Inspection on 27/02/06 for SignHealth

This inspection was carried out on 27th February 2006.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

SignHealth 17/05/07

Similar services:

Mere Hall View

Beechfield Lodge

Christopher Grange (Rhona House)

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

CARE HOME ADULTS 18-65 Sign 1 Claridge Road Chorlton Manchester M21 9WQ Lead Inspector Helen Dempster Unannounced Inspection 27th February 2006 6:00 Sign DS0000065296.V284069.R01.S.doc Version 5.1 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 Sign DS0000065296.V284069.R01.S.doc Version 5.1 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. Sign DS0000065296.V284069.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Sign Address 1 Claridge Road Chorlton Manchester M21 9WQ 01494 687600 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) Sign The National Society for Mental Health & Deafness Mr Steve Felton Care Home 6 Category(ies) of Sensory impairment (6) registration, with number of places Sign DS0000065296.V284069.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users may have associated mental ill health. The service must employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 21/12/05 Date of last inspection Brief Description of the Service: Sign, Claridge Road, is registered as a care provision to provide accommodation within self-contained flats for up to six service users under the age of 65, within the category of sensory impairment. Service users may also have associated mental ill health. The personal care and life skills are provided by the charity Sign, that specialises in providing support to people who are deaf. The home employs staff that are trained in communicating, using British Sign Language The accommodation comprises of six, single, self-contained flats with en-suite bathroom and cooking facilities. The design and lay out of the building enables those service users living there to lead independent lives. The grounds are spacious and there is a car parking facility to the side of the building. The home is situated in a residential area of Chorlton, Manchester, and is close to local shops and the leisure centre. The home is also close to public transport routes and there is easy access to local motorways. Sign DS0000065296.V284069.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and was carried out on 27th February 2006 from 6pm to 9 pm. The inspector met the 2 members of staff on duty and 3 tenants. Time was spent discussing welfare matters relating to the tenants the home supported and examining documentation in relation to the running of the home, the management arrangements, staffing, care planning and the service users’ satisfaction. The term of address preferred by the users of the service was confirmed as “tenants”. It was felt this best reflected the function and purpose of the service. The inspection only looked at a limited number of standards, so this report should be read together with the earlier report to get a full picture of how the service is meeting the needs of the tenants living there. What the service does well: On admission, the care and support was planned and tenants were fully involved in their care plans and any review of their care plan. Very clear and detailed support plans gave staff information which helped them to consistently support tenants in the way they wished to be supported. The focus of the service was to enable tenants to live as independent a life as possible, so risk assessments included strategies and interventions to manage any risk issues. There was detailed and clear evidence of the involvement of other professionals in meeting tenants’ needs and staff were committed to making sure that tenants’ rights and wishes were respected and their independence was maintained. All tenants have their own flat with bathroom and cooking facilities. They hold their own key, can have visitors when they like and can come and go as they please. Each tenant had their own individual style of dress and appearance and staff were aware of cultural needs and diversity. Tenants benefited from the support of competent, well trained and supervised staff. Staff said that access to training is “fabulous” and that training is arranged to meet the needs of staff for whom the first language is not English and for those staff who are deaf. Sign DS0000065296.V284069.R01.S.doc Version 5.1 Page 6 Almost all of the 11 staff had NVQ Level 3 in care and sign language and it is the policy of the service to train all staff to this level. This exceeds the minimum standard. Recruitment practice was good and tenants are involved in the interview process. In all observed encounters with tenants, staff demonstrated respect for the tenants and had a warm and friendly approach. The staff said that they felt very well supported by the managers who were approachable and helpful. The service does have a quality assurance package, which includes obtaining the views of tenants. Fire safety practice, including adaptations and safety tests, was good. The health and safety requirements of the service were being met. 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. Sign DS0000065296.V284069.R01.S.doc Version 5.1 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 Sign DS0000065296.V284069.R01.S.doc Version 5.1 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 the following standard(s): N/A EVIDENCE: These standards were assessed at the previous inspection and will be assessed again at the next inspection. Sign DS0000065296.V284069.R01.S.doc Version 5.1 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 the following standard(s): 6 Tenants’ individual care plans clearly and comprehensively reflected their assessed needs, choices and preferences. This enabled staff to consistently support tenants in the way they wished to be supported. EVIDENCE: Three support plans were sampled and they were found to be detailed and informative. It was evident that on admission, the care and support was planned, and there was evidence to confirm that tenants were fully involved in their care plans and any review of their care plan. The focus of the service was to enable tenants to live as independent a life as possible. All support plans included a detailed risk assessment, which included enabling strategies and interventions to manage any risk issues. The support plan clearly detailed the reason for support and the aims of the plan, for example, what the tenant wanted and the manner in which the tenant wanted support to be provided by staff. Support plans demonstrated good practice as they were person centred and enabled staff to provide support in accordance with each individual tenant’s expressed preference. The use of an audit/reminder list of key aspects of each Sign DS0000065296.V284069.R01.S.doc Version 5.1 Page 10 tenant’s support plan aided this process. The audit list highlighted key issues for each tenant on each day which were cross referenced to numbered aspects of the support plan. This meant that staff, and new staff in particular, could access information with ease about how each tenant wished their support to be delivered at specific times of the day. This ensured that continuity of support and support which met each tenant’s expressed preference was consistently delivered by the staff team. This is commendable. A discussion took place concerning what action the service would take when a tenant’s needs changed. The staff demonstrated skill and understanding of meeting the needs of individuals and of acceptance of the need to take positive action to review an individual’s support to ensure that their needs were fully met, including a transfer to another provision if this proved necessary. There was detailed and clear evidence of the involvement of other professionals in meeting tenants’ needs and staff demonstrated commitment to ensuring that tenants’ rights and expressed wishes were to the fore in all aspects of decision making. Sign DS0000065296.V284069.R01.S.doc Version 5.1 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): 16 and 17 Tenants’ rights and choices were respected and promoted and they were supported to choose and prepare food with maximum independence. EVIDENCE: Staff were able to provide clear examples of how tenants’ rights and choices are respected and that they are supported to maximise independence. The fact that the focus of the service was to enable tenants to live as independent a life as possible was also evident from viewing support plans (See individual needs and choices for details). All tenants have their own flat with bathroom and cooking facilities. They hold their own key, can have visitors when they like and can come and go as they please. At the time of inspection, 3 tenants and members of staff on duty were met and spoken with. Two of these tenants were in their flats at this time and chose not to communicate with the inspector that evening, beyond the introduction, at that time as they were doing something else. This was an Sign DS0000065296.V284069.R01.S.doc Version 5.1 Page 12 example of tenants being confident to exercise choice in what they did and whom they saw. Tenants were supported by staff to budget, plan and prepare meals in their flat. It was evident from support plans that the level of support was tailored to each individual’s needs. Staff explained that tenants can choose to have meals together, examples included planning to eat pancakes together on Pancake Tuesday and eating out together. For some tenants, nutritional needs were documented and the input of a dietician was in place. However, through discussion, it was strongly recommended that all tenants have a baseline nutritional assessment which details their needs and preferences regarding nutrition. Sign DS0000065296.V284069.R01.S.doc Version 5.1 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 the following standard(s): 18 and 20 Tenants’ support, including support to take prescribed medication, was delivered in the way they preferred and promoted independence. EVIDENCE: The service does not deliver personal care, it delivers support to enable tenants to live as independently as possible. Therefore, tenants would not be assisted to bathe, but staff may support and prompt them to maintain hygiene. The staff explained that this support consists of one to one discussions with individual tenants to establish what they want and need in the way of support. From meeting tenants, it was evident that they each had their own individual style of dress and appearance. The service has an equal opportunities policy and staff demonstrated good awareness of cultural needs and diversity. The service was a multi –cultural environment, which supported people with a range of cultural needs. Staff explained that tenants were encouraged to respect other cultures. One example was encouraging them to watch the Chinese New Year celebrations. The staff group included males and females and both deaf and hearing staff. A keyworker system was in use and staff reported good access to the support and advice of health care professionals to meet tenants’ needs. The Sign DS0000065296.V284069.R01.S.doc Version 5.1 Page 14 organisation has a website which assists healthcare professionals, including GP’s, Opticians etc, to communicate with tenants and staff. This is good practice. The service has detailed booklets which describe the manner in which the charity, Sign can promote deaf awareness and independent lives. This includes a leaflet specifically about an advocacy service available to the tenants. Tenants are supported to take prescribed medication independently by staff prompting, and in some cases, checking with the tenant that they have remembered to take it. The level of support needed for each individual was documented in the support plan. A requirement was made at the previous inspection to the effect that the service must arrange for the supplying pharmacist to include a description of multiples of medication dispensed in the dosette boxes of medication. This had been addressed and the descriptions of medication were included in each individual’s medication records and included colour drawings of the tablets. This is a good, user-friendly method of identifying medication. Sign DS0000065296.V284069.R01.S.doc Version 5.1 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 the following standard(s): 23 Systems were in place that safeguarded tenants from abuse. EVIDENCE: At the previous inspection, a requirement was made to the effect that the service must audit the policy on adult protection to ensure it is in line with the Manchester Social Services Policy. This had been addressed. Staff had received training in the protection of adults from abuse and demonstrated good awareness of this issue. Staff explained that the training had been arranged to meet the needs of staff for whom the first language was not English and for those staff who are deaf. Sign DS0000065296.V284069.R01.S.doc Version 5.1 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 the following standard(s): N/A EVIDENCE: These standards were assessed at the previous inspection and will be assessed again at the next inspection. Sign DS0000065296.V284069.R01.S.doc Version 5.1 Page 17 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): 32, 34 and 35 Tenants benefited from the support of competent, well trained and supervised staff. EVIDENCE: Staff training records were sampled and were found to be comprehensive. One member of staff stated that access to training was “fabulous”. Staff confirmed that they received training specific to their work and that training records were audited on an annual basis. Staff confirmed that they can self identify a training need and would be confident that this would be met. Almost all of the 11 staff had NVQ Level 3 in care and sign language and it is the policy of the service to train all staff to this level. This exceeds the minimum standard. The organisation has a recruitment policy. It was not possible to view recruitment files, as these were accessed by the manager only. Recruitment practice was therefore assessed through asking a member of staff about how they were recruited. The staff member explained that an application form was completed, 2 references were taken and an appropriate CRB check was done. The staff member indicated that tenants are involved in the interview process. One example was a tenant asking a prospective member of staff about their understanding of confidentiality. This is good practice. Sign DS0000065296.V284069.R01.S.doc Version 5.1 Page 18 Staff explained that they have a structured induction process, which lasts as long as the individual needs. The stated average was 2-3 months and induction takes place within the first 6 months of service. Staff have at least 5 days training per year and training was seen to be linked to the needs of the tenants. Staff also said that they had regular supervision, both formal and informal and that they were well supported by management. In all observed encounters with tenants, staff demonstrated respect for the tenants and had a warm and friendly approach. Sign DS0000065296.V284069.R01.S.doc Version 5.1 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 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 and 42. Tenants benefited from a well run service, which listens to and acts on their views and has robust health and safety procedures in place. EVIDENCE: At the time of inspection, an acting manager was in place due to the registered manager undertaking a course of study. Neither manager was on duty at the time of inspection, so this standard was assessed through asking the staff about management support, considering how the home was run and talking to the acting manager by telephone on the day after the inspection. Both the managers hold NVQ Level 4 and have appropriate management experience. Evidence of the acting manager’s extensive training record was provided following the inspection. The staff said that they felt very well supported by the managers who were approachable and helpful. The service has a clear and detailed quality assurance and monitoring procedure, which includes obtaining the views of tenants verbally and through a questionnaire. The procedure also includes internal and external monitoring Sign DS0000065296.V284069.R01.S.doc Version 5.1 Page 20 of the service, a care audit system and questionnaires to obtain the views of visitors and other interested parties. Fire safety records were viewed and good practice was evident, including safety tests being completed at the required intervals and clear, detailed records being held. The service had appropriate adaptations to safeguard deaf tenants, including flashing lights and vibrating fire warning systems. There was also clear evidence of the involvement of tenants and each tenant’s needs concerning fire safety were included in their support plan. This is commendable. Following the inspection, the manager forwarded information which demonstrated that other health and safety requirements of the service were being met. Sign DS0000065296.V284069.R01.S.doc Version 5.1 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 Standard No Score 1 X 2 X 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 X 23 3 ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X X X LIFESTYLE Standard No Score 11 X 12 X 13 X 14 X 15 X 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 X 3 X 3 X 3 X X 3 X Sign DS0000065296.V284069.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 YA17 Good Practice Recommendations It is strongly recommended that all tenants have a baseline nutritional assessment, which details their needs and preferences regarding nutrition. 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