Inspection on 09/01/06 for Templefields

This inspection was carried out on 9th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Templefields 22/09/09

Templefields 26/09/07

Templefields 10/10/06

Templefields 15/12/04

Templefields 08/07/04

Templefields 18/03/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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

CARE HOME ADULTS 18-65 Templefields Templefields House Temple Road Dewsbury West Yorkshire WF13 3QE Lead Inspector Cathy Howarth Unannounced Inspection 9th January 2006 09:00 Templefields DS0000026311.V276919.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 Templefields DS0000026311.V276919.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. Templefields DS0000026311.V276919.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Templefields Address Templefields House Temple Road Dewsbury West Yorkshire WF13 3QE 01924 461056 01924 461008 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) Valeo Limited Miss Donna McMahon Care Home 14 Category(ies) of Learning disability (13), Learning disability over registration, with number 65 years of age (1) of places Templefields DS0000026311.V276919.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th June 2005 Brief Description of the Service: Templefields is owned and managed by Valeo Ltd, a private company. It is a care home for 14 people with learning disabilities and associated challenging behaviours. Templefields is located on Temple Road, Dewsbury, off the main Huddersfield Road. The home is close to public transport links and Dewsbury with all its facilities is close by. The accommodation at Templefields is arranged in two buildings. The main house has ten places and the Coach House four places, although at present there is only one person living in the Coach House. The Coach House has been extended, to provide more spacious living accommodation, including a conservatory. All of the bedrooms in the home are single and each building has its own lounge, dining room, bathrooms, laundry and kitchen. There is also a hydrotherapy pool and aromatherapy room available on the same site. These services are used by other homes in the Valeo group. Templefields DS0000026311.V276919.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over a five-hour period. The inspector looked around communal areas of the building and was invited to see some service users’ bedrooms. The inspector spoke with several service users who were at home at the time, shared a meal and examined relevant records. The inspector spoke with staff and the manager of the home. Overall the inspector gained the impression of a home that is providing a reasonable level of service which is valued by the people living at the home, but certain areas of organisation need some attention to ensure that the safety and welfare of service users is promoted and protected. What the service does well: What has improved since the last inspection? What they could do better: Service user plans and risk assessments need to be reviewed more frequently. Medication is managed well but staff must have access to guidance regarding giving ‘as required’ medication. The home was not clean enough to ensure the health and welfare of service users. This must be improved as a matter of urgency. There are some areas of the home that need some maintenance, such as the kitchen floor. Templefields DS0000026311.V276919.R01.S.doc Version 5.1 Page 6 Key areas of health and safety, in particular fire safety, need to be monitored to ensure they are adequately addressed. Staff recruitment procedures must be improved to protect the safety and welfare of service users. 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. Templefields DS0000026311.V276919.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 Templefields DS0000026311.V276919.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): These standards were not assessed at this inspection. EVIDENCE: Templefields DS0000026311.V276919.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): 6,7 and 9 Service user plans and risk assessments are detailed but need to be kept up to date and in a form that makes them usable by staff. EVIDENCE: Two service user files were examined. These showed that there was detailed information about the lifestyle and needs of the service users available for staff. In particular the Personal Information Plans showed a good level of detail and gave a good picture of the choices of the person. Individual support requirements were found to be detailed as were the risk assessments. There needs to be some monitoring of these however, through supervision of key workers to ensure that they are up to date as those seen had not been updated for over a year. It would also be positive for the involvement of service users in developing their plans to be recorded on the plans with a signature from those able to do this to indicate their agreement with the plans. Risk assessments were detailed but because of the number and format of these, the inspector felt it would be helpful to have them in a more accessible format so that staff can refer to them more easily, making them more usable. Templefields DS0000026311.V276919.R01.S.doc Version 5.1 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 and 17 Planned leisure activities and opportunities are good for service users. Meals and opportunities for participating in food preparation are good. EVIDENCE: Service users who spoke with the inspector explained that they enjoy opportunities to go out and participate in community activities. Service user plans indicate the type of weekly activities people choose to do and these are supported well by staff as far as can be ascertained. In addition, on site the home has the benefit of a hydrotherapy pool and an aromatherapist who offers sessions to service users from other Valeo homes as well as Templefields. These are booked in for service users as they choose and are supported by staff. From discussions with service users and looking at service user plans it appears that the staff do try hard to support family and friendships within the home. Service users can invite friends and family for meals or other visits to the home and have regular telephone contact. One service user did complain that telephone contact was restricted and that they were not happy with this. Templefields DS0000026311.V276919.R01.S.doc Version 5.1 Page 11 However the manager explained that this was at the request of family. If such issues arise they need to be clearly documented and agreements written with service users to ensure that they are clear about the reasons for such restrictions. Service users reported that the food provided at Templefields is of a good quality. Service users, who are able and want to, prepare their own food. Others have opportunities to learn skills in food preparation and baking as part of a plan of activities with the staff. Service users also accompany staff to buy food on a weekly basis. This is positive and appears to be something that service users value. All service users are weighed regularly. One service user has been supported to lose weight gradually over a period of time with the weight watchers diet. Templefields DS0000026311.V276919.R01.S.doc Version 5.1 Page 12 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): 20 Medication is managed well but staff must have access to guidance regarding giving ‘as required’ medication. EVIDENCE: No service users managed their own medication at the time of this visit. In both the coach house and the main house medication is managed by staff. There is one service user for whom a risk assessment is underway to establish whether they can manage aspects of their medication however. The medication was found to be well controlled at the time of this visit. Stocks of PRN (as required) and daily medication were found to balance with recorded levels. One area that does need to be tightened up however is in the protocols for staff to refer to when considering giving PRN medication. Although these were said to exist they could not be located on the day of this visit. These must be available as a reference for staff to ensure the safety and welfare of service users. It is recommended that copies are kept with the medication file for quick reference. Templefields DS0000026311.V276919.R01.S.doc Version 5.1 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 Systems for eliciting the views of service users need to be tightened up and staff need training in this aspect of their work. EVIDENCE: There is a complaints procedure available for service users to raise concerns about the service. There are also other mechanisms such as service user meetings, although these have not been taking place at a frequency that makes this a familiar forum for service users to use. These are diarised every month but there was a significant gap in 2005, which meant that no meetings were held between April and November. The manager felt that this may have been because staff lack confidence in running the meetings. This should be improved and should be monitored by the manager. The complaints log was examined and found to contain a number of inappropriate entries by staff who had recorded issues for care practice as complaints, and themselves as the complainants. This indicates a lack of awareness of the purpose of the procedure by the staff and needs to be taken up as a training need. Templefields DS0000026311.V276919.R01.S.doc Version 5.1 Page 14 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 The home was not clean enough ensure the health and welfare of service users. There are significant maintenance issues that need to be monitored. EVIDENCE: Templefields is a fairly large home for young adults. It has communal areas that are as homelike as is consistent with up to eight service users sharing one space. One of the first impressions unfortunately gained by the inspector was that the house was rather dirty. The manager explained that the domestic post had been vacant for some time with duties being covered by staff and the new cleaner had only started just before Christmas. As a matter of some urgency, key areas such as the kitchen and bathrooms need to be thoroughly cleaned. In every room skirting boards and walls need to be cleaned. The communal lounge is homely. There is a smoking room, which was found to be rather dirty on this visit. The carpet in particular was very badly stained. Also there were problems with the extractor fan, which requires immediate attention for the comfort and well being of all service users. The flooring in the kitchen was found to be badly marked and near the cooker was ripped and very uneven. The manager advised that this has been Templefields DS0000026311.V276919.R01.S.doc Version 5.1 Page 15 reported and a problem with the floor crumbling underneath in places has been identified. This needs to be dealt with without delay as the floor presents a hazard to the health and welfare of both service users and staff at the home. Also in the kitchen the radiator cover needs to be repaired or replaced. The manager advised that there is a plan to replace all of these throughout the house, as they are unsuitable and showing signs of wear and tear. The manager advised that there is a programme of ongoing maintenance for the building and the inspector observed the handyman getting on with jobs that needed doing in the building during the course of this visit. In several bathrooms there were some problems with hot water. In one bathroom the hot water was running at too low a temperature (between 38 and 40°) and the records indicated that this had been the case for some time. Staff need to be aware of the reasons for checking the temperatures and to take appropriate action when the temperatures fall outside of an acceptable range. Templefields DS0000026311.V276919.R01.S.doc Version 5.1 Page 16 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): 34 The recruitment procedures within the home need to be tightened up to meet regulatory requirements and to protect the service users in the home. EVIDENCE: Two files for recently recruited staff were examined. Both of these were inadequate in that one had no references on file and the other lacked evidence relating to the person’s identity and experience and qualifications. No employment history was available for one person and no statement re physical and mental health to carry out the post for which they were employed. Shortcomings in the recruitment procedures were identified at the last inspection and have been raised again on this visit. This is an area that must be addressed as a matter of urgency for the protection of service users. The Commission will consider enforcement procedures if this area is not adequately addressed within the stated timescale. Templefields DS0000026311.V276919.R01.S.doc Version 5.1 Page 17 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, 42 Key areas of health and safety, in particular fire safety, need to be monitored to ensure they are adequately addressed. The manager needs to actively manage the home in all areas. EVIDENCE: The home has a registered manager who is enthusiastic and keen to provide a good service for the people who live at Templefields. The manager is registered for NVQ4 and is making progress in achieving this. There are some shortcomings however in the level of organisation within the home and the manager needs to be able to take a more positive role in monitoring these. One area that might allow for more flexibility in this respect, is if the organisation were to provide some administrative support for such things as typing of reports. The manager reported that she has to do most of this at the moment. The inspector considers this to be a waste of management time and expertise. Templefields DS0000026311.V276919.R01.S.doc Version 5.1 Page 18 Some health and safety areas within the home also gave some cause for concern. Staff do monitor such things as fridge and freezer temperatures and fire extinguishers and PAT tests were up to date. However as stated in the Environment section of this report, hot water temperature monitoring is unsatisfactory and the hygiene in the building needs urgent attention. Also fire safety training for staff in the form of drills was unsatisfactory in that the records, which are computerised since July 2005, indicated that no drills have been held. The manager was unable to identify whether drills had actually taken place. All staff should receive training in fire safety at least twice a year and this should be carefully monitored by the manager to ensure that this is achieved. Also there was no system within the home for identifying who was actually in the house at any time. It is required therefore that the home implements a roll call system to ensure that clear information can be given to the fire brigade should a fire break out. The fire risk assessment should be reviewed to ensure that all aspects of fire safety are adequately addressed within the home. Templefields DS0000026311.V276919.R01.S.doc Version 5.1 Page 19 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 2 23 X ENVIRONMENT Standard No Score 24 1 25 X 26 X 27 X 28 X 29 X 30 1 STAFFING Standard No Score 31 X 32 X 33 X 34 1 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 X X 2 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 2 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 1 X 2 X X X X 1 X Templefields DS0000026311.V276919.R01.S.doc Version 5.1 Page 20 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 2 3 Standard YA20 YA24 YA24 Regulation 12(1), 13(2) 12(1) 12(1) 16(2) 12(1) Requirement Protocols for the administration of PRN medication must be available for staff to refer to. The flooring in the kitchen needs to be replaced. The home must be thoroughly cleaned especially in food preparation and serving areas and in bathrooms. Adequate extraction must be provided in the smoking room to protect the safety and welfare of all service users. The registered person must ensure that recruitment procedures comply with all the requirements of Schedule 2 of the Care Homes regulations 2001. The registered person must ensure that the fire safety procedures within the home are adequate and that staff have received suitable training. Timescale for action 20/01/06 28/02/06 23/01/06 4 YA24YA42 30/01/06 5 YA34 19(4) Schedule 2 30/01/06 6 YA42 23(4) 30/01/06 Templefields DS0000026311.V276919.R01.S.doc Version 5.1 Page 21 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 5 Refer to Standard YA6 YA9 YA15 YA22 YA24 YA37 Good Practice Recommendations Service user plans and risk assessments should be reviewed more frequently. Any restrictions on family contact should be agreed and written into the service user plan. Staff should have training in handling complaints. Staff should take appropriate action when recording water temperatures outside an acceptable range. The organisation should consider offering administrative support to the manager to allow her the time to manage areas of the home that require attention. Templefields DS0000026311.V276919.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB 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 Templefields DS0000026311.V276919.R01.S.doc Version 5.1 Page 23 - 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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