CARE HOME ADULTS 18-65
Spring Mount 8 8 Spring Mount Harrogate North Yorkshire HG1 2HX Lead Inspector
Mrs Irene Ward Key Unannounced Inspection 17th January 2007 09:30 DS0000065577.V324798.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 DS0000065577.V324798.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. DS0000065577.V324798.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Spring Mount 8 Address 8 Spring Mount Harrogate North Yorkshire HG1 2HX 0161 872 1234 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) Henshaws Society for Blind People Miss Julie Edwards Care Home 6 Category(ies) of Learning disability (6), Sensory impairment (6) registration, with number of places DS0000065577.V324798.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 20th March 2006 Brief Description of the Service: 8, Spring Mount is operated by Henshaws Society for Blind People and is registered to provide personal care for 6 younger adults aged 65 years and under who have learning disabilities with an additional visual impairment. The house is well situated just off the Ripon Road and within walking distance of Harrogate town centre. It is a large three storey terraced house with a small garden to the front and rear paved area for parking one to two cars. All bedrooms are designed for single occupancy. The weekly fees on 17th January 2007 range from £643.77 to £729.68 and do not include costs for leisure activities, hairdressers, personal clothing and toiletries and chiropody. This information was supplied to the Commission For Social Care Inspection via the pre-inspection questionnaire received on the 21st December 2006. Service users/relatives and other interested parties are able to have access to inspection reports by requesting them from the home. DS0000065577.V324798.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This report follows an unannounced site visit carried out on the 17th January 2007. This visit was carried out by one Regulation Inspector and started at 09.30 hrs and finished at 12.15 hrs with 2 hours preparation time. A visit was carried out on the 16th January 2007, which was to look at staff files that are held centrally at the offices of Henshaws Community Housing. The inspection process included information provided by the home prior to inspection. Surveys were also sent to service users, relatives and friends and health and social care professionals. Fifteen surveys had been sent and seven surveys have been returned to the Commission for Social Care Inspection. All but one, were all very positive about the overall care provided by the home. The site visit comprised of a full inspection of the premises, which included some service users private accommodation. The care records of three service users were looked, which included service users assessments, care plans and medication records. Staff rotas and health and safety documentation were inspected. Time was spent observing activity in the home and interaction between service users and staff, talking and listening to service users. Time was also spent talking to members of staff. The focus of the inspection was a number of key standards, inspecting the case records of service users in detail to establish if they corresponded with service users experiences in the home. The two care staff on duty were available and assisted throughout the process. The registered manager was also available and present at the inspection later in the morning. There were no requirements outstanding from previous inspections. No requirements or recommendations were made at this inspection. The last unannounced inspection was carried out on the 20th March 2006. What the service does well:
The staff continues to provide a clean, warm and comfortable home for service user to live in. The home provides good care for service users and supports them to maintain their independence.
DS0000065577.V324798.R01.S.doc Version 5.2 Page 6 Members of staff were observed to provide appropriate care when supporting service users in maintaining their independence in daily tasks. One service user said, “The staff are great”. Comments from relatives/visitors and social care professionals were all positive. Relatives made comments such as “This is the best year. Our daughter has settled really well. The manager and her team work well, giving choices and interesting things to do. In fact my daughter refused to come home in the summer holidays – she was to busy. The team at 8 Spring Mount have achieved everything I have wanted for my daughter to be happy, enjoy her life and settled she has now found her home, many thanks to Henshaws”. Another relative said, “I do phone my daughter regularly and find the staff very friendly. I could visit my daughter. The staff are very good” another commented, “Every step is taken to ensure my son’s individual needs and requirements are met in every possible way”. One survey received from a care manager said, “Staff are very open and have alerted me to issues relating to my client e.g. relationship breakdown, client dissatisfaction with service. Staff have always been keen to resolve issues and open to guidance/views from impartial parties such as myself”. 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. DS0000065577.V324798.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 DS0000065577.V324798.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. Quality in this outcome area is good. Service users needs are properly assessed prior to admission. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff member on duty confirmed that a service user guide would be sent to all service users/relatives when making an enquiry about a vacancy. The home currently has one vacancy. However there has not been a new admission into the home since a vacancy became available and since the home opened over a year ago. However the staff member on duty was clear as to how the home would deal with someone moving into the home, and as to what is required to happen prior to someone moving into the home. Service users and their families would receive information about the home. Service users would be invited to visit the home with their families or care manager prior to any admissions taking place. A weekend visit or overnight stays would be arranged. The admission would be done slowly and gradually at the service users pace. Giving time for the service user and service users already living at the home to adjust.
DS0000065577.V324798.R01.S.doc Version 5.2 Page 9 The Statement of Purpose and the Service User Guide remain unchanged. Both these documents are available on audiotape, Braille and large print. Pre-admission assessments are in place and held on service users individual files. A care needs assessment from local authorities was also in place where necessary. Three service users files were looked at. All files held initial assessments, care plans and risk assessments. Each service user had an individual statement of terms and conditions or licence agreement, which had been agreed between the home and the service user. DS0000065577.V324798.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. The care provided to service users’ was good and encouraged service users’ to make their own decisions about how they lived their lives. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users’ looked well cared for and some made comments about the care they received. One service user said, “I like living here, the house is nice and it is close to the centre of town”, and another commented that the staff were “great”. Whilst staff were supporting service users during the morning it was clear that they understood individuals needs. They supported people sensitively and supported people to make choices. DS0000065577.V324798.R01.S.doc Version 5.2 Page 11 The care plans of three service users’ were looked at. These detailed how needs had been assessed and what actions were needed to meet the identified needs. Individual risk assessments, which were clear and well detailed, had been carried out to promote independence and safety and these were agreed with the service users. The care plans contained detailed information about service users, which helped staff to know about the service users’ preferences about how they wished to live their life. Through discussion with staff and the contents of the care plans it was clear that service users are able to make clear choices. Service users plans are written with service users, reviewed regularly and audited monthly by the homes manager. DS0000065577.V324798.R01.S.doc Version 5.2 Page 12 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 15, 16 and 17. Quality in this outcome area is excellent. Service users are supported to lead full and active lives. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users have the opportunity to attend specialist day centres, workshops and college placements and have days at home to participate in personal shopping, laundry and household tasks. Service users’ have opportunities to pursue other interests outside of the home. A number of them enjoy visits to the cinema, local pubs, restaurants, Phab club and the hydro gym. Service users enjoy listening and playing music. Two service users said that they were both in a band and that they played recently at a concert in Manchester. They both said that they regularly get “ We get gigs and play at pubs and wedding receptions and different venues”.
DS0000065577.V324798.R01.S.doc Version 5.2 Page 13 One service user was on their way out to Harrogate College and another service user was on their way out to visit the dentist and then go do their shopping at Asda. There are weekly programmes in service user plans about how service users spend their days and these arrangements are discussed with service users and their representatives and staff. Service users confirmed that regular house meetings are held to discuss information regarding the house. One service user discussed the Christmas break and said that everyone in the house had gone home to visit their families for Christmas, however everyone in the house had gone to the Lake District for two nights the weekend before Christmas, which they had all enjoyed. Two service users said that they had enjoyed the run up to Christmas as they attended “parties galore”. Menus provided detail of variety and choice. Service users’ planned their own menus in advance and shopping was purchased on a weekly basis. Extra foods were bought so that service users’ had options if they wanted to change their food choices. Service users’ were supported by the staff to prepare and cook their own meals where this was part of the care plan. Staff have completed the food hygiene training. DS0000065577.V324798.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. Service users’ personal and healthcare is provided appropriately and sensitively according to individual needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff aimed to promote the independence of the service users’ and to provide support in a sensitive manner. Service users’ preferences as to how they wished to be supported were recorded within individual care plans. Each service user had a GP and access to chiropody, dental and optical services and referrals were made to specialist services as appropriate. Daily record entries reflected the care that was being provided. The home has introduced a new system for medication. A monitored dosage system is now in place. There is a policy in place for the storage and administration of medication. The Medication Administration Records were up to date and well maintained. All medication checked was accurately maintained and all medication balanced. All medication was securely stored in a locked cabinet. All staff that administers medication has undertaken accredited training. The home does not hold any controlled drugs.
DS0000065577.V324798.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. Service users have access to an effective complaints procedure and are protected from harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users are provided with a complaints procedure, which is produced in different formats such as Braille, large print or tape. The complaints procedure is also summarised within the service user guide and service users knew whom they needed to speak to if they had a complaint and felt confident that any concerns would be addressed properly. One survey raised a concern about the way in which the service user was supervised when washing her clothing. This was brought to the attention of the homes manager who said she would deal directly with this issue. There is a comprehensive policy and procedure with regard to adult protection and staff have a good awareness of this. All staff receives training in adult protection issues during induction and further training organised by the organisation. DS0000065577.V324798.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. Quality in this outcome area is good. Service users live in a clean, comfortable and safe home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is a three storey Victorian terraced house and provides spacious accommodation for service users. This includes a large lounge a separate dinning room and kitchen on the ground floor. The home is clean and comfortable. It is decorated and furnished to a very good standard. The décor and furnishings reflect a “young persons” type of household. Two service users bedrooms were seen, both had been personalised and were typical of a young persons bedroom with posters and their possessions around them such as CD player, television and one-service users had an electric organ. Both rooms were both decorated and furnished to a good standard.
DS0000065577.V324798.R01.S.doc Version 5.2 Page 17 The home has sufficient bathrooms and toilets that were clean and well maintained. A good standard of cleanliness is maintained throughout the home. A range of maintenance checks is completed on a regular basis to make sure that the house is safe and secure. DS0000065577.V324798.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. Quality in this outcome area is good. Sufficient staffing levels, proper recruitment procedures and good staff training meant that service users’ needs were met and their interests were safeguarded. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staffing levels were sufficient for meeting the needs of the service users’. The duty roster showed that there were two members of staff on duty throughout the day when service users are at home. This does not include the manager’s hours. At peak times such as evenings and weekends staffing would be increased, as staff rotas are based around what service users are doing. This makes sure that service users social activities are not compromised. At night there is one member of staff on sleeping-in duties. The organisation operates an on-call service in case there is an emergency. The staff files of three members of the staff team were looked at including those of one recently appointed member of staff. These showed that all the
DS0000065577.V324798.R01.S.doc Version 5.2 Page 19 necessary pre-employment checks had been carried out prior to the new workers starting in post. Staff training records examined showed a good training programme. Staff have undertaken training in health and safety, fire safety, moving and handling, first aid, food health and hygiene, protection of vulnerable adults and equality and diversity. Two staff hold NVQ Level 3, one staff holds NVQ Level 2 and another is to commence NVQ Level 3. The registered manager holds NVQ Level 4 Registered Managers Award. Staff receive regular supervision and annual appraisals are carried out. Staff meetings are held fortnightly and minutes of meetings are recorded. Records of supervision were seen at the site visit to the home. DS0000065577.V324798.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. Quality in this outcome area is good. The residents benefit from a well managed home in which their needs and wishes are put first. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information provided from the pre-inspection questionnaire and the examination of selected health and safety documents show that regular checks to electricity and gas and fire safety equipment are regularly undertaken. The home has a good and effective management team in place. The ethos of the home is open and positive. Service users, relatives and social care professionals all commented highly about the home.
DS0000065577.V324798.R01.S.doc Version 5.2 Page 21 Staff records confirmed that staff supervision and annual appraisals is carried out. Records were held on the three staff files seen. Service users or house meetings are held regularly and minutes of these meetings are recorded. Quality Assurance systems are in place and the home is audited regularly by the organisation. The schemes manager carries out regular monthly visits to the home and a report is completed and a copy sent to the Commission for Social Care Inspection. DS0000065577.V324798.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 3 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 3 33 X 34 3 35 3 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 4 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X DS0000065577.V324798.R01.S.doc Version 5.2 Page 23 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. Refer to Standard Good Practice Recommendations DS0000065577.V324798.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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
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