Inspection on 04/05/05 for St Philips Close

This inspection was carried out on 4th May 2005.

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 Philips Close 03/10/07

St Philips Close 14/11/06

St Philips Close 23/05/06

St Philips Close 23/11/05

St Philips Close 02/11/04

St Philips Close 18/05/04

St Philips Close 25/11/03

St Philips Close 19/08/03

St Philips Close 09/10/02

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

CARE HOME ADULTS 18-65 St Philips Close 1 St Philips Close Middleton Leeds LS10 3TR Lead Inspector Valerie Francis Unannounced 4 May 2005 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 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 Stationary 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 Philips Close X00023 S1500 1St Philips V222144 040505 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service St Philips Close Address 1 St Philips Close Leeds LS10 3TR Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0113 2778069 0113 2778069 Milbury Care Services Ltd Mr J Irving CRH 4 Category(ies) of LD Learning disability 4 registration, with number of places St Philips Close X00023 S1500 1St Philips V222144 040505 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 2/11/04 Brief Description of the Service: 1 St Philips Close is a purpose built bungalow located in a residential area of Middleton close to local amenities and public transport routes. There is roadside parking to the front of the home. There are well maintained gardens to the rear of the property that are accessible to service users. The home is registered to provide personal care for four people with learning disabilities. The accommodation includes four single bedrooms, a communal lounge/dining room, a communal bathroom and toilet, a domestic style kitchen and separate laundry room. St Philips Close X00023 S1500 1St Philips V222144 040505 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector carried out this inspection over a day, which was unannounced, which started at 11am and completed at 5.pm. On arrival to the home the inspector met the person in charge. Over the last months there has been some change in the home management and at the present time, the organisation has appointed a temporary manager, to fill in, in the absence of the registered manager. At the beginning of the inspection, she was not on site but, however joined the inspector later and facilitated in the inspection process. Comment cards were given to the temporary manager for her feedback on the way in which the inspection was carried out. Comment cards for both residents and visitors and the new CSCI service users information leaflets were also left. During this time residents’ records and care plans were assessed, observation was made of staff interaction with residents. A mealtime was observed although this standard was not audited. Residents and staff were spoken with. What the service does well: What has improved since the last inspection? A temporary manager is now in place at the home whilst the home management is being reviewed. St Philips Close X00023 S1500 1St Philips V222144 040505 4.doc Version 1.30 Page 6 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 Philips Close X00023 S1500 1St Philips V222144 040505 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection St Philips Close X00023 S1500 1St Philips V222144 040505 4.doc Version 1.30 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 standard(s) 1,2,3,4 and 5. Prospective residents and their carers receive good information about the home. All new residents are assessed before admission to the home to ensure needs can be met. Each resident is issued with a contract of terms and conditions of residency. EVIDENCE: The statement of purpose and service user guide contains all the information as required. However, the information was not available in any other format i.e. symbols or makaton or any other languages. Although it was evident that an assessment is carried out of all prospective residents, the format of the assessment form needs additional information to meet standard 2.3. Each resident is given written terms and conditions, however, it was noted that one contract was signed by the manager on behalf of the resident, and not by someone who is the designated relative or advocate. Therefore there is no sure way that the resident is aware of the rights and the responsibilities of both the home and the resident. St Philips Close X00023 S1500 1St Philips V222144 040505 4.doc Version 1.30 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 standard(s) 6 &9. There were no care plans in place for assessed needs, which would enable staff to meet the all care needs that has been identified in the assessment. Risk assessments were not carried out for day to day living, which would give staff an action plan to follow and to minimise the identified possible risks to the resident on day to day basis. EVIDENCE: Two care files were inspected. Although there was copious information regarding the individual and their needs were identified, there were no plans of care in place as to how these identified needs would be met and managed. There was no evidence of a person centred approach to care planning, no information regarding choices and aspiration of the individual and how these would be encouraged and met. There was evidence of reviews with recommendations but there was no supporting plan of care. Some of the information was out of date and did not reflect any changes in the individual’s well-being and care needs. On both files there were general risk assessments in place for Moving and Handling, and one resident had specific risk assessments undertaken for day to day living. St Philips Close X00023 S1500 1St Philips V222144 040505 4.doc Version 1.30 Page 10 One of the service user’s risk assessment indicated that the resident was at risk of falling when walking unaided or staff support, however, there were no plan in place of what action would be taken to minimise the risks. Staff have access to the organisation’s missing person procedure, which is available in the operational manual. St Philips Close X00023 S1500 1St Philips V222144 040505 4.doc Version 1.30 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 standard(s) 11,12,13 &14. There are systems in place for residents to develop their personal life style in the home. EVIDENCE: Information in care files showed that the involvement of various agencies in the care of individual residents. Residents attended colleges where they learn new skills, one resident attends art classes at the local college. There were records of staff contacts with professionals who assist them in the care of individual residents, however there was little or no information of interventions from specialist trained staff, or how peoples’ spiritual needs were being met. There is information in the service user guide of community involvement with the home. The manager said as part of individual activity plans, that residents are encouraged to take part in community recreational activities; one resident had forged links with the local shops. St Philips Close X00023 S1500 1St Philips V222144 040505 4.doc Version 1.30 Page 12 It was evident that there were no real in house activities arranged for residents, other than learning domestic and catering skills. Residents were seen to be encouraged to take part in meal preparations, laundering of their clothes and cleaning of their bedroom. The inspector was told of a practice where staff attends classes with residents to help them to settle them into the class. During the audit of care files it was evident that no resident had had a nutritional risk assessment, or a record of their food likes and dislikes. St Philips Close X00023 S1500 1St Philips V222144 040505 4.doc Version 1.30 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 standard(s) 18,19 & 21. Care is provided in a way that meets the individual residents needs. despite the lack of a written care plan, which would provided any person delivering the care with enough information as to how the needs were to be met. EVIDENCE: Although the inspector found copious written information in individual residents care files, there was no care plan that would address the individual personal support and their health care. There was some indication in care files that encouragement and support are given to residents when choosing what to wear and when buying new clothes. The inspector was told that there was involvement from the physiotherapist and occupational therapist, inspection of the building showed signs that specialist equipments are used to help staff and to maximise residents independence, however there were little or no evidence in care files, to support this and for continuity. Staff confirmed that they had good links and support with Health Care Professionals; residents have annual checks with their dentist and other health care professionals. St Philips Close X00023 S1500 1St Philips V222144 040505 4.doc Version 1.30 Page 14 Although it is acknowledged that the home is for younger adult who are not receiving terminal care, there were no plans of care of what residents would like for their last wishes. Staff had not received any training on aging and illness and death, that would able them to meet the changing needs of residents and to support them in their last days. The manager said she was aware of this shortfall and was putting a training programme in place. St Philips Close X00023 S1500 1St Philips V222144 040505 4.doc Version 1.30 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 standard(s) These standards were not assessed at this time. EVIDENCE: St Philips Close X00023 S1500 1St Philips V222144 040505 4.doc Version 1.30 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 standard(s) 24 and 29 Although the house is furnished to a domestic style and provides a homely environment, the house needs refurbishing and redecoration and furniture replacement. EVIDENCE: The location of the home provides residents with easy access to local shops and recreational facilities that staff support residents to use. The outside perimeter of the building is fitted with CC TV security system. Although the house is furnished in a domestic style, it was evident that the bathroom and other areas of the building needed repainting and the dining room furniture was showing signs of wear and tear. The dining room is also used as staff office space, which impinges on residents’ space, especially when staff are using the area at meal times residents then have to take their meals in their bedroom of the lounge. This detracts from the homely and domestic environment that has been created. The inspector advised that more thought needed to given to be utilise another area so that staff could store filing cabinets and other office equipment. St Philips Close X00023 S1500 1St Philips V222144 040505 4.doc Version 1.30 Page 17 The “High Low Bath” recommended by the occupational therapist sometime ago, was still not fitted and the manager said that there was no confirmation when it would be fitted. A letter was sent to the registered person as to confirm when this matter would be resolved. St Philips Close X00023 S1500 1St Philips V222144 040505 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33 and 35 Despite their lack of training, the staff team appeared to be competent and committed to meet residents care needs. Although the present staffing numbers was appropriate for the current resident group, the present system of sharing the person in charge of the shift is not appropriate, this arrangement has an effect on the amount of staff available to resident in 1 St Phillips Close. EVIDENCE: The manager said all staff are given copies of their job description, which outlines their roles and responsibilities in the home. At the time there was only one member of staff who had an (NVQ) National Vocational Qualification in care, at the time two staff were undertaking NVQ level 2 or 3. Although the organisation offers staff a variety of training courses that would help them in the care for residents it was evident from information seen and from discussion with the temporary manager and staff that little or no training had been undertaken for some time. The main focus has been on the induction course for new staff. Specialist training was needed i.e. Handling aggression and dementia, the manager was in the process of putting together a training plan for the staff at 1 St Phillips Close. There were several staff vacancies one part time support worker (27hours) and one full time support worker (37 hours). At the time there were 7 care staff St Philips Close X00023 S1500 1St Philips V222144 040505 4.doc Version 1.30 Page 19 employed at the home. The vacancies meant that existing staff would have to cover the missing hours. The person in charge of the shift i.e. the senior support worker or the manager is also responsible for the adjoining home, 3 St Phillips Close. In most cases this person is also part of the staffing number available to residents. The staff team at the time allows residents the opportunity to have their personal care given by either male or female staff. St Philips Close X00023 S1500 1St Philips V222144 040505 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 Health and safety of service users is in the main protected. EVIDENCE: Some staff have recently undertaken course on First Aid. However training on Fire safety, Infection control and COSSH is needed to ensure that the health, safety and welfare of service users and staff are promoted. The records for safety checks from outside agencies were up to date. The issues of the Hi Low bath still remain unresolved; the inspector was told that the home was waiting the instillation date, which has been ongoing for some time. There was no risk assessment in place for the building, which would identify any areas or object that is a potential risk. Water temperatures of the hot taps were not recorded, therefore not identifying any outlet that is a potential hazard. There was no record of safety checks carried out. It was evident that the bathroom needed full refurbishment i.e. the bath panel was coming away from the bath and some of the paint work in the room was peeling. St Philips Close X00023 S1500 1St Philips V222144 040505 4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 2 3 3 3 Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 x x x x x x x Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 St Philips Close Score x x x x Standard No 37 38 39 40 41 42 43 Score x x x x x x x X00023 S1500 1St Philips V222144 040505 4.doc Version 1.30 Page 22 Are there any outstanding requirements from the last inspection? 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. 2. Standard 2 6 Regulation 4 ( c) Requirement Timescale for action 30th July 2005 30th August 2005 30th August 2005 30th August 2005 30th September 2005 30th July 2005 30th July 2005 30th July 2005. 30th August 2005 3. 4. 21 24 5. 6. 7. 8. 9. 24 29 31 33 35 all idenfied risk must be assess with an action plan in place to minimise the risk 15 each resident must have a clear care plan, which idenfies all their needs and how they would be met. 18 ( c ) (i) staff must Receive training in relation to ageing and associated illness. 23 (2) The building in areas such as the dining room was showing signs of wear and tear and was in needed of redecoration 23 (3) The matter of the use of the dining room by staff must be address. 23(2) (n) The instaltion of the High-Low bath must carried out. 8 The issue of the availablity of the registered manager must be resolved. 18 (a) staff vacancies must be filled. 18 Staff must have training in specialist areas to ensure they can meet the changing needs of residents,infection control and health and safety. Health and safety records i.e tempretures of the water from X00023 S1500 1St Philips V222144 040505 4.doc 10. 42 13 30th July 2005 Page 23 St Philips Close Version 1.30 the hot taps must be recorded. 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 5 5 31 Good Practice Recommendations contract of trerms and condation shopuld be signed when by relatives or advocate. some consideration should be given to provide residents terms and condation in format that they would be able to recognise. The arrangement of the person in charge covering both houses whilst included in the number of staff available should be address St Philips Close X00023 S1500 1St Philips V222144 040505 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Aire House Town Street Rodley 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 Philips Close X00023 S1500 1St Philips V222144 040505 4.doc Version 1.30 Page 25 - 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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