CARE HOME ADULTS 18-65
Reevy Road Resource Centre 60 Reevy Road West Buttershaw Bradford BD6 3LH Lead Inspector
Michael Smithson Unannounced Inspection 14th February 2006 07:30 Reevy Road Resource Centre DS0000046750.V283045.R01.S.doc Version 5.1 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 Reevy Road Resource Centre DS0000046750.V283045.R01.S.doc Version 5.1 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. Reevy Road Resource Centre DS0000046750.V283045.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Reevy Road Resource Centre Address 60 Reevy Road West Buttershaw Bradford BD6 3LH 01274 691035 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) Bradford District NHS Care Trust Mr Gary Hoyland Care Home 24 Category(ies) of Learning disability (24) registration, with number of places Reevy Road Resource Centre DS0000046750.V283045.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 23rd August 2005 Brief Description of the Service: Reevy Road is a local authority owned unit for service users with learning difficulties. There are 24 places available and all of the bedrooms are singles. Bedrooms are located on the ground and first floor. The unit can accommodate service users with a variety of differing needs including complex health needs and semi-independence. The home is not a nursing home, however they are very well supported by the nursing services. A good range of facilities are provided within the premises including a ball pool room, Jacuzzi and sensory area. Reevy Road Resource Centre DS0000046750.V283045.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over the early morning and into the afternoon. This was the second visit for this inspection year. The first visit took place in August 2006 and was announced. Copies of reports for this and previous inspections are available either from the home or on the CSCI website. The inspection focused on the issues highlighted at the last inspection and discussions with the manager, staff, a carer and service users. A number of requirements and recommendations were made at the last inspection. The home has gone through considerable changes over the last 2 years. The provider responsibility for the home has changed from Bradford Social Services to Bradford Health Care Trust. This has caused considerable disruption for staff and service users. Further changes are planned with the removal of the respite care services from the home. Discussions are also now taking place for the service to move again to a voluntary organisation. Despite the proposed changes the removal of the respite services is viewed as a positive step. It is hoped it will allow staff to improve the organisation of the daily routines and leisure activities knowing that the majority of the service users are long stay placements. At the last inspection the parents of one service users raised concerns about the deterioration in the standards at the home in particular the environment. One of the parents was present during this inspection and felt improvements had been made and felt more confident that the standards will continue to improve. What the service does well:
The inspection commenced at 7.30am. The staff was busy preparing service users for transport to the day centre and organising breakfast. Many of the service users do require a considerable amount of assistance with bathing, dressing and eating. Adequate staff were available to meet the needs of the service users. The staff rota is well organised around the busy periods of the day. Despite it being a very busy time the staff still had time to chat to service users in and amongst their duties. This helps to create a relaxed and friendly atmosphere. The levels of National Vocational Qualifications (NVQ) level 2 training have improved. The slightly exceeds the required number of 50 of care staff having achieved NVQ level 2.
Reevy Road Resource Centre DS0000046750.V283045.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection?
A considerable number of requirements and recommendations were made at the last inspection. The manager and the staff have worked hard to make improvements in all areas. The care documentation for service users has been reorganised and greatly improved. The information is now easier to find and is kept up to date. All the service user care needs have been reviewed. The health care monitoring has been reorganised. The health surveillance nurse is no longer based at the home. The care staff have now taken on the responsibility for health care assessments and making sure health care checks are kept up to date. A format has been produced to provide evidence of service users and carer involvement in the admission process. The details include confirmation of any pre-admission visits and trial stays prior to admission. The complaints recording system has been improved. The information held now includes details of the complaint, the investigation and copies of any correspondence. Adult protection training is being up dated for all staff and a new adult protection procedure has been produced for staff to follow. The manager and the staff now appear to have a better understanding of the adult protection process. The staff supervision has improved and staff have been involved in the progress made since the last inspection. The staff morale does appear to have improved as a result. The staff recruitment information is better organised. The manager now takes responsibility for recruitment of all casual staff and better records are kept of all permanent staff employed at the home. A staff training and development plan has been produced which includes the training required. The manager has focused on the mandatory training and the health care updates required. The overall management of the home has improved. The senior staff has been given responsibilities within the home and the manager has reaffirmed the standards of care required. The manager is much more positive about the future of the home. The standard of the cleanliness and general organisation of the premises has improved. The communal and storage areas are much better organised. Some
Reevy Road Resource Centre DS0000046750.V283045.R01.S.doc Version 5.1 Page 7 general repairs have been undertaken. However the majority of the work has now been identified in the planned building work agreed with providers. 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. Reevy Road Resource Centre DS0000046750.V283045.R01.S.doc Version 5.1 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 Reevy Road Resource Centre DS0000046750.V283045.R01.S.doc Version 5.1 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, 3 and 4. A good range of information is available for prospective service users and carers to help them make an informed choice about the home. Evidence is now provided that service users and carers are offered a choice prior to placement and they can visit the home for a trial stay. EVIDENCE: A statement of purpose and service user guide are available and provide a good range of information about the home. The manager is due to review the information, however is going to wait until the planned changes are confirmed. A new form has been produced which provides details of admissions. The details include the reasons for the placement and confirms whether introductory visits and trial stays take place. This is good practice. Reevy Road Resource Centre DS0000046750.V283045.R01.S.doc Version 5.1 Page 10 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 and 10. The care documentation has improved with records being informative, well organised and kept up to date. This should make sure the needs of service users are met. EVIDENCE: The care documentation for service users has been reorganised. New files have been provided for the current information. The information is now much easier to locate and easier for staff to keep up to date. All the care plans have been up dated and reviews have been held. Where possible service users and carers are involved in the completion of the care plans and the reviews. The care plans include detailed risk assessments, emergency contact information, pen pictures and individual likes and dislikes. Reevy Road Resource Centre DS0000046750.V283045.R01.S.doc Version 5.1 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 the following standard(s): 11, 14 and 16. Service users are offered a positive life style, which promotes independence. A good range of activities is offered, however it is hoped this will be further improved when the respite service is removed from the home. EVIDENCE: Service users have the opportunity for personal development and are able to maintain independence. Service users on Unit 3 are generally more able and the promotion of independence is part of their daily lives. During the morning of the inspection service users were observed being encouraged to develop self care skills. A range of activities are offered for service users, these can be organised in large groups or one to ones with key workers. The majority of the service users also attend day centres where they are able to partake in social, educational and work based activities. Feedback regarding activities was received from a relative on the day of the inspection. She confirmed that some leisure activities do take place within the home, however she did feel that more could be offered. The manager did feel that once the high numbers of
Reevy Road Resource Centre DS0000046750.V283045.R01.S.doc Version 5.1 Page 12 service users on respite move to alternative accommodation this will free up staff time to further develop the activities offered. Reevy Road Resource Centre DS0000046750.V283045.R01.S.doc Version 5.1 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 the following standard(s): 18, 19 and 21. The health care recording and monitoring for service users has much improved. EVIDENCE: At the last inspection it was found that a number of the health care assessments for service users where not being kept up to date. A health care nurse was based at the home and co-ordinated the completion of the assessments and staff training. The nurse is no longer based at the home and the responsibility has reverted back to the care staff. A new format has been produced to make sure all the required health checks have been completed. Any special health care needs are identified and are regularly monitored and up dated. Good records are now kept of service user’s weight, menstruation and epilepsy. A new medication profile has been included for all service users who require medication. The information includes details of medication taken and side effects. A medication check was not undertaken during the inspection. Reevy Road Resource Centre DS0000046750.V283045.R01.S.doc Version 5.1 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 the following standard(s): 22 and 23. The service users are now better protected from harm and abuse. The complaints procedure is much improved. EVIDENCE: The recording and investigation of complaints has improved. A number of complaints have been made since the last inspection, however the manager now has a clear understanding of the complaints, which have been resolved, those, which were founded, and those, which are still being investigated. All the complaints have been well recorded and complainants receive a written response. The adult protection policy and procedure has been improved. The senior staff now have a better knowledge of their role and responsibilities. A document has been produced to ensure all staff are aware of the adult protection procedures and contact numbers. Refresher training is being organised for the staff team. Reevy Road Resource Centre DS0000046750.V283045.R01.S.doc Version 5.1 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 the following standard(s): 24 and 30. The general organisation and cleanliness of the environment has improved. Further refurbishment is being agreed with the provider, which should provide service users with a better environment to live in. EVIDENCE: A full building inspection was not undertaken during this inspection however the inspector did look at a number of areas of the home, which were identified as needing attention at the last inspection. A number of the rotten windows have been replaced and new carpet tiles provided in the entrance area. This has greatly improved the first impression of the home. A level of funding for the refurbishment of Reevy Road has been agreed. The manager has produced a list of all the repairs and refurbishment required. The list includes redecoration of a number of bedrooms, communal areas and bathrooms. New carpets, curtains and some soft furnishings will be replaced. At the last inspection a number of areas of the home were disorganised and storage areas were not being properly used. This has now improved. The semiindependent flat on the ground floor has been reorganised and now provides a
Reevy Road Resource Centre DS0000046750.V283045.R01.S.doc Version 5.1 Page 16 more suitable living space for service users. The overall cleanliness of the home is greatly improved. Financial investment is being agreed with the provider to make a number of improvements to the environment. The manager has produced a detailed list of the work required and has prioritised a number of areas requiring urgent attention. Reevy Road Resource Centre DS0000046750.V283045.R01.S.doc Version 5.1 Page 17 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): 33, 34 and 36. The staff morale is much better and the levels of training, recruitment and supervision improved. EVIDENCE: The care staffing hours for the home were adequate, however vacancies exist for 2 part time domestic staff. The manger now has greater control of the employment of casual staff so any shortfall in hours can be quickly replaced. The recruitment records for the last 2 casual staff employed were checked. All the information required was available including 2 references and a Criminal Records Bureau (CRB) check. A training development plan for the coming year has been identified. The plan includes health care training and up dates. Progress continues to be made with regard to NVQ level 2 training for the care staff. The home now exceeds the required 50 . Two staff were spoken with and general discussions took place with a number of the other staff on duty. The level of staff morale has much improved. The staff have been involved in the reorganisation of the care records and the improvements made to the environment. Staff meetings and team meetings have been held and staff supervision continued. The staff had been informed of
Reevy Road Resource Centre DS0000046750.V283045.R01.S.doc Version 5.1 Page 18 the proposed changes regarding respite care, the proposed change of ownership and new admissions. The staff felt positive about many of the planned changes. They felt that the removal of the respite from the home would be of benefit for the long stay service users. They hoped it would give them more time to plan and organise activities knowing the levels of care required and the abilities of the service users. Reevy Road Resource Centre DS0000046750.V283045.R01.S.doc Version 5.1 Page 19 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 and 43. The management of the home has improved. Senior staff are taking responsibility for the development of the service provided. EVIDENCE: The management of the home has greatly improved. The manager and the senior staff have taken onboard the issues raised at the last inspection. This has greatly improved the morale of all the staff and senior team. The future of the home is being discussed with the provider and CSCI. It is planned that the home will eventually be transferred to a voluntary organisation. However the home must meet an agreed standard with regard to the environment. Some discussions have taken place with service users and carers at the recent reviews. However this process must be formalised and all involved must be fully consulted and kept informed. They must be given the opportunity to voice any concerns and comment on the proposed changes. Reevy Road Resource Centre DS0000046750.V283045.R01.S.doc Version 5.1 Page 20 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 3 2 X 3 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 3 34 3 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 X 13 X 14 3 15 X 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X 3 3 3 X X X X 2 Reevy Road Resource Centre DS0000046750.V283045.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? Yes 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 YA24 Regulation Reg 23 Timescale for action The budget for the refurbishment 31/12/06 of the environment must be agreed. The list of work required, which has been produced by the manager, must be used to prioritise the work required. CSCI must be kept fully informed of the progress of the refurbishment. The service users and carers 01/03/06 must be fully consulted and kept up to date about the planned changes for the home. Requirement 2 YA43 Reg 24(3) RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Reevy Road Resource Centre DS0000046750.V283045.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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