Inspection on 17/11/06 for Ribble Valley Respite Service

This inspection was carried out on 17th November 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ribble Valley Respite Service 23/11/09

Ribble Valley Respite Service 21/06/07

Ribble Valley Respite Service 06/03/06

Ribble Valley Respite Service 09/11/05

Ribble Valley Respite Service 15/12/04

Ribble Valley Respite Service 22/07/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Ribble Valley Respite Service 12 Croasdale Drive Off Mayfield Drive Clitheroe Lancs BB7 1LQ Lead Inspector Andrew Windsor Unannounced Inspection 17th November 2006 09:00 Ribble Valley Respite Service DS0000040803.V317486.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 Ribble Valley Respite Service DS0000040803.V317486.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. Ribble Valley Respite Service DS0000040803.V317486.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ribble Valley Respite Service Address 12 Croasdale Drive Off Mayfield Drive Clitheroe Lancs BB7 1LQ 01200 424394 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) Lancashire County Council Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Ribble Valley Respite Service DS0000040803.V317486.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. A maximum of 6 service users, requiring personal care who fall into the category of LD The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 6th March 2006 Date of last inspection Brief Description of the Service: Croasdale Drive is situated within a residential area of Clitheroe about ten minutes walk from the town centre. There are local services and shops within easy reach of the home and access to public transport. The home is a two storey domestic property with six single bedrooms, a communal lounge and dining kitchen. A ramped area enables service users to access the garden and there is parking for several cars to the front of the house. There are two bathrooms and toilets. Ribble Valley Respite service charges a flat fee of £9.25 per night for the use of the respite facility. Information about the home is given to prospective service users on referral. Ribble Valley Respite Service DS0000040803.V317486.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key unannounced inspection, which included a visit to the home, was conducted at Ribble Valley Respite Service on 17 November 2007. The purpose of the inspection was to assess quality of life in the home, and check that the home meets legal requirements. The inspection comprised of looking around the home, and speaking to staff members and one service user. It also involved the examination of service users’ records and other documents. What the service does well: What has improved since the last inspection? All staff have now completed accredited training in the administration of medication. The downstairs bedroom has had the windows replaced, and has been replastered and re-decorated. Bedrooms now contain lockable storage, for those service users that wish to self-medicate. Each bedroom now contains a minimum of two double electric sockets, to enable service users to operate electrical or medical equipment. Ribble Valley Respite Service DS0000040803.V317486.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Ribble Valley Respite Service DS0000040803.V317486.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Ribble Valley Respite Service DS0000040803.V317486.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1;2;3;4 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Pre-admission documentation does not ensure that service users know that their needs and expectations can be met by the home. EVIDENCE: Admissions to the home form part of an overall package of care. A copy of the most recent inspection report was available to service users. The Service User Guide was written in a way that was accessible to people with a learning disability. This meant that service users were able to make an informed choice about whether they would like to stay at the respite facility. However, the Statement of Purpose for the home was out-of-date and would have benefited from being written in a similar accessible format. The inspector examined the care files of two service users who were accommodated at Ribble Valley Respite Service at the time of the inspection. The first file examined contained an up-to-date assessment of need that had been completed by a social worker. Although the second file examined also contained an assessment of need completed by a social worker, it was several years old and showed no evidence of review. Consequently, it does not demonstrate that the service is still able to meet the needs of the service user. Ribble Valley Respite Service DS0000040803.V317486.R01.S.doc Version 5.2 Page 9 According to the proposed manager, prospective service users are provided with a tour of the building and a copy of the Service User Guide. They are then encouraged to make introductory visits to the home. This allows the service user an opportunity to ‘test drive’ the home, and ensure that it meets their needs and expectations. Unfortunately, the service is not documenting this good practice. Ribble Valley Respite Service DS0000040803.V317486.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6;7;9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The needs of service users are not consistently reflected in their plan of care. Service users are encouraged to retain their independence, and make their own decisions through informed choices. EVIDENCE: The inspector examined the care files of two service users who were accommodated at Ribble Valley Respite on the day of the inspection. The first care plan contained a number of areas that had not been completed. Parts of the care plan that had not been completed included Community Participation, Social Interaction, Common Dangers/Risk Related Issues and Heath Needs. This meant that staff who are new to the service may not be aware of the level of support that the service user required. The second care plan had been completed to a much higher standard. The daily routines of the service user, and their specific support requirements had been identified. The plan also stated what the parents expected the respite Ribble Valley Respite Service DS0000040803.V317486.R01.S.doc Version 5.2 Page 11 facility to do in order to support the service user. It had also been completed with the assistance of the service user’s mother. A discussion with one service user indicated that he was supported to make informed choices about things that affected his life. Ribble Valley Respite Service DS0000040803.V317486.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12;13;15;16;17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Independence and choice are encouraged, which enables service users to be part of the community. Opportunities are provided to access the community, and maintain existing relationships. EVIDENCE: Discussions with staff members and the proposed manager indicated that staffing levels were appropriate to accommodate the needs of service users. The inspector examined care plans, and discussed community and leisure activities with employees of the home. Service users were assisted to participate in the local community. One service user at the respite facility had a work placement. Another was accessing the community several days a week, through support provided by the local day centre. Activities that he regularly took part in included walks, trips to cafés, museums, pubs and the local ‘meteor’ club. Ribble Valley Respite Service DS0000040803.V317486.R01.S.doc Version 5.2 Page 13 The main activities within the house tended to be watching TV or listening to music. However, a discussion with one service user indicated that this was what he wanted to do. Care plans recorded contact with family members, which assisted service users to maintain their relationships. Meal planning was person centred. Service users would be asked what they like before meals were made. Although most service users tended to have the same meal, alternatives could be provided. Examples included Pizza with Garlic Bread, Shepherd’s Pie and Corn Beef Hash. On the day of the inspection one service user had purchased some pie’s for himself while out in the community. Service users regularly assist with the cooking of meals. Ribble Valley Respite Service DS0000040803.V317486.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18;19;20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Healthcare needs are not consistently recorded. Service users are accessing community healthcare facilities. Procedures for the administration of medication need to be improved, to protect service users. EVIDENCE: The first care file examined did not contain the physical and emotional healthcare needs of the service user. However, a diary held by the respite service indicated that he was accessing community healthcare facilities. He had recently had both an x-ray and a blood test at the local hospital. The second file examined did demonstrate that the healthcare needs of the service user had been documented. A district nurse attended whenever the service user was using the respite facility. The home contained appropriate lockable storage for both drugs, and controlled drugs. Bedrooms contained lockable storage for service users who wished to self-medicate. This meant that medicines could be stored in a safe manner. At the time of the inspection no service users was self-medicating. Ribble Valley Respite Service DS0000040803.V317486.R01.S.doc Version 5.2 Page 15 Medication examined at the time of the inspection was found to be correct. However, the Medication Administration Record did not have the signature of person who had completed it. Similarly, a second member of staff was not witnessing and verifying all handwritten charts and amendments. This meant that service users could be placed at risk. Letters from GP’s were found to be on file, that stated under what circumstances ‘as required’ medication should be given to service users. All staff had completed accredited training in the handling of medication. Ribble Valley Respite Service DS0000040803.V317486.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22;23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The complaint’s procedure does not ensure that service users are confident that their concerns will be listened to and acted upon. Policies and procedures on safeguarding adults did not fully protect service users. EVIDENCE: A complaints policy was available. However, it was four years old and showed no evidence of review. The document was not user friendly, particularly for someone with a learning disability. No complaints from service users had been received since the last inspection. One complaint had been received from a relevant stakeholder. One service user interviewed indicated that he was unaware of the complaints procedure. This meant that complaints may not be correctly reported or acted upon. Although most staff had received training in safeguarding adults, only new starters had done the training recently. While the service had an internal policy on safeguarding adults, it was seven years old and showed no evidence of review. This meant that service users could potentially be placed at risk. Ribble Valley Respite Service DS0000040803.V317486.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24;25;30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users were provided with a clean and comfortable environment. However, some parts of the building are inaccessible to wheelchair users. EVIDENCE: The building was in keeping with the local community. It was found to be clean and free from odour. The building was not ideal for wheelchair users. Only one bedroom was accessible to wheelchair users, as it was located downstairs. This means that the service is unable to provide respite for more than one wheelchair user at a time. Bedrooms were lockable, to ensure the privacy of service users. Radiators were suitably covered, to safeguard service users. The last inspection made a number of requirements and recommendations about changes to the environment. The downstairs bedroom has now been replastered, re-decorated and the windows replaced. This means that it is now a Ribble Valley Respite Service DS0000040803.V317486.R01.S.doc Version 5.2 Page 18 safe and comfortable environment for service users. Bedrooms now contain lockable storage, so that service users are able to self-medicate. Each bedroom now contains a minimum of two double electric sockets, so that service users are able to operate any electrical or medical equipment that they may have. A programme of maintenance and renewal was unavailable at the time of the inspection. Ribble Valley Respite Service DS0000040803.V317486.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32;34;35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Recruitment procedures do not demonstrate that service users are safeguarded. Staff are receiving the training they need to do their jobs in a competent manner. EVIDENCE: The files of two members of staff were examined. Neither of the files contained the required pre-employment checks. For example, both files did not contain an application form or a Criminal Records Bureau Check. This means that the service was unable to demonstrate that service users are safeguarded by its recruitment procedures. Arrangements were in place for staff supervision, to ensure that staff are supported. Fifty percent of the staff team held a National Vocational Qualification at level 2 or equivalent. New starters were being placed on the Learning Disability Awards Framework, in accordance with Skills for Care. According to a tracking Ribble Valley Respite Service DS0000040803.V317486.R01.S.doc Version 5.2 Page 20 matrix provided by the proposed manager, all staff had recently completed mandatory training. However, this was not evidenced in staff files. Ribble Valley Respite Service DS0000040803.V317486.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37;39;42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Procedures are in place to safeguard the health, safety and welfare of service users. The lack of quality assurance systems meant that it could not be shown that the home was run in the best interests of service users. EVIDENCE: There has been no registered manager since January 2006. However, the service has now appointed a manager who they hope will fill this position. The manager is a Registered Mental Health Nurse, and holds a Certificate in Management Studies. He will have completed his Registered Manager Award in January 2007. The home contained detailed policies and procedures, although most of these were several years old and would benefit from review. Health and safety procedures were available, to ensure that service users are protected. A Ribble Valley Respite Service DS0000040803.V317486.R01.S.doc Version 5.2 Page 22 number of risk assessments were available, which included one for moving and handling. Fire procedures were found to be robust and up-to-date. The last inspection recommended that a central accident record be maintained, to safeguard service users and look for trends. This remains outstanding. The registered provider does not ensure that a representative of the organisation makes an unannounced visit to the home every month. There are currently no quality assurance systems in place, so that the manager is able to audit the service. The respite service did conduct an Annual Survey. However, this was much too basic to provide meaningful information about people’s experiences of using the service. These deficiencies in measuring quality deny service users and staff the opportunity to have their say about how they see the service to be operating. Ribble Valley Respite Service DS0000040803.V317486.R01.S.doc Version 5.2 Page 23 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 2 3 3 4 2 5 X 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 3 25 3 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 x 2 X 2 X X 3 X Ribble Valley Respite Service DS0000040803.V317486.R01.S.doc Version 5.2 Page 24 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. 2. Standard YA1 YA22 Regulation 4 Schedule 1 22 Requirement Timescale for action 28/02/07 28/02/07 3. YA23 The registered person must ensure that the Statement of Purpose is up-to-date The registered person ensures that there is a clear and effective complaints procedure, which includes the stages of, and timescales for, the process and that service users know how and to whom to complain. 18 (1) (c) The registered person must ensure that all staff receive training in respect of the Protection of Vulnerable Adults. Prevous timescale of 30/06/06 not met. The registered person must ensure that pre-employment checks are both made and documented. 28/02/07 4. YA34 19 Schedule 2 (5) 28/02/07 Ribble Valley Respite Service DS0000040803.V317486.R01.S.doc Version 5.2 Page 25 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. 4. 5. 6. 7. 8. 9. Refer to Standard YA2 YA4 YA6 YA9 YA19 YA23 YA35 YA37 YA39 Good Practice Recommendations The registered person should ensure that the needs of service users are periodically reassessed, to ensure that the home still meets their needs and expectations. The registered person should ensure that introductory visits to the home are documented. The registered person should ensure that each service user has an up-to-date plan of care that has been agreed with the service user. The registered person should ensure that risk assessment is incorporated into the plan of care. The registered person should ensure that the healthcare needs of service users are assessed and recognised and that procedures are in place to address them. The registered person should ensure that policies and procedures on safeguarding adult are up-to-date. The registered person should ensure that training received by staff is documented in their files. The registered person should appoint an individual to manage the care home. The registered person should ensure that copies of the visits carried out under Regulation 26 are forwarded to the CSCI on a monthly basis. The registered person should ensure that a central accident record, stating the date and initials of the service user concerned, should be maintained in order for accidents to be monitored. This would remain Data Protection compliant. 10. YA42 Ribble Valley Respite Service DS0000040803.V317486.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Ribble Valley Respite Service DS0000040803.V317486.R01.S.doc Version 5.2 Page 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. 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