Inspection on 21/11/06 for St Judes Residential Home

This inspection was carried out on 21st November 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 Judes Residential Home 19/11/08

St Judes Residential Home 18/01/06

St Judes Residential Home 10/05/05

St Judes Residential Home 03/11/04

St Judes Residential Home 19/05/04

Similar services:

Ashlea Mews Residential Home

Eastwood

West Lodge

Arran House

Avenue Community Nursing Home

Cosin Lodge

Farmborough Court

Cragston Court

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

CARE HOME ADULTS 18-65 St Judes Residential Home 22 Breckon Hill Road Middlesbrough TS4 2DR Lead Inspector Derek Stow Key Unannounced Inspection 21st November 2006 10:30 St Judes Residential Home DS0000000135.V320718.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 St Judes Residential Home DS0000000135.V320718.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. St Judes Residential Home DS0000000135.V320718.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Judes Residential Home Address 22 Breckon Hill Road Middlesbrough TS4 2DR 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) 01642 868914 Miss Elaine Stephens Miss Elaine Stephens Care Home 8 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (8) of places St Judes Residential Home DS0000000135.V320718.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th January 2006 Brief Description of the Service: St. Judes is a large Victorian terraced house in a residential area on the outskirts of Middlesbrough, opposite to a primary school, close to shops and local amenities, within walking distance of the town and adjacent to bus routes. The home provides accommodation for eight people, in single rooms, all with en-suite facilities. Five with a shower, wash hand basin and w.c. and one of these rooms also has a bath. The other three rooms have a wash hand basin and w.c. Only. In addition, there is a bathroom containing bath, wash hand basin and w.c. There home is non-smoking and residents and staff have agreed to only smoke outside where there is a rear garden patio area. There is a large comfortable lounge, a breakfast/dining room and a kitchen, which is domestic in nature. There is a lawned garden to the front of the property. Cost of service at St Judes. On the date of this inspection the standard fee for care at St Judes was £339 per week. St Judes Residential Home DS0000000135.V320718.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced took place over five hours, with the inspector looking around the building, examining a number of records, speaking to three residents, the manager and the deputy. There were no visitors during the inspection. The residents who were not seen were either at a day services, at work and one resident was out shopping with an outreach staff member. This inspection looked at those standards, which the Commission for Social Care Inspection regard as Key minimum standards. This was a very positive inspection with only a few recommendations for improvement, which are detailed at the back of this report. What the service does well: What has improved since the last inspection? Since the last inspection St Judes has extending the building to accommodate eight residents in single rooms all with ensuite toilet and washbasin and five having a shower. All bedrooms have been decorated and supplied with new beds/mattresses and a modern, solid wood dining suite is in the dining room. St Judes Residential Home DS0000000135.V320718.R01.S.doc Version 5.2 Page 6 Quality assurance systems are continuing to improve with the assistance of a quality consultancy. 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. St Judes Residential Home DS0000000135.V320718.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 St Judes Residential Home DS0000000135.V320718.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): Standard. 2 and 5. Quality in this outcome area is good. Prospective users’ individual aspirations and needs are assessed. Residents receive a copy of their contract but these should be kept up to date each time there is a change. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There has been one new resident admitted to the home since the last inspection. There are extensive records showing that many introductory visits, meals and overnight stays took place over a period in excess of six months before actual admission took place. The manager said that this was important to ensure that not only could the service meet the assessed needs but also that staying at St Jude’s was the right decision for current as well as the new resident. The pre-admission process also involves the full multi-disciplinary care team and the resident the file examined had good evidence of care management and care programme assessment information. St Judes Residential Home DS0000000135.V320718.R01.S.doc Version 5.2 Page 9 One resident who was spoken with at length confirmed full involvement in the assessment and decision-making process and was very complimentary about the pre-admission period where he felt that staff had made the transition from hospital to St Judes a very positive experience that ensured he was confident in wanting to stay there. Copies of contracts were on file and the resident confirmed that they had their own copy. It is recommended that contracts be renewed whenever changes including fee levels take place. St Judes Residential Home DS0000000135.V320718.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): Standards 6, 7 and 9. Quality in this outcome area is good. Residents are fully involved in making decisions about their lives as part of the care planning and review process. This supports and promotes an independent lifestyle alongside appropriate risk assessment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Detailed care plans drawn up and reviewed as part of the Care programme Approach were examined. They showed that residents are fully involved in the assessment and planning process with the multi agency professionals and care staff involved with their care. Residents spoken with confirmed this and said that they attend reviews and are given a copy of the document. St Judes Residential Home DS0000000135.V320718.R01.S.doc Version 5.2 Page 11 In discussion with the manager it is recommended that care plans and review documents should always be signed by residents. Individual weekly programmes were also in evidence for each resident covering attendance at such things as work, training education, social and leisure various activities as well as clinic appointments where required. Relevant and detailed risk assessments are in place with some examples of issues considered being, absences, mood change, family contact, alcohol, and offending behaviours. One resident spoken with plans to stay at St Judes for a few years, building up his skills and work experience before moving to independent living. St Judes Residential Home DS0000000135.V320718.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): Standards 12, 13, 15, 16, and 17. Quality in this outcome area is good. Residents are encouraged and supported in taking part in a range of activities in the local community as well as maintaining relationships with friends and family. Residents legal and civil rights and responsibilities are promoted and they are treated with dignity and respect. They enjoy a healthy and varied diet, which takes account of their likes and dislikes. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All residents have an agreed weekly programme of activities ranging from attending day services at hospital or in the community as well as taking part in employment, work experience training and education. St Judes Residential Home DS0000000135.V320718.R01.S.doc Version 5.2 Page 13 One resident does work for the local wildlife trust, another on an industry project and another resident said he has recently finished a carpentry course, a computer course as well as the driving theory and is looking for work opportunities. Social and leisure activities are also programmed to each individual taste including visits to the gym, pub shopping etc. Residents each have a key to their own room, have a lockable cabinet and are responsible for their own washing and keeping their room clean. Residents are encouraged to vote and the have adopted postal voting. Comments about the food were very positive with one resident saying that staff take a great deal of care in ensuring that likes and dislikes are taken in to account and also ask if there are any special meals that they would like to see. Another resident said that they get their own breakfast and are looking forward to spending time in the kitchen learning more about preparing meals. St Judes Residential Home DS0000000135.V320718.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): Standards 18, 19 and 20. Quality in this outcome area is good. Service users receive personal support in a way that is identified, prefer and require. The healthcare needs of the service users are assessed and met and residents are protected by the home’s policies and procedures for dealing with medicines. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each resident has a care co-ordinator appointed by the multi-disciplinary team as well as a key worker to support them in their stay at St Judes. The care plans identify all physical, emotional and mental health needs and they are reviewed at stated times no less than six monthly. St Judes Residential Home DS0000000135.V320718.R01.S.doc Version 5.2 Page 15 Two staff give medication and all staff giving medication are trained in doing so. A check on medication and records was correct and each resident’s file also contains a record detailing their medication as well as symptoms and side effects that staff should look for. There were appropriate records for the ordering and disposal of medication. Each resident has a lockable cabinet in their room and one resident has been risks assessed to control and take their own evening medications. It is recommended that for all non-monitored dosage medicines there is a written start/opening date on bottles/packets to create a clear audit trail. St Judes Residential Home DS0000000135.V320718.R01.S.doc Version 5.2 Page 16 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): Standards 22 and 23. Quality in this outcome area is good. Residents are confident that their views and concerns are listened to and acted upon and that they protected from abuse, neglect or self harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A complaints procedure is in place with a copy given to residents as well as being available on the hall table. There were no complaints recorded or reported to The Commission For Social Care Inspection in the past year. The three residents spoken with said that St Judes was a good place to live and had no complaints. One resident said, “ I feel I can express any concerns and I am confident in staff”. All care staff have undertaken Adult protection Training. This was confirmed in the records seen and the deputy manager who was spoken with said that they were currently undertaking updated training. In discussion with the manager it was agreed that the policy and procedure should now be updated to make it clear to residents and relatives that the responsibility to receive, resolve and investigate complaints is with the management of the Home and those agencies such as Social Services and Primary Care who contract or commission services on behalf of individual residents. St Judes Residential Home DS0000000135.V320718.R01.S.doc Version 5.2 Page 17 The Commission for Social Care Inspection is primarily a regulator of services and not a complaints investigation body. However residents, relatives and members of the public can still report any concerns about the running of a particular service to the Commission who will consider the issues and whether the service is meeting the required standards and regulations. St Judes Residential Home DS0000000135.V320718.R01.S.doc Version 5.2 Page 18 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): Standards 24, 25 26,27 and 30. Quality in this outcome area is good. The residents who live at St Judes live in a homely, comfortable and safe environment, which is clean and hygienic. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is well decorated, comfortably furnished and well maintained. Sincethe last inspection the home has extended with an additional two bedrooms so that eight residents can now live at St Judes and a full redecoration programme has taken place. A new modern solid wood dining room suite was also in evidence. All of the bedrooms have ensuite toilet and wash basin and five also have a shower with one of these also having a bath. St Judes Residential Home DS0000000135.V320718.R01.S.doc Version 5.2 Page 19 Residents’ rooms were individually furnished and organised to their own taste and commonly included computers, televisions and sound systems. One resident said, “ it’s a lovely place, warm, inviting, comfortable and “chilled”. “It’s a home and not just a place to stay”. Residents are given a key to their own rooms and have a lockable cabinet for the safe keeping of monies or personal items. Everywhere was observed to be clean and hygienic. St Judes Residential Home DS0000000135.V320718.R01.S.doc Version 5.2 Page 20 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): Standards 32, 34, 35 and 36. Quality in this outcome area is good. Residents are supported and protected by an effective team of competent and qualified staff who are recruited safely, trained well and supervised. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff team at St Judes comprise of the manager, a deputy and six care staff. 100 of the team are qualified to NVQ 2 or above. This is excellent. The Manager holds the Registered Managers Award. The deputy is just completing NVQ 4 and five of the remaining six care staff hold NVQ 3 and one staff holds NVQ 2. Comprehensive training records are in place and the records examining showed that all staff have been trained in administrating medication, understanding mental health and adult protection training. The deputy said that all staff receive supervision to the recommended level of six times a year. St Judes Residential Home DS0000000135.V320718.R01.S.doc Version 5.2 Page 21 A stable staff team has been established at St Judes and the last member of the team was recruited in November 2005. Records show that appropriate identity checks, criminal records checks and two references had been taken up. St Judes Residential Home DS0000000135.V320718.R01.S.doc Version 5.2 Page 22 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): Standards 37, 39 and 42. Quality in this outcome area is good. The residents who live at St Judes benefit from a service, which is well managed and run with their interests, health, safety and welfare being promoted and safeguarded. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager at St Judes holds the Registered Managers Award, an Adult teaching certificate, Advanced Care Management award and is an NVQ assessor. The residents speak very highly of the Manager and staff team with one resident saying “ everybody has good respect for each other “. St Judes Residential Home DS0000000135.V320718.R01.S.doc Version 5.2 Page 23 Several quality assurance systems were seen to be in place focussing mainly on care planning; review; internal audits and an annual survey to residents, relatives as well as involved professionals. The Manager said that the quality assurance systems and policies and procedures were continuing to develop with the assistance of an external quality consultancy. A number of health and safety records were examined to confirm that up to date records were in place relating to, environmental health, as well as fire risk assessment, fire training and drills. The record showed that an evacuation drill took place on 10/11/06. St Judes Residential Home DS0000000135.V320718.R01.S.doc Version 5.2 Page 24 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 4 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 4 25 4 26 4 27 4 28 X 29 X 30 3 STAFFING Standard No Score 31 x 32 3 33 X 34 3 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 4 x 3 x x 3 x St Judes Residential Home DS0000000135.V320718.R01.S.doc Version 5.2 Page 25 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 2 3 4 Refer to Standard YA5 YA20 YA22 YA39 Good Practice Recommendations Contracts should be renewed each time there is a change in fees. It is recommended that for all non-monitored dosage medicines there is a written start/opening date on bottles/packets to create a clear audit trail. Update the Complaints policy/procedure. Continue to develop the quality assurance systems by developing an annual review, an annual plan and publishing the results of the quality surveys. St Judes Residential Home DS0000000135.V320718.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI St Judes Residential Home DS0000000135.V320718.R01.S.doc Version 5.2 Page 27 - 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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