CARE HOME ADULTS 18-65
Stubblefields House Pinfold Lane Bridlington East Yorkshire YO16 6XP Lead Inspector
Karen Ritson Unannounced Inspection 14th December 2005 10:00 Stubblefields House DS0000019833.V269238.R01.S.doc Version 5.0 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 Stubblefields House DS0000019833.V269238.R01.S.doc Version 5.0 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. Stubblefields House DS0000019833.V269238.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Stubblefields House Address Pinfold Lane Bridlington East Yorkshire YO16 6XP 01262 606036 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) Mrs Julie Druce Mrs Julie Druce Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Stubblefields House DS0000019833.V269238.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 17th January 2005 Brief Description of the Service: Stubblefields care home is registered to provide care for a maximum of four service users with a learning disability. The home has four bedrooms for service users all located on the ground floor. The home has one lounge and one bathroom. The most recent room is en suite. Patio doors lead from the lounge into a garden. The home is situated at the end of a long residential street on the outskirts of Bridlington. The local town provides service users with ample opportunity to access local amenities. The registered provider is about to apply for a variation to the registration in order to increase occupancy from four to a maximum of five service users, following an extension to the property. Stubblefields House DS0000019833.V269238.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection took place on December 14th. The manager was available throughout the inspection. Two service users were spoken to. The inspection took eight hours to complete which includes time for preparation and writing the report. This inspection has focused upon the core standards. Service user comments will be mentioned in more detail in the body of the report, however, all comments were positive regarding level of care offered by the home. What the service does well: What has improved since the last inspection? What they could do better:
There are no outstanding requirements from the last inspection and this inspection has generated no further requirements. Improvements required are identified by the home through the quality assurance system and are self monitored. This home offers a good level of care and is responsive to changing needs. Stubblefields House DS0000019833.V269238.R01.S.doc Version 5.0 Page 6 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. Stubblefields House DS0000019833.V269238.R01.S.doc Version 5.0 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 Stubblefields House DS0000019833.V269238.R01.S.doc Version 5.0 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 Service users are assured their care needs will be met. EVIDENCE: There has been one new admission since the last inspection. The assessment was examined for this service user. The service user had been given the opportunity to meet with the proprietor and other residents prior to admission and had spent time at the home. The proprietor had completed a personal profile and a thorough assessment with risk assessments in place. This service user was not present on the day of inspection. Another service user said she felt the proprietor knew what her care needs were and that these were met. Stubblefields House DS0000019833.V269238.R01.S.doc Version 5.0 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): 6,7 and 9 Service users are assured they will be supported to exercise choice and to have control over their lives. EVIDENCE: The care plan provides a detailed guide to the care required for each person and is regularly reviewed. One service user said she was involved in drawing up her care plan and in reviews. All professional health care visits are recorded and all areas of care are well covered. All activities engaged in and choices regarding these were recorded. The service user said she could choose what she wanted to do subject to her capacity. One service user cycles to visit friends and is encouraged to do so within his risk assessed car plan. Stubblefields House DS0000019833.V269238.R01.S.doc Version 5.0 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): 12,13,15,16 and 17 Service users’ social and cultural needs are met. EVIDENCE: Examples of service users being supported in personal development were seen on file. One service user has carried out work in grounds maintenance and in a supermarket through ‘work link’, which is an organisation supporting people with a learning disability in the world of work. Other service users assisted in the home with domestic chores such as washing up, preparing meals, feeding the hens and helping in the garden. All community involvement is recorded. The service users said they went out all together or individually to town and to the local pub for meals or to play pool and have a drink. Visitors are welcome at all reasonable times and sign a visitors book. Family links are well documented. All choices and work towards independence are recorded. One service user said she was helped to do things for herself and that the proprietor took time and care to ensure this happened. The home keeps a menu book and individual choices regarding meals are written down. There are options for all meals and food likes and dislikes are taken into consideration. Food temperatures are recorded daily. Service users said they enjoyed the meals.
Stubblefields House DS0000019833.V269238.R01.S.doc Version 5.0 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 and 20 Service users receive appropriate personal and healthcare. EVIDENCE: Personal care needs are recorded on file. One service user said she was assisted in a caring and appropriate way. All health care appointments are recorded and service users are accompanied to these. Two service users have attended accident and emergency in the past year. Medication is suitably kept and administered. The manager and staff have now completed distance medication training from York College. Stubblefields House DS0000019833.V269238.R01.S.doc Version 5.0 Page 12 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 and 23 Service users are assured their complaints will be listened to and acted upon and that they will be protected from abuse EVIDENCE: The home has a complaints procedure; however there have been no recent complaints. The service users are protected from abuse through staff training and the abuse awareness policy and procedure. The policy on restraint has been amended to comply with requirements. One service user said she felt very safe in the home and was assured that if she had any concerns she would not hesitate to talk with the proprietor. She said the proprietor would listen to and act on any complaints. Stubblefields House DS0000019833.V269238.R01.S.doc Version 5.0 Page 13 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 and 30 Service users live in a pleasant and safe environment. EVIDENCE: The home is safe, comfortable and well furnished and decorated. The new room is large and airy and another room is almost ready for occupation. An application to CSCI for a variation in registered numbers is pending regarding this. The home carries out fire checks on a weekly basis and fire drills every month. The latest environmental health report recommended that staff attend a food hygiene refresher course. The home is clean and has a policy and procedure for infection control. The laundry is situated away from the kitchen and meets the standard. One service user said she liked her room and the way it had been decorated to her taste. Stubblefields House DS0000019833.V269238.R01.S.doc Version 5.0 Page 14 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 and 35 Service users benefit from well-trained, supportive staff EVIDENCE: The home has a suitable recruitment procedure. Staff are well trained. Medication training has just been completed, health and safety is in progress. First aid and moving and handling have been completed within the last two years. The home operates a key worker system, although as this is a small home, all staff know the needs of all service users well. The home has also recruited a new activities organiser who attends on a monthly basis and service users said it was good to have someone different coming into the home. Stubblefields House DS0000019833.V269238.R01.S.doc Version 5.0 Page 15 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): 37,39 and 42 The health and safety of service users are protected. EVIDENCE: The manager has the registered managers award and the equivalent of NVQ in care at level 4. The other two members of staff are qualified to at least NVQ level 2 with one also having NVQ level 3. The home has a well-developed quality assurance system, with feedback obtained from service users families, GP’s and voluntary or day care placements. All feedback received was positive regarding the care at the home. The manager said she discussed the results of the questionnaires with service users in service user meetings and quality circle meetings with staff and used the information gathered to inform future practice. The home has achieved QDS at levels one and two. All health and safety policies and procedures were in place. The home has up to date maintenance certificates for electrical and gas appliances and systems and all regular safety checks were recorded. Stubblefields House DS0000019833.V269238.R01.S.doc Version 5.0 Page 16 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 X 3 X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X Standard No 24 25 26 27 28 29 30
STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Stubblefields House Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 3 X DS0000019833.V269238.R01.S.doc Version 5.0 Page 17 NO 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Stubblefields House DS0000019833.V269238.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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