CARE HOME ADULTS 18-65
Redlands 122 Woodlands Road Darlington Co. Durham DL3 9LP Lead Inspector
Jean Pegg Unannounced 29 June 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Redlands B54 S818 Redlands V228439 070705 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Redlands Address 122 Woodlands Road Darlington Co. Durham DL3 9LP 01325 243788 01325 243799 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Castlebeck Care (Teesdale) Limited Mrs Jean Murphy Care Home 5 Category(ies) of Learning Disabilities - 5 registration, with number of places Redlands B54 S818 Redlands V228439 070705 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 17 December 2004 Brief Description of the Service: Redlands is a large detached house situated in a residential area of Darlington. The home is registered as a care home providing personal care to adults between the ages of 18 and 65 with a learning disability. The home is within walking distance of Darlington town centre and Cockerton village. This location enables service users to access a full range of local facilities. Internally the home provides five single bedrooms each with wash hand basin. Shared toilet and bathing facilities are also provided nearby. Downstairs the home has two lounge areas including provision for those that choose to smoke, kitchen, breakfast room, dining room and laundry. A very good standard of furnishings and fittings has been provided within the home. Externally, the home is surrounded by well kept gardens and pathways. Redlands B54 S818 Redlands V228439 070705 stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place on June 29 as planned. Lasting for four and a half hours, all five service users and four staff were spoken to. The staff and service users were very welcoming. Service users were quite happy to talk about their life at the home and provided some good comments that have been included in this report. Although no service user relatives were spoken to, written comments were seen including one made recently that said ”all the family are more than grateful for the care and attention that has been bestowed on (our son)” All recommendations made at the last inspection have been followed and the improvements noted at this inspection. What the service does well:
The home provides clear information about what it does and how it does it. This means that people have the information they need when choosing a home. Service users are assessed so that all of their care needs are known. Plans can then be made as to how those needs are met. Detailed care plans are written and service users help to evaluate these plans each month so that they are up to date. Service users are helped to make decisions about their lives. Staff and service users prepare plans that help service users manage the different risks in their lives. This helps service users to lead an independent life. Service users are helped to take part in leisure and educational activities of their choice. Taking part in the local community is encouraged by staff and enjoyed by service users All service users are involved in the planning of holidays and other group outings making sure that everyone does the things they want.
Redlands B54 S818 Redlands V228439 070705 stage 4.doc Version 1.40 Page 6 Service users are helped to keep family links so that no contact with friends or relatives is lost. Staff and service users remind each other about the importance of being polite and respectful towards each other. Staff and service users are aware of the importance of a balanced diet and mealtimes are very much a social event enjoyed in pleasant surroundings. Complaints are responded to quickly at the home to help reach a satisfactory outcome. Care is taken to make sure that all the right checks are carried out when new staff are recruited. This will help to make sure that only people who are fit to do so care for service users. Staff are supervised regularly by the manager which helps to make sure that they know what is expected of them. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office.
Redlands B54 S818 Redlands V228439 070705 stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Redlands B54 S818 Redlands V228439 070705 stage 4.doc Version 1.40 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 & 2 The home provides an statement of purpose that accurately describes what the home does and how it does it. Service users are assessed prior to being admitted to the home and this assessment continues during the first few weeks of placement. EVIDENCE: An updated copy of the statement of purpose was sent to the commission following the last inspection. The statement was checked and found to be satisfactory. The assessments completed for two new service users were checked. The assessments undertaken were very detailed covering the areas suggested in the minimum standard. The assessment continues during the first few weeks of placement to make sure that the decision made is the right one. Redlands B54 S818 Redlands V228439 070705 stage 4.doc Version 1.40 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7 & 9 Care plans are written to reflect service user needs. Service users are helped to make decisions about their lives and are encouraged to voice their opinions and express their views. Service users are supported to take risks as part of maintaining an independent lifestyle. EVIDENCE: The care plan of one service user was looked at in detail. The care plans covered health, personal and social care needs. Areas of potential risk were identified with ways of how to manage that risk being described. The plan was written so as to help staff work in a consistent way. The service user had signed the care plan and was also involved in signing the monthly evaluations of the care plans. Key workers were identified and were known to the service user. All service users are encouraged to manage their own finances as far as possible. Each service user has an individual bank account. Service users are given information about advocacy services but the manager said that so far no one has requested this service.
Redlands B54 S818 Redlands V228439 070705 stage 4.doc Version 1.40 Page 10 Risk assessments are completed for service users and plans to manage those risks are agreed with the service users. The home has a general policy on responding to unexplained absences and for some service users, more detailed individual plans are written about how to respond to unexplained absences. Redlands B54 S818 Redlands V228439 070705 stage 4.doc Version 1.40 Page 11 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13,14,15,16 &17 Efforts are made to make sure that service users take part in social and educational activities of their choice. Service users are encouraged to take part in their local community. Service users take part in appropriate leisure activities of their choice. Family links are maintained at an agreed level including overnight stays. Staff and service users are respectful of each other’s rights and responsibilities. Service users enjoy a healthy diet. EVIDENCE: Two service user care plans were checked and all service users were spoken to. The care plans showed that efforts were made to make sure that service users continued to take part in things that interested them. A discussion during lunch confirmed that service users were involved in deciding the range of activities they participated in including both leisure and educational activities.
Redlands B54 S818 Redlands V228439 070705 stage 4.doc Version 1.40 Page 12 The home receives information about local activities and service users collect leaflets from tourist information to find out about places of interest to visit. Staff and service users use the local village shops and pubs. They talked about the ‘house’ vehicle and using public transport. Service users spoke about staff escorting them on home leaves and on trips out and holidays. Service users spoke about the plans they had made for their summer holiday. Each service user had been given a day of the holiday to plan. Service users described what they were planning to do each day and showed pictures taken from brochures and information leaflets of the places they were going to. All service users are provided with bedroom keys and are addressed by their preferred name. Staff and service users speak to each other with respect and this is reinforced at all times through their own rules of behaviour and incentive payment scheme. One member of staff said, “ If I don’t show them (the service users) respect, they won’t show me respect.” Household tasks are shared depending upon ability and skill level. Service users help to plan meals and go shopping for food. Mealtimes are unrushed and are taken in pleasant surroundings. Staff and service users showed awareness of the need to have balanced nutritional meals. All of the service users were asked to make a comment about what it was like to live at the home. These are some of the things they said. “Very good, I didn’t think I would like it but I do.” “Mixing with other people outside is a good idea” “Quite good, nice staff to talk to, meals are nice, holidays and Christmases are nice” “Bedrooms are nice and big and you can do what you like … you have the freedom to go to the toilet without pressing a buzzer” “We can go out for a drink – sometimes get takeaways” Redlands B54 S818 Redlands V228439 070705 stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None None of these standards were assessed. EVIDENCE: Redlands B54 S818 Redlands V228439 070705 stage 4.doc Version 1.40 Page 14 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 The home has a clear complaints policy and procedure that is known by service users. EVIDENCE: Service users were asked what to do if they wanted to make a complaint. They all described the procedure that should be followed and could name the key people that they should complain to. One service user got his copy of the service users guide and read out the section that describes how to make a complaint. The home also has two complaints books, one for resident complaints and one for other complaints. Entries in the book were clear with actions and outcomes identified. Service user relatives have all been sent another copy of the complaints procedure following a recommendation made at the last inspection. Redlands B54 S818 Redlands V228439 070705 stage 4.doc Version 1.40 Page 15 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None None of these standards were assessed. EVIDENCE: Redlands B54 S818 Redlands V228439 070705 stage 4.doc Version 1.40 Page 16 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34 & 36 Recruitment practices support the protection of service users. Staff receive regular supervision and guidance from their manager which helps them to do their job well. EVIDENCE: Recruitment records for staff recently employed at the home show that the home continues to carry out a good level of checks prior to employment. Staff also undergo a probationary period during the first few months of employment. Regular staff meetings are held with minutes taken. The manager has a chart that shows the frequency of supervision and appraisal sessions. The chart shows that the recommended minimum of six supervision sessions a year is now being achieved. Records are kept of these meetings. Members of staff spoken to said “ (in supervision) you get to air your views” another member of staff described how they had been given topics to research and find out about as part of their regular supervision. Redlands B54 S818 Redlands V228439 070705 stage 4.doc Version 1.40 Page 17 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None None of these standards were assessed. EVIDENCE: Redlands B54 S818 Redlands V228439 070705 stage 4.doc Version 1.40 Page 18 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 x x x Standard No 22 23
ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 4 3 x 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 x 3 3 4 3 3 4 Standard No 31 32 33 34 35 36 Score x x x 3 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Redlands Score x x x x Standard No 37 38 39 40 41 42 43 Score x x x x x x x B54 S818 Redlands V228439 070705 stage 4.doc Version 1.40 Page 19 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 Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Redlands B54 S818 Redlands V228439 070705 stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection No1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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