CARE HOME ADULTS 18-65
The Yellow House 156/158 Sackville Road Hove East Sussex BN3 7AG Lead Inspector
Merle Blakeley Announced 12th August 2005 10:00 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 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 Stationary 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 Yellow House H59-H10 S14257 Yellow House V230836 120805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service The Yellow House Address 156/158 Sackville Road Hove East Sussex BN3 7AG 01273 727211 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Gwen Wells-Brown Miss Donna Hunt Care Home 12 Category(ies) of Learning Disability (LD), 12 registration, with number of places The Yellow House H59-H10 S14257 Yellow House V230836 120805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The number of people accommodated must not exceed twelve (12) 2. The people accommodated will be aged between 18 and 65 years on admission Date of last inspection 11 January 2005 Brief Description of the Service: The Yellow House is a privately owned small care home that is registered to provide care and support for up to ten adults aged between 18 to 65 years who have learning disabilities. The home is run as a family type home. The home is comprised of two semi-detached houses, which have been converted for there current use. Accommodation is provided over two floors and includes ten single rooms. The home no longer has shared rooms. There are five bedrooms located on the ground floor and these are more suited to people who may have some mobility problems. Communal areas within the home include the dining room, lounge, quiet room and outside patio. The home is close to local transport, shops and other amenities. The proprietor has recently purchased an adjoining property and later this year it will be converted to provide an additional five single rooms with en suite facilities. Additional communal spaces will also become available once the building work has been completed. The Yellow House H59-H10 S14257 Yellow House V230836 120805 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This Announced Inspection was carried out over a period of five and a half hours on 12th August 2005. The inspection process included a completed preinspection questionnaire, returned comment cards from two residents and three relatives/visitors, informal talks with two residents (the majority of residents were out at their day care centres during the inspection), document reading, a tour of the premises and informal talks with staff and the proprietor. The next inspection will be carried out at a later time in the day to ensure that more resident’s views are obtained. What the service does well: What has improved since the last inspection? What they could do better:
The home carries out person-centred care planning, which provides a very comprehensive record of residents assessed needs, however reviews for all of the residents were not evident on the day. Reviews must be carried out regularly and they must also be dated, even if there are no significant changes made. The medication charts must accurately record when medicines are actually administered to residents, as on the day a certain residents medication chart stated that a particular medicine was to be given at 22.00 hours, however staff were administering it at 17.00 hours, as this was the residents wishes.
The Yellow House H59-H10 S14257 Yellow House V230836 120805 Stage 4.doc Version 1.40 Page 6 This procedure must be clarified by the resident’s doctor and clearly documented on the medication sheet. The home has produced a Quality Assurance System and part of this system involves receiving feedback from residents, relatives and visiting professionals about how the home is performing. This type of survey needs to be carried out at least twice a year. The survey questions also need to be expanded and reviewed, as they were seen to be rather limited. An action plan was received from the home prior to the report being published. 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 Yellow House H59-H10 S14257 Yellow House V230836 120805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection The Yellow House H59-H10 S14257 Yellow House V230836 120805 Stage 4.doc Version 1.40 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 standard(s) 2 & 4 The home carries out assessments on all new residents. Prospective residents are encouraged to visit the home prior to moving in. EVIDENCE: The Registered Manager and/or Proprietor will normally carry out a preassessment interview with the prospective resident to ascertain as to whether the home can meet their needs. Residents are often referred to the home by a social worker and they will often accompany the resident to make a visit. Family members are also invited to attend where possible. After the first initial visit prospective residents are invited back to share an evening meal and meet with the other residents. Weekend stays are also offered. The home feels that new residents need to make as many visits as possible so that they can get a feel of the home and how it is run. The Yellow House H59-H10 S14257 Yellow House V230836 120805 Stage 4.doc Version 1.40 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 standard(s) 6, 8 & 10 Care plan reviews/updates were not evident for all residents. Residents are encouraged to participate in the home. Confidential and sensitive information is securely stored within the home. EVIDENCE: The home carries out person centred planning, which provides very detailed information about each resident. Random care plans were viewed and although it appears that the home is carrying out reviews on residents it was unclear as to when these reviews are being held, as there were no dates recorded on the documents. Residents are encouraged to participate in the home as much as possible by attending regular house meetings, as this is their opportunity to discuss any issues, concerns or requests. Where possible residents are supported to discuss their feelings and to decide on certain activities within the home. Recently the residents decided that they would like to have a dog and a small terrier type dog was introduced to the home. Residents are very happy having the dog living in the home and some of them participate in her daily care. All confidential information is stored in lockable filing cabinets in the dining room. The Yellow House H59-H10 S14257 Yellow House V230836 120805 Stage 4.doc Version 1.40 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 standard(s) 11, 14, & 15 Residents are supported to develop their independent life skills. All of the residents take part in social activities. Maintaining family links is strongly encouraged. EVIDENCE: All but one of the residents attends a day centre during the week. One resident attends another type of centre for regular pottery classes. Several of the residents are quite independent and are out and about in the community on their own either shopping, attending appointments or visiting family and friends. Others need some encouragement and support from staff to become more independent both inside and outside of the home. One of the residents was spoken to during the inspection and she stated that she was able to be as independent as possible but she knew that the staff were there to give her support if she needed it. Most of the residents are out and about in the community on a daily basis and some attend various clubs etc in the evenings. Trips are organised to local swimming pools, bowling centres and pubs. Residents are always offered holidays during the year and recently a small group and several members of staff went on a week’s holiday to Croatia.
The Yellow House H59-H10 S14257 Yellow House V230836 120805 Stage 4.doc Version 1.40 Page 11 In the past holidays have also been taken to the homes special holiday house in Spain. Residents are encouraged and supported to maintain their links with family and friends. Several of the residents go home at weekends and others make visits to see relatives during the week. Other residents who have family living out of the area are able to make regular visits to see them during the year. The Yellow House H59-H10 S14257 Yellow House V230836 120805 Stage 4.doc Version 1.40 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 standard(s) 18 & 20 Six residents need help with personal care. Medication sheets need to accurately record when medication is administered. EVIDENCE: Most of the residents need some prompting with their personal care and six residents need physical help and support from staff with washing and bathing. Some residents only require help getting in and out of the bath and will call staff when they need them. The Proprietor stated that all personal care for residents is carried out in private with their dignity is maintained at all times. A number of medication records were viewed and it was noted that one resident’s records were incorrect. The time this person is requesting a certain medication is not being accurately reflected in the records and the home must ensure that the time the medication is given corresponds with the time the medication is signed for. The home must also receive clarification from the resident’s GP that it is suitable for the medication to be given earlier than stated. The Yellow House H59-H10 S14257 Yellow House V230836 120805 Stage 4.doc Version 1.40 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 standard(s) 23 The home has an Adult Protection Policy and Procedure, which includes whistle blowing. EVIDENCE: The home has produced a policy and procedure regarding adult abuse and this contains information about whistle blowing. Staff have received training in the protection of vulnerable adults. The Yellow House H59-H10 S14257 Yellow House V230836 120805 Stage 4.doc Version 1.40 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 standard(s) 25, 28 & 30 Residents have the use of single rooms. The home provides adequate communal areas. The home is clean and hygienic. EVIDENCE: All residents now have the use of single rooms. Originally the home provided two shared rooms but it was decided that sharing did not necessarily benefit some of the residents. There are two large bedrooms on the ground floor with the remainder of the bedrooms on the first floor. Rooms are nicely decorated and homely and reflect each resident’s personality. Residents are able to choose the decoration and furnishings of their rooms. One of the bedrooms on the ground floor is suitable for a wheelchair user. Communal areas within the home include a lounge room, dining room, small quiet lounge and an outside patio area. Communal space for residents will increase in the future when the recently purchased property next door is converted. There will be an additional five en suite rooms with a lounge, kitchen and large outdoor area, which all residents will have use of. The home was found to be well maintained and very clean and tidy. The Yellow House H59-H10 S14257 Yellow House V230836 120805 Stage 4.doc Version 1.40 Page 15 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 34 & 35 Several staff have completed their training in the National Vocational Qualification (NVQ) Level 2. The home carries out suitable recruitment practices. Staff receive adequate training opportunities. EVIDENCE: Of the seven staff members, two have completed their NVQ Level 2 training and another three staff are currently part-way through the course and due to complete it in eight to ten months time. The staff team are friendly and caring and work well together and they appeared knowledgeable about resident’s care and welfare. The home has a stable staff team who have been working together for some time now and staff that were spoken to on the day stated that they enjoyed working in the home. The home carries out suitable recruitment practices and a number of random files were checked. Staffing files contained all the required documentation as set out in Schedule 2 of the National Minimum Standards and CRB’s, proof of identity, recent photos and references were viewed. Staff receive core standards training, which has included manual handling, medication training, fire training, food hygiene and first aid. The Yellow House H59-H10 S14257 Yellow House V230836 120805 Stage 4.doc Version 1.40 Page 16 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39, 41 & 42 Resident surveys need to be carried out more frequently. The home maintains all the required records. There were no issues raised during the inspection regarding the health & safety of residents and staff. EVIDENCE: Residents meetings are held several times a year and recorded. At these meetings residents are able to discuss any issues, concerns or requests they may have. The home has produced satisfaction survey forms for residents to complete but the information requested is somewhat limited. Feedback forms need to contain a broader scope of questions about what it is like to live in the home and what could be improved; these forms also need to go out to relatives/friends and visiting professionals, so that they home can gain a better perspective of how they are performing. The home is correctly maintaining the required records. A tour of the premises was carried out and no health and safety issues were identified at this time. The home now has a ‘family dog’ and staff need to ensure that residents are supported and made aware of how to maintain their health & safety when caring and playing with her.
The Yellow House H59-H10 S14257 Yellow House V230836 120805 Stage 4.doc Version 1.40 Page 17 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 x Standard No 22 23
ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 2 x 3 x 3
Score Standard No 24 25 26 27 28 29 30
STAFFING Score x 3 x x 3 x 3 Standard No 11 12 13 14 15 16 17 3 x 3 3 3 x x Standard No 31 32 33 34 35 36 Score x x 3 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
The Yellow House Score 3 x 2 x Standard No 37 38 39 40 41 42 43 Score x x 2 x 3 3 x H59-H10 S14257 Yellow House V230836 120805 Stage 4.doc Version 1.40 Page 18 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. 2. 3. Standard YA6 YA20 YA39 Regulation 14(2) 13(2) 24(1)(3) Requirement That service users care plan reviews are dated and signed on the day they are written. That all medications are accurately recorded. That the questions in the service user & representative survey forms are expanded and that these surveys are carried out at least twice a year. Timescale for action Immediate Immediate 30/11/05 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. Refer to Standard Good Practice Recommendations The Yellow House H59-H10 S14257 Yellow House V230836 120805 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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