Inspection on 06/08/07 for The Respite Unit

This inspection was carried out on 6th August 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Respite Unit 09/08/06

The Respite Unit 20/02/06

The Respite Unit 31/10/05

The Respite Unit 14/02/05

The Respite Unit 26/07/04

The Respite Unit 02/02/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Muston Road (70)

Grayling

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

CARE HOME ADULTS 18-65 The Respite Unit 82 Batley Road Alverthorpe Wakefield WF2 0AE Lead Inspector Elizabeth Hendry Key Unannounced Inspection 6th August 2007 08:00 The Respite Unit DS0000034498.V347978.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 Unit DS0000034498.V347978.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 Unit DS0000034498.V347978.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Respite Unit Address 82 Batley Road Alverthorpe Wakefield WF2 0AE 01924 303589 01924 303590 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) www.wakefield.gov.uk Wakefield MDC vacant post Care Home 6 Category(ies) of Learning disability (6) registration, with number of places The Respite Unit DS0000034498.V347978.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. To provide 6 respite care beds for adults with a learning disability. The maximum number of wheelchair users at any one time shall not exceed two. 9th August 2006 Date of last inspection Brief Description of the Service: The Respite Unit, Batley Road, is owned and managed by Wakefield Metropolitan District Council. The home offers accommodation for 6 adults with a Learning Disability (6 respite). A service has been provided by the home for a number of years with the home being part of a broader service providing respite care through the Adult Placement Team and the Local Authority’s Supported Living Scheme. The Respite Unit provides short-term break services to over twenty-five individuals and their families and has a committed and stable staff team. The aim of the Respite Unit is to provide short-term break services that meet the needs of adults with a learning disability. Generally, the short breaks offered range from an overnight stay up to one or two weeks. Occasionally, breaks may be a little longer, depending on the individual needs of the service user and their family. The home is in the heart of the local community with good access by local transport to Wakefield Town Centre. There are a number of local shops close by. Accommodation is on two floors with limited facilities for more physically dependent service users. The home is generally well kept and has an open and friendly atmosphere. The service provider ensures that information about the service is available to prospective service users and the current service users by way of the home’s Statement of Purpose, the Service User Guide and through CSCI inspection reports. The Respite Unit DS0000034498.V347978.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over the course of five hours on an unannounced basis. The acting manager was present throughout the inspection. The inspector met many of the service users currently on respite within the unit, prior to their attendance at local activity and day centres. Care plans and procedures within the home were examined. The Commission would like to take the opportunity to thank the service users, the acting manager and support workers for their hospitality and patient cooperation throughout the inspection. There was only one person using the service who was able to verbally communicate in the home throughout the full course of the visit. Although this person’s feedback was limited, it was positive, indicating that they were happy using the service and comfortable about the ways they were supported. The home does not currently have a registered manager. What the service does well: The service provides a comfortable, relaxed and informal environment for up to six service users. People who use the service are treated with respect and actively involved in the day to day running of the home and making decisions regarding their daily activities and care plans. The work of the staff and the systems operated at the home make sure that people only use the service once their care needs have been assessed and assurances have been given that those assessed needs can be appropriately met. Links with the community are good and this supports people to use community facilities, engage within the community and take part in social and educational opportunities. The current staffing numbers and skill mix of qualified/unqualified staff are appropriate to the assessed needs of the service users, the size, layout and purpose of the home. The Respite Unit DS0000034498.V347978.R01.S.doc Version 5.2 Page 6 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 be made available in other formats on request. The Respite Unit DS0000034498.V347978.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 Unit DS0000034498.V347978.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 People who use this service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. People’s needs are fully assessed prior to admission so the individual and the home can be sure the placement is appropriate. EVIDENCE: A sample of resident care plans were viewed, of those seen all contained a pre admission assessment that clearly identified individual needs in areas such as personal, physical, emotional, social and educational care. The Acting Manager spoke of the admission process into the home. Social workers undertake an initial needs assessment and then make a referral to the home; once this referral has been received the application is then taken to a care management panel. The manager of the home is in attendance on this panel to assist in deciding on the most suitable placement. Once a placement has been agreed, the manager then conducts an additional assessment which will form the basis of the service user’s care plan. The Respite Unit DS0000034498.V347978.R01.S.doc Version 5.2 Page 9 This assessment also determines the individual’s suitability to the home against staff competencies and the suitability of the building. Pre admission assessment records examined confirmed this. The Respite Unit DS0000034498.V347978.R01.S.doc Version 5.2 Page 10 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,and 9 People who use this service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. Health and personal care practices are good, people who stay in the home know that their personal care needs and aspirations are met and reflected within their individual care plans. EVIDENCE: Four service user care plans were evidenced, all were found to contain detailed information about support and healthcare needs. The plans have a straightforward approach, concentrating on aspects of daily living. Restrictions are only placed on the residents following risk assessment. Two members of staff were spoken with during the inspection, all showed that they have a good understanding of the support and care needs of the people who use the service. Observations made during the visit to the home identified that staff have a good working relationship with people within the home. The Respite Unit DS0000034498.V347978.R01.S.doc Version 5.2 Page 11 One member of staff spoken with confirmed that they are responsible for supporting service users with their personal hygiene, daily living tasks and social activities. Throughout the course of the inspection, staff were observed working in partnership with individuals using the service, promoting independence, showing respect and maintaining their dignity. Staff said that they enable people using the service to take responsible risks, ensuring they have good information on which to base decisions. They added that risk is assessed prior to admission in discussion with the person and their family. Risk assessments viewed on the day of the inspection did not show evidence of six monthly reviews; all examined did not contain a signature of the member of staff conducting the risk assessment. Three risk assessments had no evidence of review since 2004. The Respite Unit DS0000034498.V347978.R01.S.doc Version 5.2 Page 12 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): 12,13,15,16 and 17 People who use this service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. People who use the service have access to a wide range of activities within the home and community. There are a number of opportunities to participate in stimulating and motivating activities. Meals and mealtimes are not rushed and offer full choices to all those using the service. EVIDENCE: During the inspection, people living in the home were observed getting ready to return to their families or take part in activities within the home. The acting manager spoke of the home encouraging those who use the service to maintain their interests undertaken prior to their stay at the respite unit. One individual spoken with said, “I like coming to stay here, it’s fun and I can play on the computer and help”. Staff were seen assisting this individual to The Respite Unit DS0000034498.V347978.R01.S.doc Version 5.2 Page 13 access the unit’s computer and support was provided in an appropriate manner that encouraged the individual to make their own decisions. Within the home, there is a wide variety of activities available, these include music, arts and crafts, watching television and DVDs, board games, table football, snooker and gardening. The acting manager spoke of people using the service choosing what to do with their free time and that, at any one time, each resident could be doing a completely different activity. Day trips to local attractions take place whenever possible, in particular during the summer months. Staff spoken to explained that the home does not have a set menu each day, people staying at the unit are able to choose what they would like for each meal and, where appropriate, are supported in preparing their meals. The acting manager said that, some days, each person could be eating something different. The food record book confirmed individual choices were adhered to. Food stocks indicated a wide variety of named and value food. A good stock of fresh fruit and vegetables was also present within the kitchen. Food preparation areas were found to be clean and tidy. Of the eleven staff training files viewed, five members of staff have attended basic food hygiene training. The acting manager confirmed that there is a mix of staff skills on each shift. The Respite Unit DS0000034498.V347978.R01.S.doc Version 5.2 Page 14 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 People who use this service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. The physical and emotional needs of people who use the service are met. Medication policies and procedures within the home are consistently followed, resulting in the safe administration of medication to those people who using the service. EVIDENCE: The acting manager confirmed that individuals are supported to maintain their health through GP checkups whenever necessary. The nature of the service is respite care so the majority of individuals’ healthcare needs are met through their long term permanent carers, however, in the event of their ill health during their stay, advice would be sought from their own GP. Upon re-admission into the unit, all of the individuals current healthcare needs are recorded within their individual care plans and all medication requirements are documented within the medication administration book. The Respite Unit DS0000034498.V347978.R01.S.doc Version 5.2 Page 15 Medication records were checked against drugs stored within the home and found to tally. The acting manager spoke of two members of staff working together to administer and double check all medication. Since the last inspection, all but one member of staff have attended medication training. The acting manager explained the process for accepting drugs into the home and returning the medication to the carers upon the departure of the service user. A list of staff signatures held within the medication record book was found to be current. The Respite Unit DS0000034498.V347978.R01.S.doc Version 5.2 Page 16 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 People who use this service experience adequate quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. Complaints management is effective, resulting in those that use the service being adequately safeguarded. People who use the service know that their views are listened to and acted upon. EVIDENCE: A complaints procedure was available to all staying within the home and this was included in the Service User Guide. One individual residing at the home confirmed that they felt safe, listened to, and able to speak to the staff and manager if they were not happy about anything to do with their care. The home’s complaints book was viewed and found to contain no complaints since the last inspection. The acting manager said that they worked hard to make sure any concerns are addressed immediately and action taken to rectify any problems. The home follows Wakefield Metropolitan District Council complaints and compliments policy. On the day of the visit to the home, access to staff recruitment files was not possible, therefore the inspector was unable to confirm that enhanced Criminal Records Bureau checks had been sought for all members of staff. However, the acting manager confirmed that a central recruitment department makes all The Respite Unit DS0000034498.V347978.R01.S.doc Version 5.2 Page 17 of the pre employment checks and new members of staff are only given a start date once all the necessary background checks have been made. Of the training records viewed for 11 staff, only five had attended safeguarding adults training. At the time of the inspection, no adult protection referrals had been made. The acting manager spoke knowledgeably of raising matters to the safeguarding team when issues are identified. The Respite Unit DS0000034498.V347978.R01.S.doc Version 5.2 Page 18 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 and 30 People who use this service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. The home provides those that use the service with a comfortable and homely environment in which to stay. EVIDENCE: A good standard of decoration and furnishing was found throughout the home. Fixtures and fittings were domestic in nature. To the front of the property, there is a large garden area with additional seating for the summer months. The acting manager of the home spoke of those coming into the home for respite being encouraged to bring personal items into the home to make their short stay more comfortable and to help personalise their bedrooms. All bedrooms were viewed with the kind permission of the service users and all were found to be clean, tidy and decorated in a manner that was age appropriate to the service user group. Some bedrooms were found to be in The Respite Unit DS0000034498.V347978.R01.S.doc Version 5.2 Page 19 need of general maintenance and repair. All areas were found to be clean and tidy, with infection control measures being appropriately followed. The ground floor bathroom was found to be not only used as the only bathroom but as a general store room. Discussions with the acting manager identified that this was because the home did not currently have any alternative storage facilities, however alternatives were being explored and hopefully be in place soon. It is strongly suggested that a review of storage arrangements is conducted in order to improve the environment in which people bathe and ensure the safety of staff when assisting people to bathe. The Respite Unit DS0000034498.V347978.R01.S.doc Version 5.2 Page 20 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 and 35 People who use this service experience adequate quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. People who use the service receive care from staff that have a caring disposition and are committed in providing quality care. However, many have not undertaken recent key training. EVIDENCE: Information provided on the day of the inspection identified that, at all times, adequate numbers of staff are on duty to ensure the needs of all those who use the service can be met. The acting manager spoke of staff working well as a team in spite of recently re-organising staff rotas to ensure that, at all times, the staff can flexibly meet the needs of all those staying at the unit. Fifty percent of staff working within the home holds an NVQ level 2 in Care. The Respite Unit DS0000034498.V347978.R01.S.doc Version 5.2 Page 21 Training records identified shortfalls in the following areas: moving and handling, fire safety, adult protection, and basic food hygiene. The acting manager confirmed that, at the time of the inspection, he was unsure how to access to the Council’s central recruitment files and, as a result, the inspector was unable to review staff files and confirm their contents. However, the acting manager confirmed that a central recruitment department makes all of the pre employment checks and new members of staff are only given a start date once all the necessary background checks have been made. The Respite Unit DS0000034498.V347978.R01.S.doc Version 5.2 Page 22 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 People who use this service experience adequate quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. The acting manager has a good idea of what needs to improve within the home and has begun to make improvements to ensure its smooth running. Systems in place for the consultation of individuals using the service are good, with evidence of service users’ views being sought. The health and safety of those that use the service are not consistently promoted and protected by the systems and procedures within the home. The Respite Unit DS0000034498.V347978.R01.S.doc Version 5.2 Page 23 EVIDENCE: The home does not currently have a permanent registered manager. The respite unit is currently being managed by an acting manager who has many years’ experience working with this service user group. The unit has been without a registered manager and, therefore, clear leadership, for a number of months and this should be addressed as a matter of urgency. Discussions held during the inspection identified that the acting manager is clear on what areas require improvement and that they are working through these issues with both staff and senior management. Wakefield Metropolitan District Council operates regular quality assurance checks within the unit to ensure service users receive a good quality service. The home confirmed that CSCI inspection reports are used to highlight areas that require improvement. Due to the nature of the service, service user meetings do not take place on a regular basis, however all service users are encouraged to make suggestions on ways in which the service can be improved. Fire safety records examined identified a shortfall in the home fire safety procedures. No fire drill had taken place within the home in the last twelve months and staff training records showed that eight members of staff had not had any fire safety training. On the day of the visit to the home, an immediate requirement was issued to address these issues and is reflected a the end of the report. Following the visit to the home, and the issue of the requirement letter, the acting manager and Responsible Individual acted promptly and confirmed that a full fire drill had taken place and would do so every six months; this would be in addition to the weekly fire alarm tests. Confirmation was also received that all staff undertake fire safety training as part of the induction process. Since the visit to the home, all staff have reviewed the home’s policies and procedures relating to fire safety. Fire safety equipment within the home was found to have recently been checked and all fire exits were clear. One member of staff spoken to on the day of the visit was fully aware of what to do in case of a fire. Training records identified a number of shortfalls in health and safety training, four members of staff required moving and handling training and seven had still not attended a basic food hygiene course, despite a requirement being issued at the last inspection. A tour of the home indicated that regular safety checks are made on electrical and gas appliances within the home. The Respite Unit DS0000034498.V347978.R01.S.doc Version 5.2 Page 24 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 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 1 X 3 X X 2 X The Respite Unit DS0000034498.V347978.R01.S.doc Version 5.2 Page 25 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 YA35 Regulation 23(4,ciii, e) Requirement Timescale for action 08/08/07 2. YA35 3. YA37 A fire drill must take place at regular intervals to ensure that those working in the home and, where practicable those using the service, are aware of the procedures to be followed in case of fire. Confirmation received 09/08/07 that this requirement had been met. 13(5)18(1,a,c,i) Staff should undertake key 23 (4) mandatory training and attend regular updates in all the following areas, in addition to those appropriate to the needs of the service user group: - Moving and handling - Adult Protection - Fire Safety. The acting manager should ensure that all training records are kept up to date. 9 A registered manager should be appointed and an application made to CSCI. 01/12/07 01/12/07 The Respite Unit DS0000034498.V347978.R01.S.doc Version 5.2 Page 26 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. Refer to Standard YA6 YA9 YA24 Good Practice Recommendations All care plans should be signed and dated by the person completing them, in addition to the person or their representative it relates to. All risk assessments should be reviewed at least every six months and be signed and dated. The home should review current storage arrangements to ensure the ground floor bathroom does not hold any equipment not required for the purposes of bathing. 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