Inspection on 24/02/06 for St Paul`s Hostel

This inspection was carried out on 24th 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

St Paul`s Hostel 31/01/08

St Paul`s Hostel 21/02/07

St Paul`s Hostel 01/07/05

St Paul`s Hostel 13/10/04

St Paul`s Hostel 21/04/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 St Paul`s Hostel 4 St Paul`s Road Middlesbrough TS1 5NQ Lead Inspector Joanna D White Unannounced Inspection 24th February 2006 12:10 St Paul`s Hostel DS0000033846.V278971.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 Paul`s Hostel DS0000033846.V278971.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 Paul`s Hostel DS0000033846.V278971.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service St Paul`s Hostel Address 4 St Paul`s Road Middlesbrough TS1 5NQ 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 241620 01642 241620 Middlesbrough Council Louise Naylor Care Home 21 Category(ies) of Learning disability (21) registration, with number of places St Paul`s Hostel DS0000033846.V278971.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named individual who is over the age category is allowed to reside in the home. 1st July 2005 Date of last inspection Brief Description of the Service: St Paul’s Hostel is situated at 4 St Paul’s Road in Middlesbrough and is a local authority care home for adults with a learning disability. The home is registered with the Commission for Social Care Inspection under The Care Standards Act 2000. St Paul’s hostel is a two-storey building providing care and accommodation for twenty-one adults. The home is divided into two distinct units for seven respite service users and fourteen assessment/long stay service users. The latter unit is further sub divided for the differing service user groups. All bedrooms are for single occupancy. Two bedrooms have en –suite facility with a toilet and wash hand basin and another two bedrooms have a bathroom and a separate toilet facility. The home also provides communal washing and bathing/showering facilities for all service users occupying the other bedrooms. Service users have access to the town centre and local amenities. Travelling further afield is by means of the home’s mini bus. Staff said service users are encouraged to continue with educational and leisure interests. Each service user has a weekly programme of activities; most attend day care, Monday to Friday, at various locations in Middlesbrough. The home has regular service user meetings where service users are able to give their views about the running of the home. St Paul`s Hostel DS0000033846.V278971.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was an unannounced inspection and took place on 24th February 2006 and commenced at 12:10 pm and concluded at 17:35 pm. Individual discussion took place with three residents. Two staff were interviewed and there was discussion with the deputy manager. There was both direct and indirect observation and a range of records was examined including residents’ and staff files, policies and procedures and maintenance records. The inspector felt warmly welcomed into the home by the deputy manager who conducted himself in a professional manner displaying a sound knowledge base. There was much discussion throughout the inspection, which was very constructive and the deputy manager positively received any areas identified for further development. What the service does well: What has improved since the last inspection? A large proportion of the remedial repairs and maintenance work identified in the previous inspection report had been carried out. St Paul`s Hostel DS0000033846.V278971.R01.S.doc Version 5.1 Page 6 The exterior of the property had been painted. 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 Paul`s Hostel DS0000033846.V278971.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 Paul`s Hostel DS0000033846.V278971.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): EVIDENCE: These standards were not inspected during this inspection. St Paul`s Hostel DS0000033846.V278971.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): 7 The service users are encouraged to make decisions about their lives within the context of their individual plan. Support is provided from the staff when necessary. EVIDENCE: It was evident from the examination of a random selection of three care plans and through conversation with the deputy manager, staff and the residents that Individual Personal Planning Books had been developed for each resident to create a detailed personal plan which reflected the residents involvement in the decision making process at an appropriate level. Internal Review meetings were held in the home after six weeks and every six months where residents were able to express their views about their life style within the home. In addition External reviews took place on a yearly basis and were chaired by a member of staff who was independent of the home. The Manual Procedures for staff of residential homes (adults)-“Reviews” was audited by the inspector. St Paul`s Hostel DS0000033846.V278971.R01.S.doc Version 5.1 Page 10 In addition residents meetings, took place every two months where the residents are encouraged to state there likes and dislikes in a pictorial version which they can easily understand. St Paul`s Hostel DS0000033846.V278971.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): 15 16 17 The staff encouraged and assisted the residents to maintain family and friendship links within the context of their individual plans. The resident’ rights are respected and responsibilities recognised in their daily lives. The residents receive a wholesome appealing balanced diet at times convenient to them. EVIDENCE: The deputy manager said the staff recognised the importance of the residents keeping in touch with their family and friendship links within the context of their individual plans both within and outside of the home. He said one resident went home for weekends and another resident went home every other weekend. Another resident went home for lunch each week. Other residents were encouraged to see their friends in their rooms. The inspector audited the Family and Friend’s involvement policy, Family involvement policy, and Visitors’ Policy. St Paul`s Hostel DS0000033846.V278971.R01.S.doc Version 5.1 Page 12 The deputy manager confirmed each resident had a key for their own room and individual lockable cabinets were available if requested by a resident. The deputy manager who spoke to the Inspector confirmed the residents open their own mail. The inspector audited the opening of mail procedure. During the Inspection staff were observed talking to and listening to the residents. The deputy manager confirmed the residents could choose to remain in their rooms or take part in the organised activities within the home eg. Cooking groups, art and craft, karaoke etc. One resident was encouraged as part of his care plan and to promote his independence to visit the town Centre on a regular basis. Kitchens were available for the residents to make their own hot drinks and snacks with staff supervision On the day of the inspection the residents had chicken curry and rice for tea and fresh fruit for desert. A resident who spoke to the Inspector said the tea had been “lovely” The deputy manager confirmed the meal times for residents were flexible and residents if they chose could eat their meals in their own rooms or whilst watching the end of a particular television programme. He also confirmed the dietary requirements of the residents were also met eg cultural, gluten free, low in cholesterol etc. St Paul`s Hostel DS0000033846.V278971.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 19 Staff meet the service users healthcare and personal needs in a sensitive and flexible manner in accordance with the wishes of the individual resident. The residents’ physical and emotional needs are met. EVIDENCE: Conversations with the deputy manager, staff and the residents and examination of the care plans indicated an awareness of the importance of providing personal care by reading care plans, consulting with the residents and their families, and supporting the residents to maintain as much control over their own lives as possible, in a sensitive and flexible manner, and in accordance with their ethnicity, religious or cultural background. Wheelchairs, bath aids, walk in shower etc were available in the home to ensure the residents had the technical aids and equipment they needed to maximise their independence. The times for getting up /going to bed, baths, and meal times and other activities were flexible subject to any restrictions agreed in the individual residents plan. St Paul`s Hostel DS0000033846.V278971.R01.S.doc Version 5.1 Page 14 The residents were supported to choose and buy their own clothes. One resident who spoke to the inspector said she liked to go to the hairdressers and had had her haircut and styled recently and her nails manicured. She said she also liked to wear make up. The Care Plans, audited by the Inspector, confirmed the residents received support from the Primary care team, dentist, optician, and the Social Worker. A physiotherapist was present with one of the residents in the home when the inspector arrived. Staff added they knew each resident very well and accompanied the residents to medical appointments. The deputy manager confirmed the male residents were being taken for check ups to the “Well Men Clinic.” St Paul`s Hostel DS0000033846.V278971.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 Written procedures are in place, which promote the welfare of the residents. EVIDENCE: The Adult Protection and Prevention of Abuse Policies and Procedures were audited and contained information about the No Secrets Protecting Vulnerable Adults Tees wide Inter agency Policy Procedures and Practice Guidance. The homes whistle blowing policy, and harassment, discrimination, and bullying policy were audited. There was evidence in the training files that the staff had received training in abuse and the protection of vulnerable adults. The staff that spoke to the Inspector confirmed they had received training and were aware of what action to take should they become aware of any form of abuse towards the Residents. St Paul`s Hostel DS0000033846.V278971.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): 24 30 The residents’ predominately live in a homely, comfortable and safe environment although there were areas of the home, which required maintenance. The home was clean and hygienic EVIDENCE: St Paul’s on the day of the inspection was observed to be predominately comfortable and homely although there were areas of the home, which required maintenance Unfortunately the broken cupboard door in the main kitchen, which had been highlighted in the previous inspection report, had not been repaired. During this inspection the inspector observed in the main kitchen the cupboard door was still missing exposing the contents of mugs and glasses to any splashes from floor cleaning. An immediate requirement was issued requiring the registered provider to make safe the cupboard thus avoiding unnecessary risks to the health and safety of the residents. St Paul`s Hostel DS0000033846.V278971.R01.S.doc Version 5.1 Page 17 The inspector also noted in the previous inspection report and during this inspection that Room 38 still had peeling wallpaper and in Room 58 the sealant around the bath was still missing. The grounds still had no ramped access for wheelchair users. A number of areas of the home-required repair, these are detailed in the requirements section of this report (Pages 24-25). The home was predominately clean and hygienic on the day of the inspection and had a friendly and welcoming atmosphere. The residents’ bedrooms were comfortable and had been personalised by the individual residents to meet their individual needs containing hi- fi systems, radios, photographs and pictures etc. There were vases of flowers observed by the inspector in the downstairs lounge, which contributed to the homely atmosphere. The laundry on the day of the inspection was observed to clean and well organised. St Paul`s Hostel DS0000033846.V278971.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35 The home has an effective staff-training programme. EVIDENCE: The deputy manager shared the contents of staff training file with the inspector, which included Stress Awareness/Report Writing/Presentation Skills/NCFE/Certificate in Nutrition and Health/Race Relations Amendment Act Regulations/RES and Equality Impact Assessment workshop/COSHH Refresher/COSHH Regulations and Risk Assessment etc. A training programme for May 2005-March 2006 was audited by the inspector and included Basic Food Hygiene/Handling People/Hoists and Slings/Violence and Aggression/No Secrets/etc. Training is delivered both in house, but also from external professionals who are involved with the home and external training agencies. 65 of the care staff have NVQ level 2 or above. St Paul`s Hostel DS0000033846.V278971.R01.S.doc Version 5.1 Page 19 The previous inspection report recommended all care staff should receive one to one supervision at least six times yearly. Whilst standard 36 was not inspected on this occasion the deputy manager confirmed the staff did not have regular recorded supervision meetings at least six times a year with their senior/manager. St Paul`s Hostel DS0000033846.V278971.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 42 The manager ensures as far as reasonably practicable the health safety and welfare of residents and staff EVIDENCE: The Homes Health and Safety Policies and Procedures were audited. The training records of the staff members were audited and confirmed Mandatory training in Health and Safety had been completed. The Pre Inspection Questionnaire confirmed there was a rolling programme of staff training, which included health, and safety training. The Homes Maintenance Records were examined. Risk assessments were in place and reviewed regularly for the products, which were used within the home. Records showed that regular checks and servicing of equipment was undertaken. St Paul`s Hostel DS0000033846.V278971.R01.S.doc Version 5.1 Page 21 The previous inspection report stated the registered provider must carry out monthly visits and write a report of the findings from that visit. On the day of the inspection a monthly visit was in the process of being undertaken when the inspector arrived. Whilst standard 39 was not inspected during this inspection the deputy manager who spoke to the inspector confirmed the monthly visits which should be undertaken by the registered provider had not been taking place on a regular basis. St Paul`s Hostel DS0000033846.V278971.R01.S.doc Version 5.1 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 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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X 3 X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X X X X X X 3 X St Paul`s Hostel DS0000033846.V278971.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA24 Regulation 13 23 Requirement The registered manager must ensure the carrying out of all remedial repairs and maintenance work to the following; Room 38- peeling wallpaper THIS REQUIREMENT IS OUTSTANDING FROM THE JULY 2005 INSPECTION Room 58- the sealant around the bath missing. THIS REQUIREMENT IS OUTSTANDING FROM THE JULY 2005 INSPECTION The grounds- no ramped access for wheelchair users. THIS REQUIREMENT IS OUTSTANDING FROM THE JULY 2005 INSPECTION Room 38 – flaking paintwork around the window Staff cloakroom - flaking plasterwork around both ceiling lights and a crack on the wall above the staff window. Staff office - (adjacent to kitchen)-dirty and worn carpet St Paul`s Hostel DS0000033846.V278971.R01.S.doc Version 5.1 Page 24 Timescale for action 30/05/06 Respite Unit - shower-door rubber seal was loose and coming away from the door Upstairs main building- shower door rubber seal was loose and coming away from the door Dining room - parquet floor worn and discoloured Room 53 - handle missing from wardrobe door Room 53 – marks on wallpaper Room 54 – discolouration of small ceiling area 2. YA24 13 23 The registered manager must ensure in the main kitchen the cupboard door, which is missing exposing the contents of mugs and glasses to any splashes from floor cleaning, is replaced to make safe the cupboard thus avoiding unnecessary risks to the health and safety of the residents. THIS REQUIREMENT IS OUTSTANDING FROM THE JULY 2005 INSPECTION The registered manager must ensure all care staff receive one to one supervision at least six times yearly with their senior/manager The registered manager must ensure monthly visits are carried out and a written report of the findings from that visit sent to the Commission for Social Care Inspection. THIS REQUIREMENT IS OUTSTANDING FROM THE JULY 2005 INSPECTION 24/02/06 3. YA36 18 01/05/06 4. YA39 26 30/04/06 St Paul`s Hostel DS0000033846.V278971.R01.S.doc Version 5.1 Page 25 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 St Paul`s Hostel DS0000033846.V278971.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Tees Valley Area Office Advance St. Marks Court Teesdale Stockton-on-Tees TS17 6QX 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 Paul`s Hostel DS0000033846.V278971.R01.S.doc Version 5.1 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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