Inspection on 14/03/07 for The Respite House

This inspection was carried out on 14th March 2007.

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 no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Respite House 20/03/06

Similar services:

Sunny Bank (P.R.S.) Ltd

Ashwood Court Unit 1

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Alfred House Residential Care Home

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Fernhaven

Thames House

Creative Support

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

CARE HOME ADULTS 18-65 The Respite House The Respite House 2-4 New Lane Breightmet Bolton Lancashire BL2 5BN Lead Inspector Mike Murphy Unannounced Inspection 14th March 2007 09:30 The Respite House DS0000063473.V308231.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Respite House DS0000063473.V308231.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Respite House DS0000063473.V308231.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Respite House Address 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) The Respite House 2-4 New Lane Breightmet Bolton Lancashire BL2 5BN 01204 337830 01204 337831 vivienne.savage@bolton.gov.uk Bolton Metropolitan Borough Council Ms Vivienne Savage Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places The Respite House DS0000063473.V308231.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 6 service users, to include: *Up to 6 service users in the category of MD (Mental Disorder under 65 years of age). *Up to 1 service user in the category of MD (E) (Mental Disorder over 65 years of age). 20th March 2006 Date of last inspection Brief Description of the Service: The home aims to provide a supportive alternative for people with mental health needs who are facing a time in their lives when they or their families/carers need to seek respite. The home provides a service for people with mental health problems in crisis where hospital admission is neither appropriate or necessary. The Respite House DS0000063473.V308231.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the second inspection undertaken at ‘The Respite House’ since the home was first registered with the CSCI in June 2005. The inspection took place over 5 hours and included discussion with service users, the manager and staff, a tour of the premises and inspection of records maintained at the home. The home was being managed adequately and appropriately and continues to provide a suitable environment for service users to be supported. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can The Respite House DS0000063473.V308231.R01.S.doc Version 5.2 Page 6 be made available in other formats on request. The Respite House DS0000063473.V308231.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Respite House DS0000063473.V308231.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users are appropriately assessed thereby ensuring their placement at the home is suitable to meet their care and support needs. EVIDENCE: All prospective service users have to be fully assessed prior to staying at the Respite House. This is to ensure that the home provides a suitable environment for them and that their special care and support needs can be properly met, particularly their mental health needs. This assessment involves the full participation of the service user, their family and other carers as well as health and social care professionals who are involved in supporting the service user. Assessment records are detailed and reflect what care and support the service user will need to ensure their stay at the home does not undermine any of the support Package they have had prior to and that will continue after their stay at the home. (The average stay at the Respite House is about 1 week). Prospective service users are encouraged to visit the home prior to their admission and many take that opportunity. Service users spoken to at the time of inspection or in returned comment cards reflected that were properly supported and involved in their admission to the Respite House. Emergency admissions occur on the understanding that the proposed service user has had a full assessment and that they have suffered from an acute deterioration of their mental health. The Respite House DS0000063473.V308231.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are encouraged to maintain as much independence as possible and make as many personal choices and decisions as possible. EVIDENCE: The Respite House provides accommodation for a maximum of 6 service users in what is essentially a domestic setting in which experienced staff provide appropriate care and support. This enables and encourages service users to be actively involved in their care planning which in the case of the Respite House is highly individualised and ‘tailor made’ made for the individual. Service users spoken to (and in observations made in returned comment cards) report very positively of being able to participate in all aspects of life in the home especially in respect of the activities of daily life for example, what time they get up, go to bed, what they want to eat, and which leisure and social activities they choose to (or not to) participate in. The Respite House DS0000063473.V308231.R01.S.doc Version 5.2 Page 10 Individual care plans were designed that are particular for that service user and are initially based on the admissions assessment referred to in the ‘choice of home’ section of this report. Care plans identified how individual service users needs are to be met and inspection of care records and talking to service users and staff revealed that service users are very involved in care planning, risk assessment and review. Service users privacy and confidentiality are extremely important to the philosophy of the home and discussion with staff revealed that they thought it was paramount to respect these. All records relating to service users were stored securely within the home. The Respite House DS0000063473.V308231.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are helped in maintaining and developing personal and family relationships whilst at the home. EVIDENCE: Service users are actively encouraged to take part in a wide range of social and leisure activities. Staff from the home, have recently held a meeting at one of the local authority day centres ( a significant number of the Respite House’s ‘regular’ service users attend) to discuss with service users how activities could be extended and developed. Whilst at the home service users are encouraged to as far as possible to continue with existing programmes of activities and training. Staff enable service users to achieve this. The small numbers of service users who are at the home at any particular time means that this highly individualised approach is able to work. Central to this approach is that all such activities are centred The Respite House DS0000063473.V308231.R01.S.doc Version 5.2 Page 12 within the local community – indeed the Respite House is essentially a ‘domestic’ house much the same as others in the area. Care records revealed that such an approach is service user focused and seeks to meet their needs and not the needs of the service. The aim is to ensure service users return to their home and life when they are ready and not to have become ‘de-skilled’ during their time at the home. There are no unreasonable restrictions to service users receiving visitors at the home. Service users spoken to (and replies contained in returned comment cards to the CSCI) speak positively in respect of the meals provided for them and stated that they were given a wide and reasonable choice, that the amounts provided were adequate, that the food was good and that they could always get something to eat or drink. Staff record meals taken by service users to monitor that a balanced diet is being taken. . The Respite House DS0000063473.V308231.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are able to obtain good quality physical and mental health care during their stay at the home. EVIDENCE: As detailed earlier in this report care plans are developed for each service user that apply only to them and are therefore completely personal to them. These care plans identify specific issues relating to the service user’s physical and mental health as well as other issues such as social and more general issues. Contact is maintained with health and social care professionals who already support individual service users – including those who specialise in mental health. Care plans also contain details of the things that need to be done to ensure service users needs in these areas are met properly. For service users with a physical disability the home have (since the last inspection) provided an adapted bedroom on the ground floor of the home. Service users can retain control over their medication following appropriate assessment. 5 of the 6 bedrooms contain a lockable space to facilitate this – but the new bedroom for disabled service users did not have this facility at the The Respite House DS0000063473.V308231.R01.S.doc Version 5.2 Page 14 time of this inspection. The registered manager said this matter was being dealt with and should be shortly sorted out. Staff training for managing service users medicines has been provided and should be completed by June 2007. Service users bring in their own medicines when they are admitted to the home. Medicines are documented, booked in on admission and booked out on discharge. Appropriate storage arrangements for medicines administered by staff are in place. And the written policies for the management of service users medicines have recently been reviewed. The Respite House DS0000063473.V308231.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Appropriate procedures are in place to ensure that service users and their relatives/carers feel comfortable with making a complaint if necessary, and to prevent residents becoming victims of abuse. These are important areas that are essential to the protection of service users, many of whom are extremely vulnerable. EVIDENCE: Discussion with service users and comments made in comment cards returned to the CSCI revealed that they were aware of how to and were provided with information that enabled them to make a complaint if they desired. A comprehensive and accessible complaints procedure is provided to all service users in the service user information guide, and includes details of how complainants can contact the CSCI if desired. Service users felt comfortable and confident enough to raise a complaint if they felt it necessary to do so or knew someone who would do so on their behalf. Inspection of policies and procedures operated at the home, discussion with staff and inspection of staff training records indicated that there is awareness of the importance of protecting service users from abuse. The Respite House DS0000063473.V308231.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29,30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home was very clean and provided a comfortable environment for residents. However although significant environmental improvements have been made there are areas that still need attention. EVIDENCE: The Respite house is situated in the Breightmet area of Bolton and provides accommodation for up to 6 service users. The home blends in completely with the other houses in the area and therefore retains a ‘domestic’ character that means it is completely integrated into the local community. The house appears to be well maintained on the outside and benefits from enclosed front and rear gardens that are accessible to service users. Disabled service users are enabled to access the property via a purpose built ramp. At the time of this visit the home was warm and very clean and free of malodour. The Respite House DS0000063473.V308231.R01.S.doc Version 5.2 Page 17 Communal areas comprise a ‘quite’ lounge, dining room, a ‘smoking’ lounge, and a kitchen. The ‘quite’ lounge and dining room have been redecorated and refurnished (since the last inspection) to a good standard and provide comfortable areas for service users to use. The ‘smoking’ lounge is in need of attention – as the wallpaper has been quite heavily stained by cigarette smoke. The kitchen was clean and appropriately equipped and stocked. The 5 service user bedrooms on the 1st floor of the home were clean, warm and in the main adequately furnished – although some furniture and floor coverings are marked/damaged. There has been damage to the décor in some of these rooms – due to a problem with the chimneystacks that has been apparently addressed. These bedrooms will require redecoration. The registered manager informed the inspector that this was schedule to begin shortly after this inspection. Adequate toilet and bathing facilities are provided within the home. The hall, stairs and landing have been re-carpeted since the last inspection. The 6th service user bedroom is on the ground floor and has been registered with the CSCI since the last inspection in March 2006. This provides suitable facilities for physically disabled service users. And is suitably furnished, adapted and benefits from an en-suite shower, washbasin and WC. The Respite House DS0000063473.V308231.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Respite House is staffed appropriately by a team who have the qualifications, training and support needed to meet the stated purpose of the home and meet the assessed needs of service users who stay there. EVIDENCE: Discussion with staff working at the time of inspection and inspection of training records indicated that staff are provided with comprehensive induction, mandatory and ongoing training that is relevant to the work they do and is regularly updated and recorded. Staff are actively encouraged and enabled to obtain NVQ 3 qualifications in care and indicated that they were supported in accessing appropriate training. CSCI inspectors periodically inspect staff recruitment files that are held at a central location by the local authority (responsible for the Respite House) – these were found to be satisfactory on the last inspection. The Respite House DS0000063473.V308231.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is being, effectively and efficiently managed by the registered manager. This is important as service users, their relatives and staff need to have confidence in and access to competent managers. EVIDENCE: The registered home manager is a very experienced manager and is qualified in social work. And has completed an NVQ4 qualification. Discussion with service users (and comments made in comment cards returned to the CSCI) and staff employed at the home indicates that the registered manager Continues to adopt a management style that is open, supportive, positive and inclusive. The Respite House DS0000063473.V308231.R01.S.doc Version 5.2 Page 20 The views of service users in respect of the service are obtained throughout their stay and more formally at the time of discharge – in the form of an exit questionnaire. The following certificates of inspection/service records were found to be satisfactory on this occasion; electrical systems/equipment, fire fighting equipment and the fire alarm system, fire safety training, fire safety risk assessment, fire procedure, gas safety, testing of fire safety systems, monitoring of hot water temperatures and general and specific health and safety risk assessments, and control of clinical waste disposal. An internal fire safety inspection was conducted in December 2005 and a number of recommendations were made– the CSCI has been informed these issues have been complied with. The Respite House DS0000063473.V308231.R01.S.doc Version 5.2 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 Standard No Score 1 X 2 3 3 X 4 X 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 2 26 3 27 3 28 2 29 3 30 3 STAFFING Standard No Score 31 x 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 x 3 X 3 X X 3 x The Respite House DS0000063473.V308231.R01.S.doc Version 5.2 Page 22 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. 1 Standard YA26 Regulation 16(2)c 23(2)(m) Requirement That the CSCI is provided with written details (including proposed completion dates) of the proposed redecoration/refurbishment programme that is proposed for service users bedrooms and the ‘smoking’ lounge. That the CSCI is informed in writing that a lockable space has been provided in the bedroom designated for physically disabled service users. Timescale for action 31/05/07 2 YA20 13(2) 16(2)(l) 23(2)(m) 31/05/07 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 The Respite House DS0000063473.V308231.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Respite House DS0000063473.V308231.R01.S.doc Version 5.2 Page 24 - 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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