Inspection on 27/08/08 for Rother Heights

This inspection was carried out on 27th August 2008.

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

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

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 13/11/2008.

CARE HOME ADULTS 18-65 Rother Heights Rother Crescent Treeton Rotherham S60 5QY Lead Inspector Christine Rolt Key Unannounced Inspection 27th August 2008 09:45 Rother Heights DS0000071502.V370574.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 Rother Heights DS0000071502.V370574.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. Rother Heights DS0000071502.V370574.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rother Heights Address Rother Crescent Treeton Rotherham S60 5QY 01142 293450 0114 269 2786 rotherheights@autismcareuk.com autismcareuk.com Autism Care (UK) Limited 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) Care Home 24 Category(ies) of Learning disability (24) registration, with number of places Rother Heights DS0000071502.V370574.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: 2. Learning Disability - Code LD, maximum number of places 24 The maximum number of service users who can be accommodated is: 24. Date of last inspection Brief Description of the Service: Rother Heights specialises in the care of people with autism. The home is on the edge of a residential estate in the Treeton area of Rotherham with open views over the countryside. It is a purpose built single storey development comprising four houses and an administration block in secure and spacious gardens. Each of the four houses has six single bedrooms with en-suite showers and toilets, a lounge, dining room, sun lounge, kitchen, laundry room, bathroom and toilets. Doors have guarded hinges to prevent trapped fingers, under floor heating is fitted and toughened glass is used in windows. Heating and lighting is computerised and can be adjusted to suit people’s individual needs. There is ample car parking space for visitors. The Statement of Purpose, Service User Guide and other information were displayed in the reception area of the administration building. Fees were from £2,100 to £6,500 per week. Hairdressing and toiletries were charged extra. The temporary manager supplied this information during the site visit on 27th August 2008. Rother Heights DS0000071502.V370574.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means that the people who use this service experience adequate quality outcomes. This was the home’s first key inspection since registration and comprised information already received from or about the home and a site visit. The site visit was from 9:45 am to 3:45 pm on 27th August 2008. The registered manager, who has since left, completed an Annual Quality Assurance Assessment (AQAA). This document is designed to give the manager the opportunity to say what the home did well, what had improved and what they were working on to improve. Various aspects of the service were then checked during the site visit. Care practices were observed, a sample of records was examined, a partial inspection of the site was carried out and service provision was discussed with the temporary manager, a house manager and the operations manager who all assisted with this inspection. At the time of this site visit there were only two people living at the home and both were on outings with their support workers. The care provided for both people was checked against their records to determine if their individual needs were being met and completed questionnaires were received from both families. Five questionnaires were sent for completion by staff and two were returned. Two members of staff were interviewed during the site visit. All information, opinions and comments were considered for inclusion in this report. The inspector wishes to thank the families, staff and the management for their assistance and co-operation. What the service does well: The home was clean and tidy, and there was a strong emphasis on a safe environment. Care plans provided good information of people’s assessed needs and wishes and detailed information of how these were incorporated into care plans. A relative writing on behalf of a person living in the home had written, “I feel safe, occupied, stimulated, happy, clean, accepted and cared for. staff are alert and responsive to meeting my needs.” The Rother Heights DS0000071502.V370574.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. Rother Heights DS0000071502.V370574.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 Rother Heights DS0000071502.V370574.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): 2 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People only moved into the home after their needs had been assessed and been assured that the home could meet their needs. EVIDENCE: Relatives considered that they had received sufficient information about the home. They also said that they had chosen this home after carrying out lots of research. The files for both people who lived in the home were checked. Both contained full needs assessments. The information provided good detail of all aspects of each person’s assessed needs covering physical, emotional, health and social needs. Files also contained people’s preferences, known routines and likes and dislikes. Rother Heights DS0000071502.V370574.R01.S.doc Version 5.2 Page 9 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 and 9 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People’s assessed and changing needs and their methods of communication were reflected in their care plans to ensure that their needs and wishes were met. EVIDENCE: Both people had care plans and these were checked. The plans provided detailed information of each person’s physical, health, social and emotional needs and how these were to be met. Also included were detailed risk assessments, likes, dislikes and wishes and how these were to be incorporated into the care plan. Care plans were reviewed regularly to ensure that needs were being met and each care need review date were listed on the care plan. The house manager confirmed that care needs were constantly monitored and showed an example of a pictorial chart system that staff were implementing to help people with a wider selection of choices. Rother Heights DS0000071502.V370574.R01.S.doc Version 5.2 Page 10 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 and 17 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People were able to participate in activities and leisure activities both inside and outside the home. Their rights were respected and choices were offered. EVIDENCE: Routines within the home were flexible and choices were offered to people within a defined programme. The home had an area for activities with a selection of table games. There was also evidence of people’s preferred leisure activities throughout the home. Staff knew what each person liked to do and spoke enthusiastically about how these were incorporated into people’s daily routines. Files also contained information of activities in the community. The home had a minibus and an estate car for outings. Two members of staff accompanied each person on outings. On the day of this site visit, one person was going for a picnic and the other person was visiting a park. Rother Heights DS0000071502.V370574.R01.S.doc Version 5.2 Page 11 People went home for the weekend if they wished to do so and relatives were also encouraged to visit the care home. Telephone contact and other means of communication were also encouraged. Staff were aware of people’s likes, dislikes and food allergies and this information was recorded in their care plans. Food stocks were checked to determine that there were sufficient supplies and varieties of food. (See section Concerns, Complaints and Protection). A menu was seen and discussed with the house manager who said that she was in the process of updating it. A file with laminated pictures was used to discuss kitchen tasks with people. Staff said that they encouraged life skills and one person had recently started participating in the preparation of meals. Rother Heights DS0000071502.V370574.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People received the personal support they preferred and their physical, emotional and heath needs were met. The service needs to improve daily records and medication practices in order to protect people’s welfare and keep them safe. EVIDENCE: People received the help and support they needed and there was good information in their care plans of how their physical, emotional, health and social needs and wishes were to be met. The daily recordings could improve. For example, on some days there was no entry made against the care need. There was no explanation of whether the care need was not relevant to that day or whether staff had just failed to complete the record. In another instance the record of meeting the need raised further questions because there was no explanation of whether the options outlined in the care plan had been considered. These daily recording were discussed with the management during feedback. Rother Heights DS0000071502.V370574.R01.S.doc Version 5.2 Page 13 Both files contained detailed information of people’s health needs. also records of health appointments with outcomes. There were The service had a policy to support people who wished to self medicate. Medication was checked against the Medication Administration Record (MAR) charts. Quantities could not be checked because the MAR chart entries stated that no medication had been supplied, no medication was booked in, no medication was brought forward and yet medication was available and the records showed that it was being administered as prescribed. This put people at risk because staff were not following safe medication procedures. Some staff had undertaken Boots training in the monitored dose system. Not all staff could demonstrate they had competent skills. This put people at risk of medication errors. This was discussed with the manager during the visit. It is important that as the home admits more people, staff are confident and understand safe medication procedures, including the importance of accurate record keeping. They were also advised to obtain the Royal Pharmaceutical Society’s guide “The Handling of Medicines in Social Care” to remind them of the correct procedures. Medication that required refrigeration was kept in a locked medication refrigerator. A daily record was kept to ensure that medicines were stored at the correct temperature. Rother Heights DS0000071502.V370574.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People were not fully protected from abuse. The home’s complaint procedure ensured that people and their representatives had the means to complain. EVIDENCE: Two members of staff were interviewed and were able to define abuse. Both said that they had received adult protection training and both had been employed since before the home opened. The acting manager was given the opportunity to supply an up to date staff training matrix, which was received shortly after the inspection. The staff training matrix indicated that staff employed before the home opened had received a range of training including Non-Abusive Psychological and Physical Intervention (NAPPI) training. However, according to this matrix staff employed since the home opened had not received much training and only 9 of the 19 staff had undertaken adult safeguarding training. This put people’s safety and welfare at risk because some staff may not identify, or take the right action, if someone is abused or harmed. It is important that as the home admits more people, staff are confident and understand safeguarding adult procedures. See also section Conduct and Management of the Home. Rother Heights DS0000071502.V370574.R01.S.doc Version 5.2 Page 15 The complaints procedure was displayed in the entrance to the administration building. A complaint was made directly to Sheffield Social Services who informed the CSCI. The complaint included concerns about food supplies and staff skills and training. During this inspection these were checked to establish any actions taken to rectify the situation. The managers said that they were aware that there had been problems and stated how these were being dealt with. See also sections Lifestyle and Staffing. Rother Heights DS0000071502.V370574.R01.S.doc Version 5.2 Page 16 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 and 30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home was clean, comfortable and safe. EVIDENCE: The home was clean and tidy. There were no offensive odours. Furniture was sturdy. Televisions and bookcases were fitted with Perspex screens to reduce the risk of accidents. Private and communal areas provided sufficient space to accommodate people in wheelchairs and all accommodation was on one level. All parts of the home were light and airy. Mood lighting was fitted. Bedrooms were personalised and had en-suite showers and lavatories. People had the choice of a bath or a shower. One person thought that the en-suite was not always as clean as it should be and considered that this probably depended on the members of staff on duty. The laundry room was clean and tidy and was kept locked. Rother Heights DS0000071502.V370574.R01.S.doc Version 5.2 Page 17 Around the houses, there were enclosed, spacious grassed areas that incorporated patio areas with seating. Rother Heights DS0000071502.V370574.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Recruitment procedures were robust but staff were not always trained and competent to provide the relevant support. EVIDENCE: Two members of staff who had been employed before the home opened were interviewed during this site visit. Both said that they enjoyed their jobs and they demonstrated good knowledge about the people they were caring for. The staff training matrix indicated that staff employed before the home opened had received a range of training including some skills training and this was confirmed during interviews. Information received about a complaint made directly to Sheffield Social Services indicated that when a person who had lived in the home had had an epileptic seizure, the member of staff had no awareness of how to deal with epilepsy because training had not been given. The training matrix indicated Rother Heights DS0000071502.V370574.R01.S.doc Version 5.2 Page 19 that seven staff had received this training and no further training had been given since this incident. According to the Annual Quality Assurance Assessment (AQAA), only one member of staff had a National Vocational Qualification (NVQ) Level 2. The AQAA also stated that “Staff use LDQ before completing probationary periods” but the staff training matrix indicated that only three members of staff had undertaken this training. See also section on Conduct and Management. Because the home has not made sure enough staff are suitably trained (e.g. epilepsy and NVQ qualification) the home cannot fully meet some people’s individual health needs safely. This could put people at risk of receiving inappropriate care. It is important that as the home admits more people, staff are suitably trained to meet people’s individual needs. The files for three members of staff were checked. All contained the relevant checks and information. Criminal Record Bureau disclosures were discussed and advice given. Other correspondence was also available which showed that the system was robust. Relatives said that they made their offspring’s needs known to staff and that they listened and ensured people’s needs were met. One person commented, “Most staff are highly engaged and committed”. Rother Heights DS0000071502.V370574.R01.S.doc Version 5.2 Page 20 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 and 42 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home’s quality assurance ensured people’s views were sought. Improvements to staff training and systems checks would help to ensure a well run home that promoted and protected people’s health and safety. EVIDENCE: At the time of this site visit, the registered manager had left and the manager from another home was working part time at this home. The operations manager confirmed that the post had been advertised. The home had a Quality Assurance system that incorporated checks of the environment and audits of most systems within the home. Rother Heights DS0000071502.V370574.R01.S.doc Version 5.2 Page 21 Personal allowances were checked and cash tallied with the records. The home had a staff training matrix that indicated that some people had not received mandatory health and safety training (i.e. moving and handling, basic food hygiene, infection control, emergency first aid, and fire awareness). The acting manager said that the matrix needed to be updated and she was offered 48 hours to produce an updated version. The updated matrix still contained gaps that indicated that staff had not received mandatory health and safety training. Certificates for the maintenance and servicing of systems and equipment within the home were available and a sample of these was checked. Weekly fire safety checks were not carried out and no fire drills had been carried out. The lack of fire safety checks puts people at increased risk of fire hazards. Also people are at risk if staff do not take the safest action in the event of a fire because they have not had training or practiced fire drills. The acting manager said that a new book for these was being set up. It is important, that as the home admits more people, staff are suitably trained and up to date in carrying out safe working practices that affect people’s health, wellbeing and safety. Rother Heights DS0000071502.V370574.R01.S.doc Version 5.2 Page 22 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 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 2 3 2 X 2 X 3 X X 2 X Rother Heights DS0000071502.V370574.R01.S.doc Version 5.2 Page 23 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 YA20 Regulation 13 Requirement To keep people safe from medication errors staff must follow safe practices when dealing with people’s medication. This must include satisfactory record keeping and storage procedures. The providers must make sure staff undertake adult safeguarding training to raise awareness and ensure people are protected. The providers must make sure staff receive the relevant training to ensure that people’s individual needs can be met, e.g. Epilepsy awareness To ensure the health, safety and welfare of people living in the home: a. Arrangements must be made for staff to undertake training and demonstrate competency in mandatory health and safety training (i.e. moving and handling, basic food hygiene, emergency or first aid, infection control and fire DS0000071502.V370574.R01.S.doc Timescale for action 22/10/08 2 YA23 13 22/10/08 3 YA32 12 22/10/08 4 YA42 13 22/10/08 Rother Heights Version 5.2 Page 24 awareness) b. Weekly checks of fire equipment must be undertaken c. Regular fire drills must be arranged to ensure that staff are fully conversant with the procedures. 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 Refer to Standard YA18 YA20 YA32 YA35 Good Practice Recommendations Information in daily records should be in sufficient detail to demonstrate that the identified needs have been met. The Royal Pharmaceutical Society’s guide “The Handling of Medicines in Social Care” would remind staff of the correct procedures for dealing with medication. Care staff should undertake NVQ Level 2 or above to provide them with the skills to carry out their roles. Staff should have structured induction training to provide them with the knowledge to carry out their duties. Rother Heights DS0000071502.V370574.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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. 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