Inspection on 28/01/09 for Reevy Road Resource Centre

This inspection was carried out on 28th January 2009.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Reevy Road Resource Centre 15/03/07

Reevy Road Resource Centre 12/07/06

Reevy Road Resource Centre 14/02/06

Reevy Road Resource Centre 23/08/05

Reevy Road Resource Centre 24/02/05

Reevy Road Resource Centre 27/07/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

Pennine Camphill

Muston Road (70)

Grayling

The Cornerstone

John Street Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Reevy Road Resource Centre 60 Reevy Road West Buttershaw Bradford BD6 3LH     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sughra Nazir     Date: 2 8 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Reevy Road Resource Centre 60 Reevy Road West Buttershaw Bradford BD6 3LH 01274691035 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Bradford District NHS Trust Name of registered manager (if applicable) Mr Gary Hoyland Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Reevy Road is a Bradford Care Trust unit for people 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 people with a variety of differing needs including complex health needs and support independence. The home is not a nursing home, however they are very well supported by the nursing services. A good range of facilities is provided within the premises including a Jacuzzi and sensory area. The current scale of charges for Reevy Road is dependent on an assessment of peoples individual needs and requiremnets. Previous inspection reports and service information is made available on request. 24 Over 65 6 care home 24 Care Homes for Adults (18-65 years) Page 4 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: We looked at information we have received about the home since the last key inspection. We asked for information to be sent to us before the inspection, this is called an annual quality assurance assessment. On an unannounced visit to the home we talked to people, staff and the manager. The extent to which we were able to ask people about their views varied and was sometimes limited due to peeples communication needs. However we used observation of non verbal communication and direct care to help us form our opinions of the service. We also checked some of the records, policies and procedures the home Care Homes for Adults (18-65 years) Page 5 of 27 has to keep. We concentrated on the key standards and what the outcomes are for people living in the home, as well as issues which were raised at the last inspection. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 Care Homes for Adults (18-65 years) Page 7 of 27 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A thorough admission and assessment process helps people to decide if the home will suit their needs Evidence: When someone is considering living permanently at the home they are given information to help them make a decision. This includes a service users guide, which can be provided in large print and photograph format if people need. People are also invited to visit as often as they like and stay for an evening meal and have an overnight stay. We saw on one persons file there was a list of planned visits showing that there was a phased move at that persons pace. All potential admissions are fully assessed by either a social worker or registered learning disabilities nurse within the Community Learning Disabilities Team, however the home would always, also complete its own preadmission assessment. This process gives the person and their family the opportunity to make an informed Care Homes for Adults (18-65 years) Page 10 of 27 Evidence: decision and helps the home decide if they are able to meet the persons needs. The assessment helps staff develop a suitable plan of care and support. Care Homes for Adults (18-65 years) Page 11 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Detailed care planning helps the service make sure that peoples individual needs are met Evidence: Three individual care and support plans were looked at. They show that people are involved in developing and reviewing their plans. The plans reflect the individuals preferences and needs and clearly demonstrate the persons involvement in making all the decisions that affect them. We saw one care plan which used pictures to help the person decide about their intimate care needs. This is good practice. Other people also contribute to the care plan review procedure, to make sure a full picture of the individual is obtained. These people could include the persons relatives, their keyworker, the homes manager, their social worker and someone from the day services he or she attends. Care Homes for Adults (18-65 years) Page 12 of 27 Evidence: The care and support plans reflect peoples individuality and contain sufficient detail to guide staff and help them understand each person. Everyone is supported and encouraged to make their own choices about how they lead their lives. The care plans reflect this and show that people are supported to achieve their goals. Those who commented confirmed that the service supports people to live the way they choose and agreed that the service meets their different needs. The plans are updated frequently, to make sure they always reflect peoples choices and wishes. Where any activity involves a potential risk, an assessment is made and plans are agreed to minimise the risk, while still supporting peoples right to independence and choice. These assessments are reviewed and kept up to date. All the evidence we saw clearly indicated that the homes staff support people to maintain their independence and improve the quality of their lives. There was evidence of the service involving advocates to represent and support people. Care Homes for Adults (18-65 years) Page 13 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People enjoy a varied lifestyle which generally meets their choice and preferences but better communication and recording will help ensure that peoples nutritional needs are not overlooked. Evidence: The majority of people living at the home attend daycentres during the week and this gives them the opportunity to meet people and learn new skills. Some people stay at home and take part in either individual or group activities. One person we spoke to told us they were happy to sit and watch TV. Another person was enjoying the multisensory room. This still needs some refurbishment as the bubble tubes are not working. We saw people making use of the minibus to go to daycentres. Staff told us about trips to local pubs and restaurants. Care Homes for Adults (18-65 years) Page 14 of 27 Evidence: The files we looked at showed there were strong links with families and people are supported to maintain contact with their relatives and friends. Although the building and grounds are owned by the local authority there are signs displayed that these are NHS premises and smoking is not permitted either in the building or in the grounds. This means that people do not enjoy unrestricted access to the grounds. A shelter is not provided and the the service should check that their rules about smoking take into account peoples lifestyle, risktaking and comfort. They should also consider whether the rules form part of the original contract or terms and conditions. We observed lunch, this was fish fingers peas and buttered bread. The menus showed that the main meal of the day is served in the evening as most people are out during the day. A number of people have a soft or pureed diet. One person had a pureed meal with all the components, fish fingers and peas blended together. The cook said that the family have said this was the persons preference. Staff said that the person was on a soft not pureed diet. The persons file did not indicate a preference for the meal to be blended together but did state that the person should have pureed meals and that they did not like fish. The service should make sure that information about peoples dietary needs and preferences is recorded accurately and shared with the staff team. Care Homes for Adults (18-65 years) Page 15 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People generally receive the personal and healthcare support they need however the ongoing monitring of health care needs to improve. Evidence: We saw that people are supported to maintain their personal hygiene, hairstyles and appearance. The service should make sure that people are asked about and supported with any shaving needs they may have. The manager said that people are supported flexibly with personal care but people are not always able to have a bath or shower at times that suit them due to the problems with water pressure on one unit. This means they have to wait for facilities to be available on another unit. This was a requirement at the last inspection and although investigated by the service, has not been remedied. We saw that people have very good access to health care and that the service supports them to access services on a regular process. A visiting health professional told us staff contact us appropriately, we always see people in private However, we did see two examples where healthcare advice to weigh and to record Care Homes for Adults (18-65 years) Page 16 of 27 Evidence: dietary intake had not been closely followed. We looked at the files of two people for whom advice had been sought by the service due to poor dietary intake and weight loss. In both cases the checking and recording of weights was advised by the health professional but this record had not been maintained. One persons last recorded weight was March 08 , the other was August 2008. This issue was highlighted in the homes own review of one person in January 2009. The home does not have weighing scales that can be used for people with poor balance. We were told that people may be weighed at the day centre but such recording is not shared in a consistent way. The service should make sure that healthcare advice is communicated with all staff and systems put in place for implementation. Peoples care records should support the service in monitoring peoples health and identifying any problems at an early stage. This may include for example where someone has responded to medication for constipation. The service has now implemented a process for recording medication carried forward. All medication administration records looked at were found to be complete. Staff told us poeple who need medication whilst at daycentres take medication with them for example in a bottle. There is no medication administration chart sent as the service belevie the daycentre use their own records. As unused medication is not returned, staff at Reevy Road cannot double check whether medication has been administered. We discussed the service adopting more robust communication around medication that is sent with people to the day centre. The medication room was very hot despite the use of a large fan. The fridge temperature was 10 degrees and this was not within the safe range. The service should review the ventilation and siting of medication storage to make sure that medication is stored within safe temperatures. Care Homes for Adults (18-65 years) Page 17 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Robust complaints and protection procedures keep people safe. Evidence: Complaints procedures are in place for staff, carers and visitors and there is an easy read version for people who live at the home. Relatives are also informed at review meetings, carer forum or visits that they can raise issues which will be addressed seriously.The manager has attended a training course on the role of the manager in adult protection. Training on keeping people safe from abuse is made available during induction and repeated at least every two years. Care Homes for Adults (18-65 years) Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe and clean environment. Evidence: The home is maintained to a good standard and rooms are decorated to reflect personal taste and furnished to meet individual needs. People have aids and adaptations available to meet their assessed needs. The building is owned and maintained by the Council. The home offers access to local amenities and relevant services.The home has an annual fire and health and safety inspection. All regulatory standards are observed with health and safety.All staff have to attend basic infection control training and adhere to guidelines in practice.The home has an established team of domestic staff who maintain high standards of cleanliness throughout the home. Due to low water pressure the bathroom and shower facilities on one unit are not used. This means people have to wait for and use facilities on other units. Care Homes for Adults (18-65 years) Page 19 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sufficient staff are employed to meet peoples needs. People are protected by the recruitment procedures, which ensure that staff are suitable to work with people who live at the home. Evidence: We saw that staff were respectful and communicated well with people at the home. Staff told us about the training they have undertaken. One told us that they received support to deal with behaviour that challenges people which was specific to the individual concerned. This is good practice. We looked at three recruitment files and saw that in all cases the service ensures that checks are carried out to make sure potential staff are suitable to work with vulnerable people. The manager completes a training analysis and has a schedule which helps to identify training gaps and renewals. We asked about training in first aid and were told that basic life support will only be Care Homes for Adults (18-65 years) Page 20 of 27 Evidence: made available to staff employed in the Trusts nursing homes. We were told that in instances where first aid or emergency treatment was required the service would always contact the ambulance service. This may not be enough to safeguard peoples health and wellbeing. The service should refer to recent National Patient Safety Agency advice on ensuring staff have sufficient skills to deliver effective first aid and that management of choking is included in basic life support training for staff. Care Homes for Adults (18-65 years) Page 21 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is well managed and there are robust policies and procedures in place. Evidence: The manager has the skills and qualifications gained from working in similar care settings for a number of years. She is not registered with the Commission and this would give people added reassurance about her skills and experience. A selfassessment we sent to the service was completed well and gave us a detailed picture of the service. The service takes account of government guidelines in drafting policies and procedures. People who live at the home and relatives are invited to regular reviews and contribute their views. The extent to which some people can contribute to the development of the service can be limited due to communication needs. The service would like to make more use of advocacy services but are limited due to availability of advocates. Care Homes for Adults (18-65 years) Page 22 of 27 Evidence: Policies and procedures are in place at the home to ensure the health and safety of the service users, visitors and staff, and are reviewed on a regular basis to ensure they comply with present legislation. The systems for monitoring and recording compliance with healthcare instructions need to be made more robust. The home is supported by a number of different departments within the two organisations and the manager confirmed that there are clear lines of accountability with external management. Bradford District Care Trust is responsible for the overall management of the service and for ensuring that suitable financial procedures are in place. The service is supported to ensure there are safe systems of work in place including appropriate policies and procedures for moving and handling and infection control. However the services first aid provision should be reviewed, This may include the service carrying out a first aid risk assessment to help decide the level of first aid training and support required, taking account of peoples needs, the likelihood of them needing first aid support and the nature of any first aid required. Care Homes for Adults (18-65 years) Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 18 13 The problems with hot water 13/02/2010 supply to one unit should be investigated and repaired to give people access to bathing and washing facilities on their unit. This will ensure that people are able to bath and wash at times that suit them. 2 20 13 The arrangements for storing medications must be kept under review and more suitable storage identified if required. This will help ensure that medication is stored at safe temperatures. 16/04/2009 3 42 12 A first aid risk assessment must be carried out. This will help make sure that the service identifies and can respond to the first aid needs of people living in the home. 15/05/2009 Care Homes for Adults (18-65 years) Page 25 of 27 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 17 The home should have suitable facilities to weigh people. Individual records should show evidence that the advice given by dietitians has been followed. Staff should ensure that any healthcare advice is communicated, implemented and recorded so that peoples needs are not overlooked The service should review its plans for first aid training and basic life support to make sure people are not put at risk. The manager should make application to be registered with the Commission so that people can be more confident and reassured about her skills and experience. 2 19 3 4 35 37 Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!