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Inspection on 13/06/05 for Village The (8)

Also see our care home review for Village The (8) for more information

This inspection was carried out on 13th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

It provides a comfortable well furnished home with good staff and makes it a pleasant place to live.. The home is clearly run for the residents who were encouraged to make choices about their daily lives both in the home and for activities outside the home. This made them feel in control of their lives. The manager and staff team work together to provide an atmosphere where the residents needs can be met

What has improved since the last inspection?

The home has a more settled staff team so less agency staff are needed. Staff training is improving.

What the care home could do better:

Ensure that the protection of vulnerable adults procedure is reinforced to staff at regular intervals. All staff should have specialist communication skills training. Fire training for all staff. Involve staff and residents in the development of the homes policies and have them in a format suitable for the residents to understand. The environment could be improved.

CARE HOME ADULTS 18-65 8 The Village 8 The Village Haxby York YO32 3HT Lead Inspector Terry Downey Unannouced 13 June 2005 09:30 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. 8 The Village J53_J04_S15840_The Village_V229668_130605_Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Village The (8) Address 8 The Village, Haxby, York, YO32 3HT 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) 01904 750308 01904 750308 United Response Care Home 8 Category(ies) of Learning disability (8) registration, with number of places 8 The Village J53_J04_S15840_The Village_V229668_130605_Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 25th October 2004 Brief Description of the Service: 8, The Village is registered to provide residential, social, and personal care for six people with learning disabilities, under 65 years of age. The home consists of two properties, The Mews which has two service users who live semi independently with 24 hour support, and the main house which has four service users. The home is situated close to the centre of Haxby and provides good access to the local services and amenities. The service is part of the United Response organisation. There is no registered manager at present but Ms Wendy Green is acting manager and will be applying for registration. 8 The Village J53_J04_S15840_The Village_V229668_130605_Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out as part of the inspection process on 13th June 2005. At the time of the inspection Ms Cecily Watson was the officer in charge and assisted with the inspection until the acting manager Ms Wendy Green arrived. Both were very helpful and well organised. During the course of the inspection it was possible to speak to three residents and three members of staff. Communication with the residents was difficult so many of the findings are based on observation. The inspection also involved a check on the requirements and recommendations from the previous inspection, a tour of the premises and a check on the records kept by the home. The inspection took 9 hours which included preparation time. All the residents and some of the staff have been at the home for many years so know each other well and have established routines. The more settled staff team helps to overcome the communication difficulties and also provides re-assurance to the residents. The home was clean, well decorated and furnished, and there was a pleasant atmosphere. Some residents were in the home doing life skills training others were at day services. All the residents have individual programmes of activities and the staff are constantly looking for new opportunities to encourage and challenge them. The residents were happy in the home and were encouraged and supported to take control of their lives The inspection showed that the home was being organised and that the staff were aware of their duties, and the residents were well cared for. What the service does well: It provides a comfortable well furnished home with good staff and makes it a pleasant place to live.. The home is clearly run for the residents who were encouraged to make choices about their daily lives both in the home and for activities outside the home. This made them feel in control of their lives. 8 The Village J53_J04_S15840_The Village_V229668_130605_Stage 4.doc Version 1.30 Page 6 The manager and staff team work together to provide an atmosphere where the residents needs can be met 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. 8 The Village J53_J04_S15840_The Village_V229668_130605_Stage 4.doc Version 1.30 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 8 The Village J53_J04_S15840_The Village_V229668_130605_Stage 4.doc Version 1.30 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) 2,5. Residents know that if they choose to live in the home that they will be well cared for. EVIDENCE: Most of the residents have lived at 8 The Village for several years but assessments involving residents’ family / carers and other professionals were carried out prior to admission to ensure that the staff could meet their needs. All residents have an individual contract and reasonable steps have been taken to ensure that it is explained to them. This makes sure that they are aware of the terms and conditions of their stay in the home and that their needs can be met by the staff in the home 8 The Village J53_J04_S15840_The Village_V229668_130605_Stage 4.doc Version 1.30 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) 6,7,8,9. The residents health and personal care needs are met and they are encouraged and supported to make choices about their daily lives. This helps them to have control over their lives in the home EVIDENCE: Assessments and care plans are being upgraded following recent training. These will identify the residents personal and social care needs. Risk assessments are included in the care plans so that both staff and residents are aware of the support required. There was no evidence to show that residents had been involved in compiling their care plans. The residents are involved in most aspects of running the home and it was clear that they valued and enjoyed this. Residents hold regular meetings to discuss issues related to the home and they found these helpful and a good way of being involved in the running of the home. 8 The Village J53_J04_S15840_The Village_V229668_130605_Stage 4.doc Version 1.30 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) 11,13,14,15,16,17. Residents eat well and enjoy a wide range of activities both inside and out of the home and are part of the local community EVIDENCE: Each resident had an individual programme aimed at developing their skills and staff are available to support them. The staff are constantly looking for new activities which will interest the residents and provide further stimulation and development. All residents use the local facilities in Haxby e.g. supermarket, cafes, pubs, church. They are well known, and felt part of the local community and enjoy Haxby. 8 The Village J53_J04_S15840_The Village_V229668_130605_Stage 4.doc Version 1.30 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 standard(s) 18,19,20. The residents physical and emotional health needs are met. EVIDENCE: Residents have their personal support needs identified in their care plans and include instruction about how support is provided safely and according to the service users preference The home has very good communication with other professionals and agencies which ensures that the healthcare needs of residents are met when required. The home uses the Boots MDS system. All medication records were well maintained and the storage and administration meets with the requirements and is checked by the pharmacist. All staff have done the Boots training in the administration of medication which ensures that they are up to date with current good practice. 8 The Village J53_J04_S15840_The Village_V229668_130605_Stage 4.doc Version 1.30 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 standard(s) 22,23. Residents are protected from abuse, neglect, and self harm. EVIDENCE: The home has a detailed complaints procedure, in suitable formats for the residents. Not all the residents would be able to express their concerns so it is considered important that staff are trained in suitable communication skills. The vulnerable adults procedure is available in the home and training of staff has been recorded. The officer in charge was not fully aware of the procedure and it is recommended that it should be part of the staff meeting agenda at least quarterly so the staff become familiar with the process. There were no concerns about residents not being protected. All the residents go out regularly and meet with many people who could be advocates for them if they were not being cared for properly. The home has a robust recruitment procedure which is well practised. 8 The Village J53_J04_S15840_The Village_V229668_130605_Stage 4.doc Version 1.30 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 standard(s) 24,25,28,30. The home is clean, and well decorated and furnished and provides a comfortable place to live but some improvements are needed. EVIDENCE: Residents are encouraged to choose their own decorations and furniture in their rooms and to provide their own personal items which makes it their own private space. The communal rooms are well furnished and decorated and meet the needs of the residents. The home was clean and hygienic and free from offensive odours. There is an infection control policy to alert staff and ensure good hygiene practices. The following improvements were recommended :The chipped melamine surrounds to the wash basins in the bedrooms should be replaced. Bedrooms should be considered for re decoration. The broken shower over the bath should be repaired / replaced. The floor in the ground floor toilet should be repaired. 8 The Village J53_J04_S15840_The Village_V229668_130605_Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,35. The staff are being well trained and well organised which ensures that residents feel supported and staff are aware of their duties. EVIDENCE: The staff rota is organised around the needs of the residents who all felt supported by them. Staff also felt that there were enough staff on each duty to meet the needs of the residents. Agency staff were being used to cover some shifts due to sickness but the same staff were being used to offer some consistency for the residents. Staff training is on going and relates to the specific needs of the residents which makes staff more confident in their role. It was recommended that staff should have specialist communication skills training. The home has a robust recruitment procedure which is well practised. 8 The Village J53_J04_S15840_The Village_V229668_130605_Stage 4.doc Version 1.30 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 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) 38,39,42. The health, safety and welfare of the residents is promoted but gaps exist which could put residents and staff at risk EVIDENCE: The home has not had a registered manager for some time but the new acting manager says she will be applying for registration. Most residents have been at the home for many years and it was clear that the home has developed to suit their needs. There is no quality assurance system in place aimed at seeking the views of residents and other stakeholders. All full time staff have health and safety training and were aware of the issues but fire training was not up to date. 8 The Village J53_J04_S15840_The Village_V229668_130605_Stage 4.doc Version 1.30 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 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 2 x x 3 x 3 Standard No 11 12 13 14 15 16 17 3 x 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 2 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 8 The Village Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x 1 1 x x 2 x J53_J04_S15840_The Village_V229668_130605_Stage 4.doc Version 1.30 Page 17 yes 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 24 Regulation 23 Requirement The following work is required in the home :The chipped melamine surrounds to the wash basins in the bedrooms needs to be replaced. The broken shower over the bath needs to be repaired / replaced. The floor in the ground floor toilet needs to be repaired. The home must have a registered manager An effective quality assurance system must be implemented Timescale for action 5th August 2005 2. 3. 38 39 8 9 24 26th August 2005 Timescale of 30.01.05 not met 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 6 25 Good Practice Recommendations The home should find a way to demonstrate that service users have been involved in the development of their care plan and agree with it. The residents bedrooms should be considered for redecoration J53_J04_S15840_The Village_V229668_130605_Stage 4.doc Version 1.30 Page 18 8 The Village 3. 4. 32 42 The staff team should have the specialist communication skills required to meet the service users needs. Fire training for staff should be up to date. 8 The Village J53_J04_S15840_The Village_V229668_130605_Stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection York Area Office Unit 4, Triune Court Monks Cross York, YO32 9GZ 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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