Inspection on 07/11/05 for Third Row 19

This inspection was carried out on 7th November 2005.

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 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Third Row 19 28/06/07

Third Row 19 09/05/06

Third Row 19 27/01/06

Third Row 19 19/03/05

Third Row 19 19/01/05

Third Row 19 16/03/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 Third Row 19 19 Third Row Linton Morpeth Northumberland NE61 5SB Lead Inspector Carole McKay Unannounced Inspection 7th November 2005 15:30 DS0000035930.V255896.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 DS0000035930.V255896.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. DS0000035930.V255896.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Third Row 19 Address 19 Third Row Linton Morpeth Northumberland NE61 5SB 01670 862893 01670 862342 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) Mr John Thomas Cole Mrs Delia Cole Mrs Lynn Walton Care Home 2 Category(ies) of Learning disability (2) registration, with number of places DS0000035930.V255896.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th March 2005 Brief Description of the Service: Linton is a small village situated in a rural ex coal mining area of Northumberland. The village is a small close-knit community comprising of rows of attractive terrace houses. The village has a small shop, which is run by the local community as a co-operative, and a local pub. 19 Third Row is a small terraced house with a garden to the front and a rear yard. The nature of the service is not obvious from the outside. The home blends totally with neighbouring properties. The small staff team are drawn from the village and other communities nearby, so car parking is not a problem. This is one of three small homes in the village, all owned by Mr.John Cole and Mrs Delia Cole. Lynn Walton manages it, with six regular carers as support. The service is home to one young man and is also the base for providing day care to a small number of clients. This is an unusual arrangement, which has been accepted by the Commission for Social Care Inspection because the person using the service was previously a user of the day care service and went on to use the service for one overnight stay per week, before becoming a resident at the home. DS0000035930.V255896.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This service has developed from the needs of one individual. The inspection took place in the late afternoon. The clients who use the house as a base for day care left shortly after the Inspector arrived. The Inspector spent time with the person who lives at the home, the member of staff on duty that evening and with two of the day care staff. During the inspection the member of staff on duty for that evening had to leave to attend to an emergency appointment with a service user from another service. The day care staff stayed on into the evening to support the person living at the home. The day care staff through attending the day care activities they organise knows this person. The Inspector also looked at the care records kept in the home and was shown around the home. What the service does well: What has improved since the last inspection? The house has been altered to suit the needs of the service user. The service user has settled well into his new home and the local community. The service user has developed his communication skills and has enjoyed breaks away from the home. DS0000035930.V255896.R01.S.doc Version 5.0 Page 6 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. DS0000035930.V255896.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 DS0000035930.V255896.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): 2,5 The needs of the person living at the home had been assessed. An individual contract was in place. EVIDENCE: The care record includes a Care Manager’s assessment of the care needs of the person living at the service. A re assessment of the service user’s needs was carried out when the client became a permanent resident. The assessment does not show whether the service user can consent to treatment. DS0000035930.V255896.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 The service responds well to individual needs of the service user. Goals have been identified from the knowledge staff have of the service user. It is not clear from the records how the staff will support the person living at the service to communicate his wishes and to make decisions. EVIDENCE: Day care staff demonstrate a strong commitment to their relationship with the service user. The service user has responded happily to moving from the family home to living at 19 Third Row. The records do not show how the service user can control or influence the service he receives. There are no arrangements in place for the service user to have an independent advocate. DS0000035930.V255896.R01.S.doc Version 5.0 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 the following standard(s): 11,13,15 The service identifies personal development needs and identifies actions for some of these needs. Links with family and friends are supported. EVIDENCE: The record includes a brief action plan for social integration and maintaining family links. Staff are able to describe how the action plan works to the benefit of the service user. Staff can describe how the service user’s communication has developed previously. The record does not describe how the service user will be supported to develop his communication in the future. DS0000035930.V255896.R01.S.doc Version 5.0 Page 11 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 The physical and emotional health needs of the service user are identified. The service does not clearly state how needs will be met. The procedures for administering medication do not fully protect staff and service users. EVIDENCE: The care record includes an assessment of the service user’s needs and describes areas for development. The staff can describe the service user’s needs and show that they understand how he communicates. The record identifies that the service user is unable to communicate verbally. The record does not include a plan for developing communication with the service user. The record shows that non-prescribed medication is administered to the service user. There is no plan of care for administering non-prescribed medication. There is no recorded evidence that the service users can consent to treatment. The Registered person said that a referral for speech therapy had not been made. DS0000035930.V255896.R01.S.doc Version 5.0 Page 12 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): These standards were not assessed at this inspection EVIDENCE: DS0000035930.V255896.R01.S.doc Version 5.0 Page 13 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): 24,25,27,28,30 The premises are being altered and decorated to provide the most suitable arrangements for the person living there. EVIDENCE: The Inspector saw that work to improve the home was almost completed. An upstairs toilet is installed and the re decoration is underway. The home is warm, clean and comfortable. The person living at the service shares the ground floor facilities with a small group of people who come to the home for day care on three days of the week. The service user has known these people for several years. The service user appears to be very comfortable with this arrangement, however he is unable to communicate his views about this verbally. DS0000035930.V255896.R01.S.doc Version 5.0 Page 14 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): 35 From the partial assessment of standard 35, it is considered that staff are not trained to meet the developing needs of the service user. EVIDENCE: These standards were not fully assessed at this inspection. However specialist training in communication techniques for staff was discussed with the Registered Person. Day care staff said that the person living at the service was attempting more verbal and non-verbal communication. Staff are very enthusiastic about encouraging and supporting this. Non-verbal communication techniques, such as makaton had not been attempted. DS0000035930.V255896.R01.S.doc Version 5.0 Page 15 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): 41,42 The health, safety and welfare of service users are protected through comprehensive procedures. Medication procedures need to be improved. EVIDENCE: The Inspector saw a comprehensive procedures manual in a neighbouring service. The manager of the service said that the procedures were common to all three services owned by the Registered Person. The medication procedure does not describe what is the locally agreed list of homely remedies. The records included a record of NYTOL, a homely remedy for sleeping, being administered to the person living at the home. The person living at the home may not be able to give consent to treatment. The procedure does not describe what staff should do where service users cannot give consent to treatment. DS0000035930.V255896.R01.S.doc Version 5.0 Page 16 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 X 3 Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 2 2 X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 X 3 3 X 3 LIFESTYLES Standard No Score 11 2 12 X 13 3 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X X X X 2 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X Standard No 37 38 39 40 41 42 43 Score X X X X 2 3 X DS0000035930.V255896.R01.S.doc Version 5.0 Page 17 none 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 Standard YA8YA7YA6 YA18YA11 Regulation 12(2) 15(1) 14(1) Requirement The service user plan must show how the service user will be consulted about his care. The service user plan must include; • The plan for developing the service users’ communication skills • An assessment of the service user’s ability to consent to treatment • Arrangements for consent to treatment, to include homely remedies The registered manager must revise the medication procedures to include the arrangements for consent to treatment and the agreed list of homely remedies. The registered manager must ensure that the advice of a speech therapist is taken. The registered manager must arrange for staff to receive training in the use of non- verbal communication systems. Timescale for action 31/01/06 31/01/06 3 YA42YA20 13(2) 31/12/05 4 5 YA19 YA35 13(1)(b) 18(1)©(i) 31/03/06 31/03/06 DS0000035930.V255896.R01.S.doc Version 5.0 Page 18 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 YA7 Good Practice Recommendations The registered manager should look for an independent advocate for the service user. DS0000035930.V255896.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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. 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