CARE HOME ADULTS 18-65
Riverside Park (12) South Hylton Sunderland SR4 0RT Lead Inspector
Elsie Allnutt Announced Tuesday 23 August 2005 at 10:00am
rd 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. Riverside Park (12) B52 B02 S15757 Riverside Park (12) V219409 220805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Riverside Park (12) Address South Hylton Sunderland SR4 0RT 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) 0191 534 6695 0191 534 6695 Community Integrated Care Mrs M Turner Care Home 4 Category(ies) of LD - Learning Disability - 4 registration, with number D (E) - Learning Disability Over 65 - 1 of places Riverside Park (12) B52 B02 S15757 Riverside Park (12) V219409 220805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 17th January 2005 Brief Description of the Service: Riverside Park is a service run by Community Integrated Care, a registered charity, and has been opened since 1995. The home is registered to provide a residential service for four younger adults with learning disabilities.The home is situated amongst other new and varied housing near to the river in the South Hylton area of Sunderland. It was built as a domestic building and still retains that appearance. There is a large garden at the back and a drive at the front, which is spacious enough to allow four cars to park. There are local shops and other resources nearby. Each person has a single bedroom that locks, and the use of the communal areas of the building that includes a lounge, dining room, kitchen and two bathrooms. Staff are available 24 hours per day, seven days a week to support people in their daily lives and to provide sleep in night cover. A consistent approach to all areas of service user’s needs is achieved by a key worker system. The aim of the service is to offer the people who live here a good quality of life by promoting independence as far as possible and a valued lifestyle through access to community based activities. Riverside Park (12) B52 B02 S15757 Riverside Park (12) V219409 220805 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This announced inspection took 6 hours over one day in August 2005. The views of four service users and four members of staff were sought. Service users’ satisfaction of the service provided not only relied on verbal communication but it was also interpreted through observations of body language, interaction with staff, discussions with staff and the examination of records. This process demonstrated that all were satisfied with the service and the care and support given by staff. Service users also gave positive feedback in relation to the satisfaction of the service provided via surveys carried out prior to the inspection. None were received from relatives. As part of the inspection process a sample of service users’ care files and the homes records were examined. The inspection process was accommodated by the senior support worker who was in charge of the home in the absence of a manager. However the former registered manager for the home was also present. What the service does well: This service provides accommodation of a good standard. It is well maintained and as a result of effective cleaning routines offers a clean and hygienic environment. On the day of the inspection the friendly interaction of service users and staff created a warm and welcoming atmosphere. By observing life in the home it was evident that service users are supported to live a full and active lifestyle. One service user discussed the tennis club that they attend and the interest they have in learning to play golf. They also demonstrated how they develop their tennis skills by playing swing ball in the garden. Another service user showed enthusiasm about the new greenhouse, as they attend a local horticultural group where they grow different vegetables, staff proudly showed some French beans that the service user had brought back to cook for dinner.
Riverside Park (12) B52 B02 S15757 Riverside Park (12) V219409 220805 Stage 4.doc Version 1.40 Page 6 Another service user showed a scrapbook where they keep cards and other items they make at a local women’s group. The same staff have worked at the home for many years, and as a result positive relationships have developed with the service users. The staff have detailed knowledge of the service users’ needs and this enables a consistent approach. Staff work with respect and skill and involve service users in making their own choices about what they prefer to do. A mutual respect was observed between staff and service users. Care plans are well documented, up to date and relevant, and are recorded in a way that is understood by service users and their families. What has improved since the last inspection? What they could do better:
So that any interested parties know who is in currently in charge of the home the appropriate areas of the Statement of Purpose and Service User Guide should be updated. The staff recently appointed should, as soon as possible, be given the opportunity to attend training in relation to the local authority’s MAPPVA procedures (Multi Agency of Protection Policies for Vulnerable Adults) so that
Riverside Park (12) B52 B02 S15757 Riverside Park (12) V219409 220805 Stage 4.doc Version 1.40 Page 7 they are aware of what to do if an incident of abuse is witnessed or reported to them. The senior support worker who is sometimes left in charge of the home should also up date their training. So that staff are aware of their responsibilities relating to the Health and Safety Law and the appropriate responsibilities of others this poster should be up dated. When staff receive fire instruction, so that it can be monitored easily who has taken part in this event, names and dates of attendance should be kept separately with the fire log/file. 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. Riverside Park (12) B52 B02 S15757 Riverside Park (12) V219409 220805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Riverside Park (12) B52 B02 S15757 Riverside Park (12) V219409 220805 Stage 4.doc Version 1.40 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 standard(s) 1, A range of information is available which enables service users to make a fully informed choice about where they would like to live, however the Statement of Purpose and Service User Guide need to be reviewed to reflect the current change in the management structure. EVIDENCE: The home has developed a comprehensive Statement of Purpose and Service User Guide. The Service User Guide has been tastefully developed into a format that is accessible to the service users with the use of photographs and illustrations. However both documents should be reviewed to reflect the current changes in the service in relation to the present management structure. Riverside Park (12) B52 B02 S15757 Riverside Park (12) V219409 220805 Stage 4.doc Version 1.40 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 standard(s) 6,7,9 Service users assessed needs are reflected within their individual plans of care that provide guidance for staffs’ care practice. To ensure service users remain safe, and that their independence is promoted, the care plans are supported with risk assessments, while staff also support them to make informed decisions. EVIDENCE: A good care planning system, that covers all health, welfare and social issues, is in place. However to develop this further the home is currently transferring this to a picture format system so that service users have access to them. This however is not yet fully in place. Individual care plans are easily identified by service users due to the colour of the files, one service user seeing that their file was being examined approached to point out certain sections and showing what they are involved in. A discussion took place with the person in charge in relation to the new system. Although there are many good points to this, it was concluded that the positive parts of the present system should not be abandoned and care should
Riverside Park (12) B52 B02 S15757 Riverside Park (12) V219409 220805 Stage 4.doc Version 1.40 Page 11 be taken to complete the new document in a consistent manner, two that were examined were completed in a different way. The current care plans describe a “story” by illustrating how the individual service user has progressed. Once an action plan has been achieved it then becomes routine and another action plan is developed. This clearly portrays for each service user, “this is how I have progressed.” Observations of service users confirmed the records in the care plans were relevant and appropriate. Relevant risk assessments were in place with guidelines for staff to follow so that the risk was minimised through a consistent approach for example, in relation to challenging behaviour and smoking. Riverside Park (12) B52 B02 S15757 Riverside Park (12) V219409 220805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,15,16,17 Service users are supported to take part in a variety of leisure and community based activities, and as a result live a valued lifestyle. The service continues to support service users’ rights and to successfully support them in maintaining relationships. The food is of good quality and sufficient to meet the needs of service users. EVIDENCE: All of the service users attend college during term time and all were enthusiastic to discuss this and other activities that they enjoyed doing. All were appropriately recorded in the care plans. Records showed that other activities enjoyed included using local shops, 10 pin bowling going to the cinema and eating and drinking at local pubs. A midday meal was taken with the service users and staff where much of the discussions took place. This was a pleasant experience where nutritious food that service users had chosen prior to the meal, was served attractively at a
Riverside Park (12) B52 B02 S15757 Riverside Park (12) V219409 220805 Stage 4.doc Version 1.40 Page 13 nicely set table. Service users confirmed that the meals were generally good and they always had a choice. Records proved that nutrition is monitored. Riverside Park (12) B52 B02 S15757 Riverside Park (12) V219409 220805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20 Service users personal and healthcare needs are met in a flexible but consistent manner, with the aim of allowing service users to take the lead. Medication arrangements are appropriate for the needs of service users, and are managed in a safe manner. EVIDENCE: Staff support service users to address their individual healthcare needs by assisting them to visit local GPs and attend hospital appointments. The outcomes of such visits are recorded in the care plans. Although all of the service users are independent in relation to some personal tasks, staff were observed to prompt and support them where needed. Clear information is recorded in the care plan in picture format clearly identifying what tasks are carried out independently and what tasks need support. Guidelines were in place in relation to one service user’s epilepsy and how this is managed, with an emphasis on how to maintain the person’s dignity, while also listing possible links in relation to what may trigger a seizure. Apart from a shower seat and grab rails in the bathrooms, service users do not need any special aids. Staff confirmed that they have attended training in the administration of medication and their knowledge and the way medication was stored reflected
Riverside Park (12) B52 B02 S15757 Riverside Park (12) V219409 220805 Stage 4.doc Version 1.40 Page 15 this. Some of the dates written on some of the medication by the Pharmacist did not include the year, this was discussed and the person in charge was to address this with the Pharmacy. Riverside Park (12) B52 B02 S15757 Riverside Park (12) V219409 220805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 Arrangements are in place to help protect service users from abuse and to seriously address complaints and concerns about the service. EVIDENCE: Staff confirmed that they have received awareness training regarding abuse and adult protection, as well as training in relation to handling verbal and aggressive behaviour. In discussion staff were able to appropriately describe what action to take in a situation where they witnessed abuse. The local authority’s adult protection procedure is available within the home, to guide staff on what to do and the people to contact in the event of witnessing abuse or having an alleged abusive situation reported to them. The person in charge was advised to make himself familiar with these procedures. The complaints Book confirmed that complaints and concerns are taken seriously recorded and satisfactorily addressed. Riverside Park (12) B52 B02 S15757 Riverside Park (12) V219409 220805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,27,28,29,30 As a result of a planned refurbishment programme the standard of the environment is good, providing service users with a spacious, attractive, hygienic and homely place to live. EVIDENCE: This home maintains its high standards of décor and furnishings, and recent refurbishments have improved bathing facilities giving service users more choice. The refurbished kitchen has provided a safe and hygienic area, however a discussion took place in relation to the use of the laundry facilities. Care must be taken to follow risk management guidelines in relation to washing, as these facilities are also sighted in the kitchen area. The gardens are attractive and can be accessed independently by service users. Staff confirmed that they have attended training in relation to control of infection and the person in charge also confirmed that he attends 3 monthly meetings with The Infection Control Link Scheme in South Tyneside whose aim is to reduce infections in care homes, for example MRSA, and to promote good standards in relation to catheter care, spread of infection and outbreak control.
Riverside Park (12) B52 B02 S15757 Riverside Park (12) V219409 220805 Stage 4.doc Version 1.40 Page 18 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 The home employs a competent and qualified staff complement via robust recruitment and selection processes, who are also supervised regularly, which means that service users are effectively supported and protected by staff. EVIDENCE: The examination of staff files provides evidence that good recruitment procedures are in place including the request of two references and clear CRB checks. However although the CRB number was evident the actual document was not. The person in charge was advised of this. Staff discussed the needs of the service users with respect and understanding. When observing staffs’ social interaction with service users, their response, and the way they addressed service users’ needs, it was evident that positive relationships have developed between them. The last supervision date recorded on two staff files was June 2005. Staff confirmed that supervision was due in August. A discussion took place with the person in charge in relation to who would be carrying this process out in the absence of the Registered Manager. This was to be addressed. Riverside Park (12) B52 B02 S15757 Riverside Park (12) V219409 220805 Stage 4.doc Version 1.40 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 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) 37,41,42 The service is currently without a permanent manager, however temporary arrangements are in place to effectively manage the home and promote the health, safety and welfare of the service users. EVIDENCE: The Registered Manager has been transferred, on a temporary basis, for six months to a new service within the Company and will decide at the end of the period whether she will return to Riverside Park. In her absence two Registered Managers from other homes and the Senior Support Worker are temporarily managing this service, with the Service Manager overseeing the situation. Although not an ideal situation this temporary measure has been discussed with and agreed by the CSCI. Records prove that staff are up to date with mandatory training and they were observed working with health and safety in mind, however the Health and Safety Law poster had the former Registered Managers name on as the Health
Riverside Park (12) B52 B02 S15757 Riverside Park (12) V219409 220805 Stage 4.doc Version 1.40 Page 20 and Safety Responsible Person, this was discussed with the person in charge and must be changed. The accident book and fire log were examined and were satisfactory apart from one discrepancy in the fire log. Although the fire drills also include the initials of the staff that attended the drill, if this is to be counted as the required 3 monthly fire instruction, a separate list of people who were in attendance, should be recorded. Riverside Park (12) B52 B02 S15757 Riverside Park (12) V219409 220805 Stage 4.doc Version 1.40 Page 21 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 2 x x x x Standard No 22 23
ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 3 x 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 x x 3 3 3 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x x 2 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Riverside Park (12) Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 x x x 2 2 x B52 B02 S15757 Riverside Park (12) V219409 220805 Stage 4.doc Version 1.40 Page 22 no 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 1 & 41 Regulation 6 Requirement The Statement of Purpose and Service User Guide must be brought up to date to reflect the currrent change in management. All staff must receive training in relation to the local authorities POVA procedures known as MAPPVA and any person left in charge of the home must up date this training. A permanent manager must be employed to manage the home and this person must apply to register with the CSCI. The Health and Safety Law HSE poster must be updated and completed appropriately. Timescale for action 30.09.05 2. 23 13(6)&18 (1)(c ) (i) 31.11.05 3. 37 8 30.03.06 4. 42 & 41 13(4) 30.09.05 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 6 Good Practice Recommendations Care should be taken when changing to the new care plan stystem that the positive aspects of the current system are not lost. Also that the new documentation is completed appropriately and consistently.
B52 B02 S15757 Riverside Park (12) V219409 220805 Stage 4.doc Version 1.40 Page 23 Riverside Park (12) 2. 3. 4. 34 36 41 & 42 CRB documents of new members of staff should be kept until checked by the inspecting officer at the nearest inspection. In the absence of a permanent manager appropriate provision should be made for the supervision of staff. The three monthly fire instruction received by staff should be recorded separately and kept with the fire log book/file. Riverside Park (12) B52 B02 S15757 Riverside Park (12) V219409 220805 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Baltic House Port of Tyne South Shields Tyne and Wear NE34 9PT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
© This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Riverside Park (12) B52 B02 S15757 Riverside Park (12) V219409 220805 Stage 4.doc Version 1.40 Page 25 - 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!
