Inspection on 15/05/06 for Walby Hill, 4

This inspection was carried out on 15th May 2006.

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

Walby Hill, 4 14/06/07

Walby Hill, 4 19/01/06

Walby Hill, 4 03/11/05

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 HOMES FOR OLDER PEOPLE 4 Walby Hill 4 Walby Hill Rothbury Morpeth Northumberland NE65 7NT Lead Inspector Carole McKay Key Unannounced Inspection 09:30 15th May and 26th May 2006 X10015.doc Version 1.40 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 DS0000065896.V290243.R01.S.doc Version 5.1 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 Older People. 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. DS0000065896.V290243.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 4 Walby Hill Address 4 Walby Hill Rothbury Morpeth Northumberland NE65 7NT 01669 620737 01670 518118 linda.arkle@oakleatrust.co.uk 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) The Oaklea Trust Mrs L Arkle Care Home 6 Category(ies) of Learning disability (2), Learning disability over registration, with number 65 years of age (4) of places DS0000065896.V290243.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th January 2006 Brief Description of the Service: 4 Walby Hill is a care home providing personal care and accommodation to six people with a learning disability. Currently five people, male and female, live in the home. They are aged between 57 and 80. There is one vacancy For the purposes of this inspection the home has been assessed against the standards for home for older people, however at future inspections the standards for services for younger adults may be applied. The home has also changed ownership recently and is now operated by the Oaklea Trust, a national organisation specialising in care for people who have a learning disability. The home is located on the fringe of the village in close proximity to shops and other amenities. It is a domestic property in a two-storey terrace house. There is an open and lawned area to the front of the home and a driveway access shared with neighbours. The back of the property has a small yard and shared driveway access. The home is domestic in style and warm and comfortable in character. The weekly fees are £245 per week. No additional charges are made. The home has a copy of the last inspection report and other information about the home is available. DS0000065896.V290243.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The service was visited on two occasions and lasted a total of ten hours. The inspector spoke to all of the service users and two of the care staff. A meeting was held with the manager to discuss the findings. Service users and their representatives and visitors returned surveys. Feedback form the surveys was positive. The inspector and the manager had productive discussions around the issues raised by the inspection. What the service does well: What has improved since the last inspection? The manager is writing a business plan that will identify future improvements to the service. This will ensure that service users continue to have their needs met. DS0000065896.V290243.R01.S.doc Version 5.1 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. DS0000065896.V290243.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000065896.V290243.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13 Quality in this outcome area is adequate. This judgement is made using available evidence including a visit to the service. The home does not have clear enough aims and objectives. The home does not provide intermediate care. As far as possible the service makes an assessment of the needs of service users before they come to live permanently at the home. EVIDENCE: Oaklea Trust has devised a broad Statement of Purpose and Service User Guide. Most of the service users have lived at the home for several years. Three service users came together to live at Walby Hill last year from another service. The manager said that very little information was shared by the other service and this made the assessment process rather difficult. This now needs to be expanded. The manager said that she sees these three people as having very different and distinct needs. Two people have special needs to do with communication and understanding the world around them. DS0000065896.V290243.R01.S.doc Version 5.1 Page 9 The staff and manager have not yet been able to meet the needs of all the most recent service users, who are younger than the people who have lived there for many years. Future admissions will have to be very carefully considered and the aims and objectives of the service should be reviewed before an admission takes place, in order that staffing levels, premises, staff support systems and the views of service users are fully considered. The Trust that runs Walby Hill is committed to carrying out assessment and this is stated in the information they provide to service users. The service has a written assessment process. Assessments are included in service users’ files. These include the personal, social and medical care needs of service users. Individual “ My Life” files are also in place. Service users are involved in producing these. Things such as a person’s strengths / needs, community links, personal aspirations and preferences are included. This part of the assessment process is long term and on going, rather than a one off task. It is very person centred. DS0000065896.V290243.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement is made using available evidence including a visit to the service. Service users’ health needs are identified and are met. Specialist needs are identified and the service responds to these. The service should review needs more regularly as these change. The service supports people with their medication and protects people who cannot manage this independently. Privacy and dignity of service users is ensured. EVIDENCE: The service users plans contain detailed information about the health care needs of service users. This includes care plans for meeting these needs, additional information to assist staff in understanding health needs and records of routine and specialist health support. There are some unresolved health issues which are possibly to do with ageing and loss. The service has clear policies and procedures for the administration of medication and staff have received training in this. Small amounts of DS0000065896.V290243.R01.S.doc Version 5.1 Page 11 regular medications are stored at the home. These are securely stored and access is restricted. All of the service users have been assessed as unable to self medicate, apart from one person who said that they prefer to be assisted with some of their medication. This has been put in place. The medication records are properly maintained. Service users have their own rooms and said that they can hold a door key if that is their wish. One service user keeps the bedroom door locked when not using it. Another service users prefers to leave the door open during the day so that access is easier. Staff remind other service users that they should not wander into this room unless they are invited. Records that contain information about service users are kept in a locked cupboard in the office area. Service users also hold some information in their rooms. Some of the service users are happy to share this information as part of participating in the inspection. Relatives and visitors surveys included the following comments: “ very well run”, “ staff are kind and caring”, “ladies/gents are given choices. “ DS0000065896.V290243.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement is made using available evidence including a visit to the service. The service is very good at providing the kinds of activities that are suited to older people. Older service users have a high level of presence in the community, as do some of the younger people. The social needs of the younger service users are not so well assessed and provided for. The social needs of service users who have communication difficulties and/or are younger need to be better provided for. Links with family and friends are very well supported. The home is welcoming to visitors and encourages comment on its service. A well balanced diet is provided, using good quality ingredients. EVIDENCE: Service users who have the necessary communication skills, are involved in identifying their social needs and preferences. These are written down with the service user concerned. Two of the older service users said that they feel they are very much part of the local community. One service user attends local community groups for activities and social outings, such as the local music club and “Over 60s” club. DS0000065896.V290243.R01.S.doc Version 5.1 Page 13 Younger service users, who have previously attended day services, when living in another part of the County, have had to lose these supports, as the journey time was very tiring. These day services have not been replaced and the support has to be found from within this service. This places extra demands on the staff cover at the home. All service users are supported to take an annual holiday. Holidays have been planned for this year. The planning has taken individual needs and preferences into account. One of the service users, with a support staff, returned from a short holiday on the day of the inspection. This service user said that she had enjoyed the break and was glad to be back at home. Family contact is encouraged and supported, where service users want this. One service user was able to talk about her family and had photographs, letters and cards from family members. Relatives’ and visitors’ surveys include the observations; the home is welcoming and has a happy atmosphere…it feels like visiting …in her own home. Service users are involved in shopping for food locally and in food preparation and planning. Choices are taken into account in planning menus. These are discussed at house meetings, which are recorded. DS0000065896.V290243.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 17 and 18 Quality in this outcome area is good. This judgement is made using available evidence including a visit to the service. Service users and their representatives are confident that their complaints will be addressed. The service strives to protect service users from abuse. EVIDENCE: The service has written policies and procedures for receiving and investigating complaints. The service users do make complaints from time to time. These are recorded and the action taken is documented. No complaint from other agencies has been made to the service. The Commission for Social care Inspection has not received any complaints against the service. The responses to the relatives and visitors surveys showed an overall awareness of the procedures to do with complaints and a high level of satisfaction with the service. Some of the service users may not have the capacity to give consent. Legal advice about this has not been taken. The home has Adult Protection procedures. These include what staff are expected to do should they suspect a vulnerable adult is being abused. To supplement this information, the home has a copy of the Department of Health guidance, No Secrets, and a copy of the local authority Protection of Vulnerable Adults procedures. DS0000065896.V290243.R01.S.doc Version 5.1 Page 15 Staff files show that all staff have received Adult Protection training within the last two years. POVA checks are taken up for new staff. The service users said that they were happy and settled at the service and had no complaints. Service users said that they would inform the staff if they were not happy. DS0000065896.V290243.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,22,26 Quality in this outcome area is good. This judgement is made using available evidence including a visit to the service. The service provides a safe, comfortable, clean, pleasant home for the people living there. The home has been adapted slightly to improve access for older service users. DS0000065896.V290243.R01.S.doc Version 5.1 Page 17 EVIDENCE: Routine maintenance and safety checks are carried out and recorded. The home does not employ domestic staff. The care staff follow written cleaning schedules to good effect. The home is clean and hygienic throughout. Access at the rear of the home has been adapted to provide for a service user who needs to use a wheelchair when out of the home. The home is not ideally suited to the needs of people who are, or may become physically frail, as it has only one ground floor bedroom and no lift. This should be taken into account when the statement of purpose/aims and objectives are reviewed. On going decoration and replacement ensures that the home is attractive and comfortable. The furnishings are domestic in style and character. No areas of the home are obviously in need of repair or attention. DS0000065896.V290243.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement is made using available evidence including a visit to the service. Staff are trained and qualified and competent to care for service users general social and health care needs. Further specialist training should be offered to enable service users’ needs to be better met. The procedures for recruiting staff protect service users, but should be consistently applied as service users may be put at risk. EVIDENCE: The service provider has a system for recruiting and employing staff in place. Staff files contain evidence that the necessary checks are carried out and references are taken before staff are employed. One of the checks was not to the required level. 60 of the care staff hold NVQ level 2 qualification. Records show that mandatory training is provided to all staff and is up to date. Other specialised training is also offered, for example some of the staff have had training in autism and mental health. Staff have not received training in ageing and age related illness. Staff have not all undertaken training in the Learning Disability Award Framework, when undertaking NVQ training. The staffing compliment is sufficient and flexible enough to ensure that staff rotas can provide for service users’ outings and appointments. However the dependency of service users is very diverse. The staff group is small, made up DS0000065896.V290243.R01.S.doc Version 5.1 Page 19 of 6.75 whole time equivalent care staff, with no ancillary support staff. On going daytime activity for younger service users, one of whom has a condition which is likely to lead to increasing dependency, has to be provided alongside support for older and more physically dependent people. The staffing levels have not been reviewed since the new residents moved in which does not ensure that all of the service users’ diverse needs can be fully met in the longer term. DS0000065896.V290243.R01.S.doc Version 5.1 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38 Quality in this outcome area is good. This judgement is made using available evidence including a visit to the service. An experienced and qualified manager runs the home. Examples of quality assurance processes are evident. Service users control their money where able and for those who cannot, their interests are protected. Safe working practices are ensured. EVIDENCE: The manager, Linda Arkle has been in post for most of the time the home has been open and has worked for three different providers. Linda has the registered managers award and has had additional training. Linda has formed productive relationships with the service users, the staff and service user representatives. DS0000065896.V290243.R01.S.doc Version 5.1 Page 21 Quality assurance processes are informal rather than formal. These include regular staff and service users meetings and a welcoming atmosphere, which encourages service user representatives to visit the service and to make comment on it. One to one time for staff with service users and person centred care plans also give staff an opportunity to discuss and think about service users’ opinions. Service users’ money is managed with service users and all transactions are clearly accounted for in records. The manager is not acting as appointee, except in one circumstance where no other person is available. Legal processes are in place to protect service users’ interests where this is needed. There are issues to do with service users’ abilities to give consent. Legal advice should be taken. The safety of the premises is assured. Safety checks are logged and up to date. Safety training is mandatory and kept up to date in staff records DS0000065896.V290243.R01.S.doc Version 5.1 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 2 18 3 3 X X 2 X X 2 3 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 DS0000065896.V290243.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? None 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 OP1 Regulation 6 Requirement The registered manager must review the aims and objectives/ statement of purpose/ service user’s guide to ensure that the service is resourced to properly support service users in the longer term. The registered manager must review the aims and objectives/ statement of purpose/ service user’s guide to ensure that the service is resourced to properly support service users in the longer term. Timescale for action 30/09/06 2. OP22 6 30/09/06 2 OP3 14 3 OP7 14(2)(b) 15(2)(b) 4 OP17 13,14 The registered manager must 30/06/06 ensure that a full assessment of needs is obtained beforehand for future admissions to the home. The registered manager shall 31/07/06 ensure that the assessment and the service user’s plan is revised, having regard to any change of circumstances The registered manager must 31/08/06 identify where people are unable to give consent and provide legal advice to the manager. DS0000065896.V290243.R01.S.doc Version 5.1 Page 24 5 OP27 18(1)(a) 6 OP30 18(1)(a) A review of the staffing levels must be undertaken using the Residential Forum Model. This should include contingencies for the change in dependency levels of service users. The staff team must be offered training in the ageing process and its effects on health and well - being. LDAF training should be offered to staff who undertake NVQ training. 31/08/06 30/09/06 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 OP25 Good Practice Recommendations Provide individual thermostatic controls to each radiator. DS0000065896.V290243.R01.S.doc Version 5.1 Page 25 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. Extracts may not be used or reproduced without the express permission of CSCI DS0000065896.V290243.R01.S.doc Version 5.1 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!