Inspection on 14/11/07 for The Yellow House

This inspection was carried out on 14th November 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Yellow House 05/11/09

The Yellow House 19/01/06

The Yellow House 12/08/05

The Yellow House 11/01/05

The Yellow House 04/08/04

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Insight - Eastchurch

Southfields

Thorndene

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

CARE HOME ADULTS 18-65 The Yellow House 154 - 158 Sackville Road Hove East Sussex BN3 7AG Lead Inspector Merle Blakeley Unannounced Inspection 14th November 2007 09:30 The Yellow House DS0000014257.V345608.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 Yellow House DS0000014257.V345608.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 Yellow House DS0000014257.V345608.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Yellow House Address 154 - 158 Sackville Road Hove East Sussex BN3 7AG 01273 727211 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) Mrs Gwen Wells-Brown Donna Hunt Care Home 15 Category(ies) of Learning disability (15) registration, with number of places The Yellow House DS0000014257.V345608.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The maximum number of service users to be accommodated is fifteen (15). Service Users must be aged between eighteen (18) and sixty-five (65) years on admission. Service users only with a learning disability may only be admitted, not falling within any other category e.g. physical disability That one service user who was over the age of sixty-five (65) years of age on admission may be accommodated. 3rd August 2006 Date of last inspection Brief Description of the Service: The Yellow House is a privately owned care home that is registered to provide care and support for up to fifteen 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 three semi-detached houses, which have been converted for there current use. Accommodation is provided over two floors and includes fifteen single rooms some of which have en suite facilities. The home is close to local transport and communal facilities. The fees range from £460.00 to £630.00 per week. Additional charges are payable for hairdressing and chiropody services. The Yellow House DS0000014257.V345608.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over a period of four hours on November 14th 2007. As well as this site visit information was also gained from a returned Annual Quality Assurance Assessment (AQAA), the homes Inspection Record and feedback from a visiting professional. The site visit consisted of a tour of the premises, looking at the particular needs of three people, document reading and observation of staff interacting with residents. During the day the inspector was able to talk to three residents, two staff, the manager and the proprietor. What the service does well: What has improved since the last inspection? Two requirements were made during the last inspection and the home is ensuring that all staff have updated their core skills training in food hygiene, manual handling and safeguarding adults. Some of the staff still need to attend infection control training. The second requirement was for the home to ensure that all staff recruitment files contained the required information. The manager has set up new staffing files and these are now well organised and contain all the correct documentation. It was recommended that risk assessments cover a broader range of risks that people may encounter in their everyday lives. The manager has carried these out and has also produced a specific risk assessment file. The manager has also updated the care plan format to make it more user friendly and easier to find relevant information quickly. The Yellow House DS0000014257.V345608.R01.S.doc Version 5.2 Page 6 Since the last inspection the kitchen has been totally refurbished, some people’s bedrooms have been redecorated in the colours of their choice and the building exterior has been repainted. 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 Yellow House DS0000014257.V345608.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 Yellow House DS0000014257.V345608.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. The home carries out a thorough assessment of a person’s needs prior to them moving into the home. EVIDENCE: Two people have moved into the home since the last inspection and their assessments were viewed. The records showed that the home had carried out a thorough assessment of each person’s needs before they moved into the home. The manager also visited parents to obtain further information and viewed one person’s college care plans to ascertain her current needs. The manager also liaised with other care professionals. Both people had the opportunity to come to the home for several visits and overnight stays. The Yellow House DS0000014257.V345608.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 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The new care plan format is comprehensive and easier to understand. People are able to make informed choices. Risk assessments now cover all areas of people’s daily lives. EVIDENCE: Four care plans were viewed and the information they contained was comprehensive and easy to understand. The manager stated that she had recently updated the care planning format, to make it more user-friendly and ‘straight to the point’. The care plans also showed that they are being reviewed six-monthly or more frequently if needed. Relatives and friends are encouraged to provide input into people’s person centred plans. Three residents were spoken to during the visit and they were asked as to whether they felt they could make choices and decisions about their daily lives. They said they were able to go out when they want, they choose the clothes The Yellow House DS0000014257.V345608.R01.S.doc Version 5.2 Page 10 they wear, who they see and where they go and what they do during the day and evening. There was evidence to show that people were being supported to take informed risks in their lives. During the last inspection the home was requested to ensure that risk assessments covered all areas of people’s lives not just the health and safety aspects. The manager has produced a specific risk assessment file, which contains the details of all the assessments that have been undertaken on people. The manager stated that these are kept under review. The Yellow House DS0000014257.V345608.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, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are provided with the opportunities and support to take part in a lifestyle that suits their needs and capabilities. EVIDENCE: Most residents attend local day centres, college courses and clubs throughout the week. The home also offers people a selection of various activities such as quizzes, shopping, cooking art, day trips and meals out. Four people went on holiday to Spain this year. Everyone is out and about in the local community on a daily basis. Maintaining relationships with family and friends is encouraged and supported and some residents regularly visit their family and will stay over for the weekend. Family and friends are invited to the home for meals and other activities. The home tries to ensure that at Christmas time all the families are invited to join in with the celebrations plus five of the residents will be staying with their families for Christmas. The Yellow House DS0000014257.V345608.R01.S.doc Version 5.2 Page 12 There was evidence to show that people have their rights and responsibilities respected by the home. One person wishes to be totally responsible for her own healthcare and she is able to make her own appointments and administer her own medication. People who were spoken to during the day said that they had their freedom and could make their ‘own decisions about things that mattered’. Residents had been choosing their own meals but the manager stated that their choices were very unhealthy and concerns were raised about the quality of the food that was being eaten. People just wanted to eat very high fat foods without including any fresh vegetables or fruit in their diets. The staff have now become more involved with the choice of meals that are eaten and residents now make suggestions. The home is trying to ensure that people receive a well-balanced and varied diet, whilst still including some of the high fat foods that people continue to want to eat. The Yellow House DS0000014257.V345608.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 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff support people to carry out their own personal care. The current healthcare needs of people are being met and medication is being appropriately administered. EVIDENCE: The people who live in The Yellow House are all fairly independent and they are able to carry out their own personal care. Three people need some support with their washing and dressing. One person is very independent and is completely responsible for all her own care. People have access to their own doctors and other specialist services such as dentists, chiropodists, optician etc. One person was due to go in for a small operation this year after she decided she wanted to go ahead with it, however she was able to change her mind and is now not going into hospital. The manager stated it was the resident’s choice, which everyone respected. The operation was only minor and the person would not suffer unnecessarily as a result of not having the operation carried out. The Yellow House DS0000014257.V345608.R01.S.doc Version 5.2 Page 14 Medication records were checked and they were found to be in order. Medication is securely stored within the home. The Yellow House DS0000014257.V345608.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 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home needs to ensure that the complaints procedure is produced in an easy read format. The home has produced a safeguarding adults policy and procedure. EVIDENCE: The home has provided each person with the complaints procedure. It would be recommended that this document be also provided in an easy to read format. There have no complaints made. The home has a policy and procedure regarding the protection of vulnerable adults. There have been no adult protection referrals. All the staff have recently updated their training in safeguarding adults. The home looks after people’s finances and two of these were checked and they were found to be in order. The Yellow House DS0000014257.V345608.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 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The homes environment is homely and comfortable. The home is kept very clean and tidy. EVIDENCE: The Yellow House has a friendly and relaxed environment and all residents have their own bedrooms. Most of the rooms have en suite facilities and some include either baths or showers. All the rooms have been individualised to reflect each person’s tastes and preferences. Since the last inspection the kitchen has been completely refurbished and the exterior of the home repainted. Some people’s bedrooms had also been redecorated. The property was found to be very clean and tidy. The Yellow House DS0000014257.V345608.R01.S.doc Version 5.2 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. 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. Most of the staff have obtained NVQ qualifications. The home carries out suitable recruitment practises and staff are now up-to-date with core skills training. EVIDENCE: The Yellow House has a very stable, caring and committed staff team who have worked in the home for a number of years. This has enabled people to receive consistent care and build caring relationships with the staff. The home has a team of nine staff, six of whom have obtained an NVQ qualification. People who were spoken to on the day stated that they got on well with the staff and liked them. Several staff recruitment files were viewed and they were found to contain all the required information such as a CRB check, two references and proof of identity. Training staff that have attended this year includes safeguarding adults, manual handling, first aid, and basic food hygiene and fire protection. It was also recommended that some staff attend training in infection control. Several The Yellow House DS0000014257.V345608.R01.S.doc Version 5.2 Page 18 staff were spoken to during the visit and they said they continued to be happy working in The Yellow House. They all get on very well together as a team and spend time with each other socially. They also felt that the home was being managed in a very caring and friendly manner and both the manager and proprietor were very supportive. The Yellow House DS0000014257.V345608.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 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager runs the home in a relaxed and friendly manner. The home has a quality assurance programme in place. The home tries to ensure that the health and safety of both residents and staff is protected at all times. EVIDENCE: The manager has obtained the Registered Managers Award (RMA) and she is running the home in a friendly, caring and relaxed manner. Both residents and staff felt the manager was very approachable and they could always go to her if they had any issues or concerns. The home has produced a quality assurance system and satisfaction surveys had been carried out in May 2007 with residents, relatives and friends, visiting professionals and stakeholders. The manager also stated that the home has The Yellow House DS0000014257.V345608.R01.S.doc Version 5.2 Page 20 received positive verbal feedback about the service it provides. House meetings are held regularly and staff meeting two monthly. The proprietor comes into the home everyday and the inspector was able to have an informal chat with her. The proprietor stated that she continues to be very much involved with the home and she knows exactly what is happening on a daily basis, as she spends time talking to the residents and staff. A health and safety check was carried out and there were no immediate concerns. A fire risk assessment is due to be carried out this month. Staff have attended fire training and fire drills are carried out regularly. Hot water temperatures are checked monthly and the fire alarms and emergency lighting are checked weekly. There was one door that required an automatic closure and the manager stated that she would see to this immediately. The Yellow House DS0000014257.V345608.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 X 26 X 27 X 28 X 29 X 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 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X The Yellow House DS0000014257.V345608.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. Standard Regulation Requirement Timescale for action 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. Refer to Standard YA22 YA35 Good Practice Recommendations That the homes complaints policy and procedure is produced in an easy read format for service users. That some of the staff team attend a training course in infection control. 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