Inspection on 07/07/05 for Saltshouse Road

This inspection was carried out on 7th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Saltshouse Road 27/02/09

Saltshouse Road 11/12/06

Saltshouse Road 22/12/05

Saltshouse Road 25/01/05

Saltshouse Road 12/08/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

Pennine Camphill

Muston Road (70)

Grayling

The Cornerstone

John Street Nursing Home

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

CARE HOME ADULTS 18-65 Saltshouse Road 199a 201a 203a Saltshouse Road Hull HU8 9HG Lead Inspector Tina Bettison Unannounced 7 July 2005 9:30 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. Saltshouse Road J54 Saltshouse Road 911 V235954 7 July 2005 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Saltshouse Road Address 199a 201a 203a Saltshouse Road, Hull, HU8 9HG 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) 01482 618096 01482 329337 Avocet Trust Carol Osbourne CRH 8 Category(ies) of LD 8 registration, with number of places Saltshouse Road J54 Saltshouse Road 911 V235954 7 July 2005 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25/1/05 Brief Description of the Service: The service at 199a-203a Saltshouse Road is managed by Avocet Trust who rent the premises from Sanctuary Housing. It is one of a small number of similar services that Avocet provides. Avocet Trust is a registered charity. 199a-203a Saltshouse Road consists of three separate units registered to provide care for 8 service users with a learning disability. The property is set back from the main road in the corner of a new residential estate, built in the old grounds of Tilworth Grange Hospital. 199a has three bedrooms one upstairs; all other accommodation is at ground floor level. 201a has two bedrooms and 203a has three. All bedrooms are singles four of which have ensuite facilities. Each unit has it’s own lounge, dining room, laundry room and shared bathroom. All units have their own front door and separate garden areas to the rear. The properties adjoin each other and share a large communal patio / garden at the front. Nearby there is a range of local shops, pubs, and health services. Public transport to various parts of the city is easily accessible and in addition some of the service users have leased their own cars; arranged through their mobility benefits. Saltshouse Road J54 Saltshouse Road 911 V235954 7 July 2005 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 6 hours and was an unannounced inspection. A tour of the premises took place, staff files, care records, rotas, policies and procedures, quality assurance files, staff lists and training records were all examined. 2 of the staff, the service manager and the service users that were at home were spoken to. Care practices and interactions were observed during the inspection. What the service does well: All service users are provided with a single room that is nicely personalised to their own taste, in a house for no more than 4 people thereby providing them with a home and private areas to their liking where they can spend private time or receive visitors. The houses are well decorated and well maintained and the gardens very well looked after and maintained. There was an abundance of greenery and flowers and seating areas enabling service users to enjoy the outside space. The staff team at Saltshouse Rd is a well established team with a number of them having transferred from Tilworth Grange hospital. There have been no new staff appointments since the previous inspection, thereby leading to stability and consistency in the provision of care and support to meet service users needs. All Service users at Saltshouse Rd have complex care needs, they all had a detailed Individual plan and supporting management plans that clearly outlined their needs, wants and aspirations thereby ensuring that their needs are met. These were regularly reviewed and updated as necessary. Service users were enabled to access a variety of health care provision thereby ensuring that their health needs are met. Service users had detailed activity programmes and spent a lot of time accessing community facilities; these were well organised, creative and provided stimulation and interest for the service users. Relatives are involved in the home and are made to feel welcome, thereby maintaining family contacts. Relatives spoken to stated that the home is perfect, the staff very committed and that they are always made to feel welcome and offered a cup of tea when they visit. The houses are immaculate, Saltshouse Road J54 Saltshouse Road 911 V235954 7 July 2005 stage 4.doc Version 1.40 Page 6 kept very clean and tidy and plenty of good food provided. They said that Staff always contact health professionals when this is required. 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. Saltshouse Road J54 Saltshouse Road 911 V235954 7 July 2005 stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Saltshouse Road J54 Saltshouse Road 911 V235954 7 July 2005 stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 5 All service users are provided with a statement of terms and conditions, however not all had been agreed with service users and / or their representatives. Therefore there is no assurance that there is an understanding of what service users could expect from the home. EVIDENCE: There had been no new service users (who would have had their needs assessed) come to stay at Salltshouse Rd since the previous inspection; therefore the majority of these standards were not assessed. A contract / statement of terms and conditions that meets the requirements of this standard had been developed however not all had been agreed with service users and / or their representatives, therefore this remains an outstanding requirement. Saltshouse Road J54 Saltshouse Road 911 V235954 7 July 2005 stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9,10 Service users have detailed individual plans/IPP that ensure their specific needs and goals are met and enables them make decisions as much as they can. EVIDENCE: Samples of Individual plans were examined as part of the inspection process and had been developed to cover all aspects of assessed needs. Staff were able to confirm that the plans were kept under review and that they were formally reviewed every 6 months. Copies of the notes from reviews were seen to support this. Risk assessments were in place for any areas that posed a risk to service users and measures put in place to minimise the risks, e.g. personal safety, access to the kitchen and leisure activities. All service users had a key worker. All service users were enabled to be as independent as possible within their capabilities this was confirmed by taking to staff and families. Saltshouse Road J54 Saltshouse Road 911 V235954 7 July 2005 stage 4.doc Version 1.40 Page 10 Information was observed to be securely kept and handled in accordance with the Data Protection Act. Lockable facilities were used. Staff were observed to knock on doors and to ask service users permissions to enter their bedrooms Saltshouse Road J54 Saltshouse Road 911 V235954 7 July 2005 stage 4.doc Version 1.40 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 standard(s) 11,12,13,14,15,16 Service users are enabled to be part of the local community by the provision of an ordinary housing located in a residential area and access to a wide range of community activities. Staff focus on the individual person and ensure that they are listened to and have a say in their daily lives by the use of their individual plan/IPP that details the way in which they like to be supported and their likes and dislikes thereby promoting their rights and responsibilities. EVIDENCE: Service users social, emotional, communication and independence skills are developed and maintained by the use of detailed care plans and risk management guidelines and risk assessment. Saltshouse Road J54 Saltshouse Road 911 V235954 7 July 2005 stage 4.doc Version 1.40 Page 12 Specialist staff from the community team learning disability offers specialist intervention and support. Each service users had a detailed activity programme, this was kept under review and amended when service users were unwell or made a choice not to attend. Service users participated in a range of leisure activities in the community and in the house e.g. baking and cooking, arts and crafts, pampering, household chores, gardening, looking at photos/reminiscence, computers, swimming, food and personal shopping and attendance at day services, gateway club, community centre, pub, and the community farm. Contact with families is encouraged and maintained. Families are welcomed to visit and all families spoken to say that staff kept them well informed of progress, problems and/or illness. On the whole service users had unrestricted access to the houses and gardens, where access was restricted due to safety reasons this was documented in the service users care file/ management plan. Saltshouse Road J54 Saltshouse Road 911 V235954 7 July 2005 stage 4.doc Version 1.40 Page 13 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 The service users physical and emotional needs are met, by the provision of a wide range of healthcare professionals and outside agencies, however the inadequate medication training provided to staff compromises this. EVIDENCE: Two service users care files were examined as part of the inspection process. There was evidence that contact with GP, dentist, optician, audiologist, chiropody, community nurses and therapists and consultants was being facilitated on a routine basis for service users. The home has policies and procedures for the administration of medication however staff have not yet received training for the administration of medication that includes a competency check or a workbook to complete at the end to ensure staff understand their responsibilities. This remains an outstanding requirement from the previous inspection. From observations and discussion with relatives it is apparent that staff promoted service users dignity, privacy and respect. Staff were observed to behave in an appropriate manner towards service users. Saltshouse Road J54 Saltshouse Road 911 V235954 7 July 2005 stage 4.doc Version 1.40 Page 14 Times for going to bed and getting up were flexible. Individual likes and dislikes were recorded on the individual plan and the communication passport. Saltshouse Road J54 Saltshouse Road 911 V235954 7 July 2005 stage 4.doc Version 1.40 Page 15 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 Service users and/or their representatives are listened to and their views acted on by a wide range of methods. Avocet has a complaints procedure. The staff team are not fully aware of the Protection of Vulnerable Adults policies and procedures and their responsibility within these therefore strategies are not in place to ensure that service users are protected from abuse, neglect and harm EVIDENCE: Avocet had a complaints policy/procedure that included timescales. Minor issues were dealt with in the houses. There are regular parents meetings were issues can be raised and serious issues were taken up by the QA coordinator who responds to these areas of concern and/or complaint. There had been no complaints regarding the service at Saltshouse Rd since the previous inspection. From discussion with staff it was apparent that they were not fully informed about the Protection Of Vulnerable Adults Policies and Procedures and their responsibilities within this. There was no evidence to support that all staff had received any training or briefings. Saltshouse Road J54 Saltshouse Road 911 V235954 7 July 2005 stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28,29,30 The houses were well decorated and well maintained and the gardens very well looked after. There was an abundance of greenery and flowers and seating areas enabling service users to enjoy the outside space. EVIDENCE: 199a-203a Saltshouse Road consists of three separate units registered to provide care for 8 service users with a learning disability. The property is set back from the main road in the corner of a new residential estate, built in the old grounds of Tilworth Grange Hospital. 199a has three bedrooms one upstairs; all other accommodation is at ground floor level. 201a has two bedrooms and 203a has three. All bedrooms are singles four of which have ensuite facilities. Each unit has it’s own lounge, dining room, laundry room and shared bathroom. All units have their own front door and separate garden areas to the rear. The properties adjoin each other and share a large communal patio / Saltshouse Road J54 Saltshouse Road 911 V235954 7 July 2005 stage 4.doc Version 1.40 Page 17 garden at the front. Nearby there is a range of local shops, pubs, and health services. Public transport to various parts of the city is easily accessible and in addition some of the service users have leased their own cars; arranged through their mobility benefits. Saltshouse Road J54 Saltshouse Road 911 V235954 7 July 2005 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) 31,32,33,34,35,36 The staff team at Saltshouse Rd is a well established team with a number of them having transferred from Tilworth Grange hospital. There have been no new staff appointments since the previous inspection, thereby leading to stability and consistency in the provision of care and support to meet service users needs. Service Users are cared for by a satisfactory number of staff, however inadequate provision of mandatory, service specific training and low morale is compromising the quality of care provided. EVIDENCE: From examination of records, discussion with staff and observation it was evident that staff work to support the written aims and objectives of the home. It was also evident from discussion with staff that they knew how to meet the needs of service users and there was good evidence in case records of the involvement of other agencies with specific expertise. It was evident that the manager and staff had well-developed relationships with service users. Saltshouse Road J54 Saltshouse Road 911 V235954 7 July 2005 stage 4.doc Version 1.40 Page 19 Each house has different staffing levels; 199a has a minimum of 2 staff during the day and 1 waking night staff, with additional staff brought in for activities. 201a has 1; 1 staffing for the two service users all day from 8.00 am to 10.00pm and 1 waking night staff. 203a has a minimum of 2 staff during the day and 1 waking night staff with additional staff brought in for activities. Staff spoken to confirmed that this was adequate staffing to meet service users needs. Throughout the inspection it was evident that staff respected service users and were seen to be accessible, approachable, and comfortable with them. The Service manager had an up to date list of the staff working at Saltshouse Rd. The service manager confirmed that she did not yet have 50 of staff that have achieved NVQ level 2 therefore there is an outstanding requirement from the previous inspection. A sample of staff recruitment records were examined, there had been no new staff appointed since the previous inspection. All existing staff had an up to date CRB disclosure and written references obtained, however some staff files did not contain all the ID required by schedule 2. This did not support a thorough recruitment process and must be addressed. The manager reported that within Avocet Trust there is a Human Resources section responsible for organising training. From examination of records and discussion with the manager and staff there was some evidence of training and this was linked to the needs of service users, e.g. moving and handling, epilepsy, use of stesolid, basic food hygiene and first aid, however not all staff were up to date with their mandatory training and had not received appropriate medication training. Staff spoken to were not clear about their responsibilities with regard to the Protection of Vulnerable adults, therefore all staff must receive updated training. Saltshouse Road J54 Saltshouse Road 911 V235954 7 July 2005 stage 4.doc Version 1.40 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 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) 37,38,39,40,41,42,43 Service users are encouraged on an informal basis to contribute to how the home is run. A formal approach has been devised but not yet fully implemented. EVIDENCE: Saltshouse Road J54 Saltshouse Road 911 V235954 7 July 2005 stage 4.doc Version 1.40 Page 21 The Service Manager and staff presented themselves as helpful,friendly and approachable throughout the inspection, they had a clear sense of direction and aims for the home and the staff and registered manager provide ongoing stabilty and development of the home. Staff commented that they found the registered manager to be very nice, supportive, approachable and an excellent manager. They commented that if issues are raised she will do her best to resolve them and feedback the outcomes. The Service Manager reported that budgets are set by the provider and she has responsibility for managing a range of budgets e.g. staffing, food, petty cash,and training. There was suitable insurance cover in place. Avocet have developed a quality assurance system however this has not yet been fully implemented within the home, this means that service users and their families views are not yet utilised to help shape the way the service is provided in the future. As part of the inspection the maintenance records were examined and those seen were in order. It was evident throughout the inspection that the service is centred around the service users. The Service Manager supported staff to ensure this was the case. Policies and procedures were examined as part of the inspection process, although some have been updated the majority date back to 1995/98 with no evidence of update or review. The registered person must ensure that Avocet,s policies and procedures are reviewed and amended in line with changes in legislation and best practice guidance. Saltshouse Road J54 Saltshouse Road 911 V235954 7 July 2005 stage 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 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 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 x Standard No 31 32 33 34 35 36 Score 3 2 3 2 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Saltshouse Road Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 2 3 3 3 J54 Saltshouse Road 911 V235954 7 July 2005 stage 4.doc Version 1.40 Page 23 yes 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 5 Regulation 5 Requirement The Registered person must ensure that the homes written contract or statement of terms and condtions is agreed to and signed by the service user and /or their representaive and by Avocet Trust. (Target dates of 30/9/04 and 31st March 2005 not met) the registered person must ensure that all staff receive training in the safe handling of medication and are assessed as competent The registered person must ensure that all staff receive training in the protection of vulnerable adults The registered person must ensure that at least 50 of staff are qualified to NVQ level 2 The registered person must ensure that all staff files contain ID documentation as required by 2 The registered person must ensure that all staff are up to date with mandtory training and this must include infection control The registered person must Timescale for action 30/9/05 2. 20 13 30/9/05 3. 23 13(6) 30/9/05 4. 5. 32 34 18 7,9,19 schedule 2 18 1/12/05 30/9/05 6. 35 30/9/05 7. 35 18 30/9/05 Page 24 Saltshouse Road J54 Saltshouse Road 911 V235954 7 July 2005 stage 4.doc Version 1.40 8. 9. 35 40 18 24 10. 40 24 ensure that a training audit is undertaken and a training plan developed for the staff team in the home. The registered person must ensure that all staff have an individual training profile The registered person must ensure that Avocets policies and procedures are updated and amended in line with legislation and best practice guidance. The registered person must ensure that the policy and procedure for the use of restrictive physical interventons is reviewed and amended 30/9/05 31/1/06 1/12/05 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 37 Good Practice Recommendations The registered manager should complete the registered managers award by the 31st December 2005 Saltshouse Road J54 Saltshouse Road 911 V235954 7 July 2005 stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 Saltshouse Road J54 Saltshouse Road 911 V235954 7 July 2005 stage 4.doc Version 1.40 Page 26 - 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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