Inspection on 20/03/06 for The Respite House

This inspection was carried out on 20th March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Respite House 14/03/07

Similar services:

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Alfred House Residential Care Home

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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 09:30 20 March 2006 th The Respite House DS0000063473.V258275.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 The Respite House DS0000063473.V258275.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. The Respite House DS0000063473.V258275.R01.S.doc Version 5.0 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 Bolton Metropolitan Borough Council Ms Vivienne Savage Care Home 5 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (5) of places The Respite House DS0000063473.V258275.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The home is registered for a maximum of 5 service users, to include: Up to 5 service users in the category of MD (mental disorder under 65 years of age). The service should employ a suitably experienced and qualified manager who is registered with the Commission for Social Care Inspection. The Registered Person must ensure that all staff working in the home have training in Mental Disorder which equips them to meet the assessed needs of service users accommodated, as defined in the individual plan of care. The Registered person must implement the action and work required identified in the fire risk assessment conducted by Bolton Council SSD in relation to the home on the 3rd May 2005, and also review the fire risk assessment at appropriate intervals. 4. 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.V258275.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the first inspection undertaken at ‘The Respite House’ since the home was first registered with the CSCI in June 2005. The inspection took place over 4 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 appropriately and effectively managed and provides a suitable place for this group of service users to be supported. What the service does well: What has improved since the last inspection? What they could do better: Whilst it is acknowledged that the home was providing a clean, warm and comfortable environment for service users there are a number of decorating/refurbishment issues that the inspector was informed are to be addressed shortly. The Respite House DS0000063473.V258275.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. The Respite House DS0000063473.V258275.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 The Respite House DS0000063473.V258275.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): 1,2,3,4. The home provides appropriate information and has developed an admissions assessment procedure that enables prospective service users to be fully involved in their admission and able to make informed choices of how appropriate the service is for them. EVIDENCE: The scheme has produced a statement of purpose and a service users guide that outline the aims and objectives of the home, and its services and facilities and which has been recently reviewed and updated. This information is provided to all prospective service users and includes information of how service users can make complaints or complimentary comments about the service including how to contact the CSCI. Prospective service users are assessed using a ‘needs led’ assessment that is carried out with the full involvement of the service user and their family/carer. On Occasion emergency admissions occur but only on the basis that the proposed service user has had a full assessment and that they have suffered from a deterioration of their mental health. In respect of planned admissions prospective service users are actively encouraged to visit the home prior to their admission and many do take that opportunity when possible. Service users spoken to on the day of inspection were of the view that they were appropriately supported and consulted regarding their admission. The Respite House DS0000063473.V258275.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): 6,7,8,9,10. Service users are enabled to retain as much independence as possible and maintain their ability to make personal choices and decisions. EVIDENCE: The fact that the home is of a very ‘domestic’ nature and accommodates a total of only 5 service users who are supported by very experienced staff enable service users to maintain their individuality and retain personal control over their lives. Service users spoken to commented very positively regarding being able to participate in all aspects of life in the home particularly in respect of the activities of daily life for example when they get up, go to bed, what they choose to eat, and what activities they choose to participate in. Individual care plans are developed for each service user and are initially bases on the admissions assessment referred to earlier in this report. Care plans identify how service users needs are to be met and it was evident from inspecting care records and talking to service users and staff that service users are actively involved in care plan and risk assessment development and review. Maintenance of service users privacy and confidentiality is a key aspect of the work done at the home. All records relating to service users were stored securely. The Respite House DS0000063473.V258275.R01.S.doc Version 5.0 Page 10 The Respite House DS0000063473.V258275.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,15,16,17. Service users are enabled to maintain and develop personal and family relationships whilst at the home within an environment that seeks to provide the serviced user with a supportive environment that gives them ‘respite’. EVIDENCE: By adopting a very individual approach to the needs of each service user the ability of service users to engage with their family, friends, or the local community can be developed in a way that is appropriate for them. The fact that each service user has a key worker enables such an individual approach to be adopted. Discussions with service users and staff and inspection of care records revealed that such strategies are service user centred and are designed to meet their needs and not the needs of the service. The aim is to maximise service users return to their homes and life when they are ready and not to have become ‘de-skilled’ during their stay at the home. There were no unreasonable restrictions to service users receiving visitors at the home – indeed visitors were at the home on the morning of the inspection. Service users spoken to reported positively in respect of the meals provided for them and stated that they were given a wide and reasonable choice, that the The Respite House DS0000063473.V258275.R01.S.doc Version 5.0 Page 12 amounts provided were adequate, that the food was good and that they could always get something to eat or drink. Staff record of meals taken by service users to monitor that a balanced diet is being taken. . The Respite House DS0000063473.V258275.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20. Service users are enabled to receive good quality physical and mental health care whilst at the home. EVIDENCE: Discussion with service users and staff plus inspection of care records revealed that service users were being supported and enabled to access medical (including psychiatric support), nursing and other health and social care services that their individual needs require. Service users are enabled to retain, administer and control their own medication on a ‘risk assessed’ basis. The arrangements for service users medication were secure and appropriately documented. The Respite House DS0000063473.V258275.R01.S.doc Version 5.0 Page 14 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): 22,23. 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 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 wish. Service users felt comfortable and confident enough to raise a complaint if they felt it necessary to do so. They also stated that when any every day concerns were raised these were addressed promptly by the manager and staff. Inspection of policies and procedures operated at the home, discussion with staff and inspection of staff training records indicated that staff were aware of the importance of protecting service users from potential abuse and how to communicate any concerns they may have in this area. The Respite House DS0000063473.V258275.R01.S.doc Version 5.0 Page 15 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): 24,25,26,27,28,29,30. The home is registered to provide accommodation for up to 5 service users. Whilst the home was clean and provided a comfortable environment for residents it is due for redecoration/refurbishment. The inspector was informed that this has been planned in detail and was due to be shortly addressed. EVIDENCE: The home provides a homely and comfortable environment for service users. Two communal lounge/dining areas are provided (one is a designated smoking area for service users), a fitted and appropriately equipped kitchen, a bathroom and shower room, and adequate WC facilities. Bedroom facilities were clean, warm and appropriately furnished. 1 new bedroom has been adapted from a room on the ground floor that was used as a meeting/craft room (since the home was registered) into a bedroom suitable for a disabled service user. This room has also been fitted with an en-suite shower and WC. The inspector was informed that this room still required some modifications to be made before it was suitable for use. Also the introduction of this room will give total of 6 service users that can be accommodated. The inspector understands that an application to vary the home’s registration is being submitted to the CSCI to enable 6 service users to be accommodated. The home was very clean and hygienic throughout. The Respite House DS0000063473.V258275.R01.S.doc Version 5.0 Page 16 It was evident during the tour of the premises that there were decorating, furnishing and floor covering issues but that these were to be addressed in the programme of redecoration/refurbishment referred to above. The Respite House DS0000063473.V258275.R01.S.doc Version 5.0 Page 17 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): 31,32,33,35,36. The home is staffed appropriately by a staff 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 for a respite period. EVIDENCE: The staff team have a clearly defined structure that clarifies roles and responsibilities. This is clearly reflected in the service user information pack provided to all service users. Adequate and appropriate staff are provided both day and night and staff are appropriately managed and supervised informally on a daily basis and regularly on a formal basis. Discussion with staff 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 were of the view that they were well supported in accessing training. CSCI inspectors occasionally inspect staff personnel files that are held at a central location by the local authority – these were found to be satisfactory on the last inspection. The Respite House DS0000063473.V258275.R01.S.doc Version 5.0 Page 18 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): 37,39,42. The home is being, effectively and efficiently managed by the registered manager. This is important for 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 is currently near the completion of an NVQ4 qualification. Discussion with service users and staff employed at the home indicates that the registered manager adopts a management approach that is open, supportive, positive and inclusive. 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 a 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 The Respite House DS0000063473.V258275.R01.S.doc Version 5.0 Page 19 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 Respite House DS0000063473.V258275.R01.S.doc Version 5.0 Page 20 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 3 3 3 X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 2 3 2 2 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 X 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Respite House Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 3 x DS0000063473.V258275.R01.S.doc Version 5.0 Page 21 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 YA28YA26 Regulation 16, 23. Requirement That a written action plan detailing the planned/completed programme of redecoration/refurbishment of the home (including time scales) is submitted to the CSCI. That the CSCI is informed in writing that the modifications to the ground floor bedroom for disabled service users have been completed. That the CSCI is informed in writing what actions have been taken following the fire safety inspection conducted in December 2005. Timescale for action 31/05/06 2 YA29 23. 31/05/06 3 YA42 12, 23. 31/05/06 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.V258275.R01.S.doc Version 5.0 Page 22 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: 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 The Respite House DS0000063473.V258275.R01.S.doc Version 5.0 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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