Inspection on 02/02/06 for St Alban`s Cottage

This inspection was carried out on 2nd 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

St Alban`s Cottage 23/08/07

St Alban`s Cottage 06/09/06

St Alban`s Cottage 10/05/05

St Alban`s Cottage 29/09/04

St Alban`s Cottage 04/05/04

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 St Alban`s Cottage 2a St Alban`s Close Harehills Leeds West Yorkshire LS9 6LE Lead Inspector Stevie Allerton Announced Inspection 2nd February 2006 09:30 St Alban`s Cottage DS0000001496.V281552.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 St Alban`s Cottage DS0000001496.V281552.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. St Alban`s Cottage DS0000001496.V281552.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service St Alban`s Cottage Address 2a St Alban`s Close Harehills Leeds West Yorkshire LS9 6LE 0113 240 1837 0113 2401837 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) None United Response Miss Sally Casterton Care Home 4 Category(ies) of Learning disability (4), Physical disability (4) registration, with number of places St Alban`s Cottage DS0000001496.V281552.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: St. Albans Cottage is a four-bedroomed bungalow, purpose built to accommodate service users with multiple disabilities, who do not require nursing care. The bungalow is situated at the head of a cul de sac in a quiet residential area just off the York Road in East Leeds, with nothing to distinguish it from the outside as a care home. The area is a short distance from local shopping centres, sports and leisure facilities, with good access via public transport from Leeds. The home accommodates four young adults with learning disabilities and some physical disabilities, all of whom are wheelchair users. The property is managed by a housing association but the care service is provided by United Response, a national charity specialising in the field of learning disabilities. There is currently a new Manager in post, who has yet to apply for registration, and there is close line management supervision from the area office in York. St Alban`s Cottage DS0000001496.V281552.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was arranged in advance with the new Manager and was conducted by one inspector over the course of one day. It was the second of two inspections scheduled to take place during the year commencing 1st April 2005, the previous being an unannounced visit in May 2005. Comment cards were sent out to the home in advance of the inspection, to distribute to relatives, health care professionals and others who have contact with the service. Three were returned, two from relatives and one from a Community Occupational Therapist. The previous Manager has left to manage the domiciliary care package for one of the previous service users, who has recently moved out into his own tenancy nearby. The inspector saw two of the service users as they returned home from their daytime activities, and also spoke to the Manager and other support staff. Some records were looked at, as well as the building. What the service does well: What has improved since the last inspection? There is a stronger sense of direction and leadership with the new Manager, who has been able to move some things forward for the benefit of service users, including one person finally moving out to his own house. Long-standing problems with repairs to the building have now been resolved. A new bath has been installed and the previously unusable shower room has St Alban`s Cottage DS0000001496.V281552.R01.S.doc Version 5.1 Page 6 had the floor and wet area re-done. New flooring throughout the home has made it easier for wheelchair users to self-propel. Support plans are easier to use and appear to be being used more consistently. 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. St Alban`s Cottage DS0000001496.V281552.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 St Alban`s Cottage DS0000001496.V281552.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): 2&4 EVIDENCE: The home has a vacancy for the first time since it was registered. The documents were seen for a prospective service user, currently undergoing assessment for suitability to be placed in the service. The Manager said that the Social Services standard “Easycare” document had not provided enough information, so she was going out to meet the service user at the respite unit that currently provides some support. This would enable her to speak with the respite unit Manager to gain more accurate detailed information about the person’s care needs. There were also plans to meet with other professionals currently involved in providing care for this person, so that a profile could begin to be drawn up. If the team feel that the person’s needs can be met by the service, they will be invited to visit and meet the other service users. There could be a number of visits or overnight stays, depending on the individual, before they move in. A Life Plan tool is used to draw up the person centred profile, outlining the person’s assessed needs and matching them with appropriate support plans. St Alban`s Cottage DS0000001496.V281552.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): None of this group of standards was looked at on this visit. EVIDENCE: St Alban`s Cottage DS0000001496.V281552.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of this group of standards was looked at on this visit. EVIDENCE: St Alban`s Cottage DS0000001496.V281552.R01.S.doc Version 5.1 Page 11 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 & 19 This service is person-centred and staff provide support in each individual’s preferred way. Every area of care and support is written down in great detail, which promotes consistency, even when the staff team changes. Staff are conscious of the need to protect individuals’ privacy and dignity when providing personal care. EVIDENCE: New Support Plans have been put in place for all three of the service users, condensing the written information kept on each person into one file. Support plans are very detailed and written in the first person, the Manager believing that the way that they are structured helps staff to challenge each other’s practice. New health check documents are being introduced, to be in place by the end of June, when everyone will have a Health Action Plan. The home’s computer has been moved out of the office into the lounge. By using the “Change Picture Bank” computer programme, service users have been able to become more involved in their own reviews of care, by using the computer. Reviews had not been happening frequently enough, but 3 monthly review dates are now built in to the Support Plans. St Alban`s Cottage DS0000001496.V281552.R01.S.doc Version 5.1 Page 12 There was evidence in the Support Plans and progress notes that appropriate help is sought from health care professionals, where changes in health are identified. One example is of a service user who has had some episodes of choking on food and becoming afraid to eat, hence losing weight. Advice has been obtained about nutrition and swallowing, with the result that the service user now has meals produced in a blended or soft form, is eating better and now gaining weight. Another service user now has two days a week at home, as attending the Day Centre five days a week was becoming too tiring and affecting her health. The home has established good contacts with the Leeds Social Services Occupational Therapist Department and the central equipment store, so that specialist beds, etc., can be obtained where needed. The Manager feels that service users’ dignity is currently being compromised by having to use the mobile hoist for bathing, toilet, etc.; this requires two staff in attendance, so privacy becomes an issue. She feels that ceiling tracking would be much better, as only one staff member is needed to operate it. A service user’s family has raised concerns about the gender mix of staff providing personal care, which the Manager is consciously addressing, trying to ensure that the staff rota is balanced with at least one female worker on duty at any time. St Alban`s Cottage DS0000001496.V281552.R01.S.doc Version 5.1 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 The organisation has an accessible complaints procedure and the Manager has an open approach to concerns being raised. However, the provider must ensure that the constant changes in Manager do not leave relatives feeling uncertain that their views and concerns will be listened to. There are appropriate procedures and working practices in place to protect service users from abuse or poor practice. EVIDENCE: The organisation’s complaints procedure is on display and service users have access to a version supported by visual symbols and pictures. There has been a recent complaint made by a relative, which has been dealt with by the provider. The Manager met with the relative to discuss his concerns and agree how to resolve them. Some concerns were raised on a comment card regarding poor communication between staff and relatives, which the Manager was already aware of and is trying to address. Relatives have expressed concern that the constant turnover of Managers and other staff has made it more difficult to raise any concerns they have, as they have to get to know and build up trust in new workers. One of the service users has just been appointed a Citizen’s Advocate and the staff are now trying to get advocates for the rest of the service users. Staff all receive Adult Protection training within the foundation training provided by their employer. One of the Senior Support Workers was booked St Alban`s Cottage DS0000001496.V281552.R01.S.doc Version 5.1 Page 14 onto an Adult Protection course the day after the inspection, run by an external organisation, which she would be cascading to the rest of the staff at a team meeting. The organisation’s Code of Conduct for staff was on display; this makes clear the responsibility that each individual worker has to protect service users from abuse or poor practice. None of the service users are able to look after their own finances. An inspection of individual financial records showed the system to be transparent and accountable. St Alban`s Cottage DS0000001496.V281552.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 27 Recent works have improved the environment for service users. The addition of ceiling tracking in part of the building has improved how service users receive support, and the new flooring enables wheelchair users to propel themselves more easily. The staff are making subtle changes to the housekeeping systems in the home, to try to promote a “shared house” rather than “residential” culture for the people they support. EVIDENCE: The long-standing problem with the shower facility has been resolved, with a whole new wet floor area installed. Ceiling tracking has also been installed in one of the bathrooms, which the staff say has made a great difference to how service users are moved. They are in the process of getting quotes for installing this throughout the home, as service users are currently limited as to how much furniture and equipment they can have in their own rooms, to allow space for the mobile hoist. Wood flooring has been installed throughout the home since the last inspection. Service users were able to choose their own colour and style. This is enabling wheelchair users to have more independence, as their wheelchairs St Alban`s Cottage DS0000001496.V281552.R01.S.doc Version 5.1 Page 16 can be self-propelled much more easily than on carpet. The staff are planning for redecoration now. Changes have been made to how laundry is done, moving away from the “residential” culture to a situation found in many ordinary shared houses. Name tags have been dropped in favour of discreet coloured stitches, a different colour for each service user. Individual loads are washed as far as possible, rather than everything going in the washing machine together. St Alban`s Cottage DS0000001496.V281552.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 & 36 The new Manager is experienced in managing and developing teams of staff and is able to translate the organisation’s values into practice, with the result that service users are supported by a well-trained and supervised group of staff. EVIDENCE: Some key members of staff have left recently, some to support a former service user who now has an individual support package in his own tenancy. The home Manager also supervises and supports the Senior in charge of the day-to-day support for this person. The Manager is supported by two Senior Support Workers and there is a vacant post for a third. One of the Senior Support Workers on duty described her role. She had been Senior for one year and had been able to take part in some good training and development opportunities, including some management training. She said she felt valued as a worker within the organisation. Staff and service users attended a recruitment fair recently, from which they received a good response and were able to fill some vacant posts. Service users were actively involved in the recruitment process, helping to post out letters and application forms and sitting in on interviews. Recruitment St Alban`s Cottage DS0000001496.V281552.R01.S.doc Version 5.1 Page 18 processes follow best practice guidelines, with references and background checks taken up prior to employment commencing. A new induction training pack has been introduced for the new staff, who now go through a process of continuous assessment of competencies over the first six months. Supervision is taking place monthly, the Manager feeling that this is a very important part of staff support and the key to keeping them motivated in their work. Team meetings are being held monthly and all staff are taking turns at chairing the meetings, the Manager feeling that this is good experience for them when they attend review meetings as a key worker. St Alban`s Cottage DS0000001496.V281552.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): 42 & 43 Health and Safety is treated seriously within the organisation and within the home, which protects service users. The procedure for supervision and support of the home’s Manager ensures that the home runs smoothly and for the service users’ benefit. EVIDENCE: Health and Safety audits are carried out by Line Managers and training issues or omissions in recording are noted and actioned. There is an extensive Health and Safety file within the home, which outlines those checks that need to be carried out and the frequencies they should be done. The records show where service users have also been involved in routine checks, for example the vehicle check or the water temperature check. All staff have a basic one-day Health and Safety course within their six-month probationary period; those doing the LDAF Foundation training also cover St Alban`s Cottage DS0000001496.V281552.R01.S.doc Version 5.1 Page 20 Health and Safety matters. It is also a regular agenda item for the staff team meetings and in supervision. The home has an extensive collection of risk assessments; these have recently been reviewed by the organisation’s Health and Safety Manager, who found that the home had far too many and has recommended they be condensed. The home Manager is supervised by a Line Manager and the organisation’s regional office in York. Regular monitoring and internal audits take place. St Alban`s Cottage DS0000001496.V281552.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 3 3 X 4 3 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 3 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X X X X X X 3 3 St Alban`s Cottage DS0000001496.V281552.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 YA18 Good Practice Recommendations The provider must look at developing more consistency and stability in the long-term management of the service, so that service users and their relatives do not have to constantly get used to new Managers. The provision of ceiling tracking throughout the home would improve the environment for service users. 2 YA29 St Alban`s Cottage DS0000001496.V281552.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 St Alban`s Cottage DS0000001496.V281552.R01.S.doc Version 5.1 Page 24 - 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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