. At this time few home records and none of the policies are in suitable formats for the residents. All staff have had training in most areas of health & safety. However none of the staff have had training in Infection Control, which is a mandatory training course. Some staff still need training in Food Hygiene, and this has been arranged. Red Admiral Court (3) DS0000066171.V293013.R01.S.doc Version 5.2 Page 27 Accident records are in good order, and only 2 minor accidents (to one resident and one staff) have been reported in the past 6 months. The home has been fire risk assessed, and all electrical equipment used by residents and staff is tested for safety. However, the fire log records show that the required fire alarm testing has not been carried out weekly, and that staff on sleep-in duties have not had the 3 monthly in-house fire instruction. Satisfactory financial clearances were received in respect of HSBP during the registration process last year which demonstrated its on-going business viability to continue to provide the service at 3 Red Admiral Court. Red Admiral Court (3) DS0000066171.V293013.R01.S.doc Version 5.2 Page 28 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 3 4 3 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 2 25 3 26 2 27 3 28 3 29 4 30 3 STAFFING Standard No Score 31 3 32 2 33 3 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 2 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 2 2 3 2 3 3 2 3 Red Admiral Court (3) DS0000066171.V293013.R01.S.doc Version 5.2 Page 29 N/A 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 5(1) Requirement The Service Users Guide must be given to each resident in an accessible format that meets their individual communication skills. The home must supply to each resident, in suitable formats, a standard form of contract that includes the terms and conditions of their residence at this home Care records must demonstrate how the residents have been involved and included in their own care planning. The residents must have information about the complaints procedure in a format that suits their individual communication methods. Arrangements must be made for all staff to have training in the local Social Services Department POVA procedures, as soon as this becomes available. Further advice must be sought about the substantial movement of the kitchen ceiling to assess the potential risk. Timescale for action 01/09/06 2. YA5 5(1)c 01/10/06 3. YA6 15(1) 01/10/06 4. YA22 22(6) 01/09/06 5. YA23 13(6) 01/12/06 6. YA24 23(2) 01/09/06 Red Admiral Court (3) DS0000066171.V293013.R01.S.doc Version 5.2 Page 30 7. YA26 23(2) 8. YA26 13(4) 9. YA39 26(4) & (5) 10. YA42 13(3) 11. YA42 23(4)c (v) & 23(4)e The minor premises issues raised by relatives and residents must be addressed as soon as practicable, i.e. fix stiff bathroom lock; fit coat hooks and shelves to bedroom; and check water pressure to ground floor shower. The temperature of hot water to the kitchen sink must be regulated to 50°C, and the use of the kitchen sink by residents be risk assessed. The Provider (or representative) must visit the home unannounced at least once per month and prepare a written report about the conduct of the home. A copy of the report must be submitted to the CSCI. All staff must be nominated for Infection Control training, and the remaining staff without training in Food Hygiene must complete such training. Staff carrying night time duties (e.g. sleep-ins) must have inhouse fire instructions at least every 3 months; and fire alarm tests must be carried out weekly. 01/09/06 01/10/06 01/09/06 01/03/07 01/09/06 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. 2. 3. Refer to Standard YA9 YA10 YA10 Good Practice Recommendations Risk assessment records should demonstrate how residents have been involved and included in agreeing the strategies for managing acceptable risks. Residents should have information in suitable formats about their right to access their own records. The home should have comprehensive policy about the protection of confidential information including reference to sharing information, 3rd party information and residents DS0000066171.V293013.R01.S.doc Version 5.2 Page 31 Red Admiral Court (3) 4. 5. 6. 7. 8. 9. YA16 YA17 YA20 YA21 YA23 YA36 rights to access their own information. Consideration should be given to supporting residents to use a front door key when arriving or leaving the house in order to promote their independent living skills. HSBP should consider how to manage the dining needs of 6 residents and 3 or 4 staff as the current dining space is not likely to be sufficient. The Provider should ensure that the medication training for staff is sufficient to meet medication management within the home. The Provider should develop procedure to guide staff in the event of the death of a resident. Records of outgoings and receipts should continue to be kept to support any residents whom need help with keeping track of their personal monies. Each member of staff should receive supervision sessions with an appropriate supervisor at least 6 times per year. Red Admiral Court (3) DS0000066171.V293013.R01.S.doc Version 5.2 Page 32 Commission for Social Care Inspection South of Tyne Area Office Baltic House Port of Tyne Tyne Dock South Shields NE34 9PT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Red Admiral Court (3) DS0000066171.V293013.R01.S.doc Version 5.2 Page 33 - 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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