CARE HOME ADULTS 18-65
Riverside Park (12) South Hylton Sunderland SR4 0RT Lead Inspector
Mrs Elsie Allnutt Unannounced Inspection 5th January 2006 10:00 Riverside Park (12) DS0000015757.V269990.R01.S.doc Version 5.0 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 Riverside Park (12) DS0000015757.V269990.R01.S.doc Version 5.0 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. Riverside Park (12) DS0000015757.V269990.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Riverside Park (12) Address South Hylton Sunderland SR4 0RT 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) 0191 534 6695 0191 534 6695 www.c-i-c.co.uk. Community Integrated Care Mrs. Mairi Turner Care Home 4 Category(ies) of Learning disability (4), Learning disability over registration, with number 65 years of age (1) of places Riverside Park (12) DS0000015757.V269990.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 23rd August 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 that is situated near the river in the South Hylton area of Sunderland, is registered to provide a residential service for four younger adults with learning disabilities. 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 users’ 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) DS0000015757.V269990.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This announced inspection took 4.5 hours over one day in January 2006. The views of three 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. As part of the inspection process a sample of service users’ care files and the homes records were examined. The home is currently without a permanent manager and is being temporarily managed by two managers from two other homes belonging to the Company and in their absence by the senior support worker. The area manager is also overseeing the home. The inspection process was accommodated by one of the temporary mangers. What the service does well:
This service continues to provide accommodation of a good standard. It is well maintained and as a result of effective cleaning routines offers a clean and hygienic environment. The friendly interaction of service users and staff creates 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. Activity programmes pinned to the notice boards in individual bedrooms demonstrates individual service user’s commitments to different activities during the week. All service users confirmed their attendance at college and one confirmed that they continue to attend church and various activities related to it. On arrival at the home all service users were engaged in different activities, this included playing cards, tidying a bedroom and watching a DVD in the privacy of their own room. One service user was not available at the home as they were attending a D I Y class supported by a member of staff. Some of the 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. These provide
Riverside Park (12) DS0000015757.V269990.R01.S.doc Version 5.0 Page 6 valuable information for the staff to access and guidelines for them to follow when addressing service users’ needs. What has improved since the last inspection? What they could do better:
Not all of the Requirements from the previous inspection report have been addressed. The Statement of Purpose and the Service User Guide should be kept up dated so that service users and other interested parties have access to accurate information about the service. The documents must be reviewed and adjusted to reflect the current management situation and any other changes that have recently taken place. So that information in the care files is accurate and confusion does not occur, care should be taken to record information in the appropriate place. In one service user’s file the last monthly review of the care plan was recorded to take place 19.07.05 and later in another section a key worker meeting, where the care plan was reviewed, was recorded 14.11.05. This was brought to the attention of the manager. The home’s Administration of Medication Procedures must be consistently followed and so that mistakes are avoided and service users are not put at risk medication should be signed for at the same time as it is administrated. So that staff understand the local authority’s procedures for the protection of vulnerable adults and know how to put it into action, all staff should attend training in relation to them. The fire procedures as advised in the Fire Brigades Fire Log Book must be carried out at the frequencies advised so that staff and service users are aware of the procedures to take in the event of fire.
Riverside Park (12) DS0000015757.V269990.R01.S.doc Version 5.0 Page 7 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) DS0000015757.V269990.R01.S.doc Version 5.0 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 Riverside Park (12) DS0000015757.V269990.R01.S.doc Version 5.0 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): 1,2 A range of information is available which enables service users to make a fully informed choice about where they would like to live, however some of the information in the Statement of Purpose and Service User Guide is not accurate. A detailed assessment process is in place and confirms that the home can meet service users needs. 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 must be reviewed and changed to reflect the current changes in the service in relation to the present management structure. This was discussed with the manager who noted the changes to be made. Pre admission assessments were carried out prior to the service users moving into the home and the care plans in place reflected the assessed needs and risks identified. Staff confirmed that one service user’s needs were currently being re assessed to ensure that a particular activity continues to meet their needs. Another service user confirmed that their aspiration to take part in sporting activity is successfully met. Riverside Park (12) DS0000015757.V269990.R01.S.doc Version 5.0 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 Service users assessed needs are reflected within their individual plans of care that provide guidance for staffs’ care practice. EVIDENCE: A good care planning system, that covers all health, welfare and social issues, is in place. The care plans have recently been further developed. Information included is now written in the person centred approach and the addition of a picture format system now gives service users easier access to them. The transfer to this system has included all relevant accumulated information. The guidelines for staff to follow in the care plans clearly identify the amount of support needed by service users with different tasks. The information written in one file was confirmed when one service user was observed being assisted with a personal task. One discrepancy was found in relation to where the monthly review of the care plan should be recorded. This was discussed with the manager and a conclusion found. Riverside Park (12) DS0000015757.V269990.R01.S.doc Version 5.0 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): No standards assessed on this occasion. EVIDENCE: Riverside Park (12) DS0000015757.V269990.R01.S.doc Version 5.0 Page 12 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): Good systems for storing and administering service users medication are in place, however staff have put service users at risk of harm by neglecting to follow correct procedures in relation to the administration of medication. EVIDENCE: This home has comprehensive procedures for the Safe Handling and Administration of Medication, however records demonstrate that staff have not consistently followed these procedures on more than two occasions over the previous two weeks to this inspection. Staff failed to identify that medication had been administered by omitting to sign the medication record sheet. The manager identified this during a “spot check” prior to the inspection and confirmed that appropriate action is to be taken to address it. Staff and records confirmed that staff have received training in relation to the administration of medication. Riverside Park (12) DS0000015757.V269990.R01.S.doc Version 5.0 Page 13 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): 23 There are satisfactory procedures in place that protect the service users from abuse. 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. Although the manager has attended training in relation to the local authority adult protection procedures some staff have not. Riverside Park (12) DS0000015757.V269990.R01.S.doc Version 5.0 Page 14 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): 24,27,30 The standard of the environment of this home 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. Recent refurbishment to one of the bathrooms has improved bathing facilities giving service users an additional facility of a walk in shower. One service user confirmed that they enjoyed this facility and this was established later in the day when they took a shower assisted by a member of staff. The refurbished kitchen has provided a safe and hygienic area, and staff were able to confirm the measures to take to reduce the risk of cross infection due to having the washing machine sited in the kitchen area. Risk assessments in relation to this are in place as well as individual risk assessments related to service users doing their own laundry. Staff confirmed that they have attended training in relation to the control of infection. Records and observations of their domestic and care practices confirmed this. Riverside Park (12) DS0000015757.V269990.R01.S.doc Version 5.0 Page 15 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): 34,35,36 Robust recruitment & selection procedures, regular training opportunities and supervision ensure that service users are appropriately supported and protected by a competent and qualified staff team. EVIDENCE: This home is fully staffed and the number of staff available during the day adequately addressed the needs of the service users, this includes a manager and 3 support workers. Staff were observed working with interest and discussed their training schedules with enthusiasm. The manager and records confirmed that all staff are either qualified in, or are working towards NVQ. Staff confirmed that they have attended training relevant to their role that includes moving and handling, first aid, administration of medication and infection control. One member of staff showed their training schedule and the courses attended within the past 8 months. The manager confirmed that the home continues to follow the Company’s robust recruitment procedures, which includes receiving 2 references and a clear CRB. However there has been no new staff recruited since the last inspection. Riverside Park (12) DS0000015757.V269990.R01.S.doc Version 5.0 Page 16 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): 37,39,42 Although the service continues to be without a permanent manager, there are temporary arrangements in place to effectively manage the home and promote the health, safety and welfare of the service users. EVIDENCE: The previous registered manager of this home has now taken up a permanent position in another of the Company’s homes. The arrangements for the temporary management of the home, as found at the previous inspection, have successfully continued. However the manager stated that interviews for a permanent manager are now organised to take place during the following week. One of the service users confirmed that they had been invited to sit on the interviewing panel and was currently, with the assistance of staff, organising questions to ask. The person in charge of the home during this inspection is a registered manager for another home and has many years experience, he has also achieved the Registered Managers Award. Riverside Park (12) DS0000015757.V269990.R01.S.doc Version 5.0 Page 17 Records showed that the manager is often included on the staff rota as one of the 3 staff on duty. As a result of this, little time is allocated to address managerial duties. So that the new manager can fulfil their full responsibilities without the care needs of the service users being jeopardized, care hours and managerial hours must be allocated accordingly. The Health and Safety File was examined. There is a system where the quality of the service is monitored on a monthly basis and this was up to date, however it was noted that the fire safety procedures had been ticked as satisfactorily carried out and when checking the fire log book it was found that there had been no fire drill carried out or staff fire instruction delivered since August 2005. As all staff carry out night shift duties a fire drill and staff fire instruction should be carried out every three months. This was an issue also raised at the last inspection. An Immediate Requirement notice was served and the manager confirmed that it would be addressed immediately. Riverside Park (12) DS0000015757.V269990.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 X X X Standard No 22 23 Score X 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X X X Standard No 24 25 26 27 28 29 30
STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X X 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Riverside Park (12) Score X X 2 X Standard No 37 38 39 40 41 42 43 Score 2 X 2 X 2 2 X DS0000015757.V269990.R01.S.doc Version 5.0 Page 19 yes Are there any outstanding requirements from the last inspection? Riverside Park (12) DS0000015757.V269990.R01.S.doc Version 5.0 Page 20 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 YA1YA41 Regulation 6 Requirement The Statement of Purpose and Service User Guide must be brought up to date to reflect the currrent change in management and any other changes in the service provided. (Timescale of 30/09/05 not met.) Staff must follow the home’s procedures in relation to the Safe Administration of Medication at all times. 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. (Timescale of 31/11/05 not met.) Quality monitoring systems must be carried out accurately so that neglected tasks are identified and improved. A permanent manager must be employed to manage the home and this person must apply to register with the CSCI. Fire drills must be carried out as advised in the Fire Brigades Fire Precautions Log Book for example for staff who work night shift every three months. Timescale for action 31/01/06 2 YA20 13 (2) 05/01/06 3 YA23 13(6)&18 (1)(c)(i) 30/03/06 4 YA39 24 31/01/06 5 YA37 8 30/03/06 6 YA42 23(4) 05/01/06 Riverside Park (12) DS0000015757.V269990.R01.S.doc Version 5.0 Page 21 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 YA6 Good Practice Recommendations So that information in the care files is accurate and confusion does not occur, care should be taken to record information in the appropriate place. Riverside Park (12) DS0000015757.V269990.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection South of Tyne Area Office Baltic House Port of Tyne Tyne Dock South Shields NE34 9PT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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