Inspection on 19/11/08 for Wensleydale

This inspection was carried out on 19th November 2008.

CSCI found this care home to be providing an Good service.

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

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Extracts from inspection reports are licensed from CQC, this page was updated on 09/06/2011.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Wensleydale 109 Wensleydale Avenue Penshaw Houghton le Spring Tyne and Wear DH4 7PD two star good service The quality rating for this care home is: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Nicola Shaw Date: 1 9 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Internet address www.csci.org.uk Information about the care home Name of care home: Address: Wensleydale 109 Wensleydale Avenue Penshaw Houghton le Spring Tyne and Wear DH4 7PD 01915849176 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Northumberland, Tyne & Wear NHS Trust Name of registered manager (if applicable) Anne Rosenthal Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 6 0 care home 6 learning disability Additional conditions: The registered person may provide the following category of service only: Care Home only Code PC To service users of the following gender: Either Whose primary care needs on admission to the Home are within the following category: Learning Disability, Code LD - maximum number of places 6 The maximum number of service users who can be accommodated is: 6 Date of last inspection A bit about the care home Wensleydale is a large bungalow. Six peple who have learning disability live here. Wensleydale is in a housing estate in Penshaw. Its close to shops and pubs. There are a bus stops near by so people can easily visit local towns, like Sunderland. Everyone has their own bedrooom. There are seperate baths and toiltes for people to use. There is one lounge/dining area, a kitchen, office and laundry room. The weekly fee charged at the home has not as yet been agreed with the Local Authority. Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home How we did our inspection: This is what the inspector did when they were at the care home The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. Before the inspection visit: We looked at: Anything we have found out about the home since May 2008. How the manager has dealt with any complaints and concerns. What the manager thinks about the home. The visit: We visited the home on the 19th November 2008. During this visit we: Looked at some of the care plans to see how well the staff meet the needs of the people who live here. Looked at other records which must be kept, like staff files. Checked that the staff have had good training to meet the needs of the people they care for. Talked to the manager, staff and service users. Spent some time watching how staff communicated and supported the service users. We told the manager what we found at the end of the inspection. What the care home does well There is good information about the home. This helps people decide if they want to move here. The manager always makes sure she finds out about peoples needs before they move into Wensleydale. This helps to make sure Wensleydale is the right place for them to live. Support plans are very good. They tell staff about the best way to support the service users. There are also good risk assessments. This is important as they show how staff help service users to be independent. There are lots of activities going on, both in the home and out and about. There are always lots of staff on duty to go with people on trips out. Staff training is very good. There are good recruitment policies and procedures which help to make sure only the right people are employed to work in the home. There is a good complaints procedure. Service users are protected from abuse by staff training. The home is clean. The Manager The manager is very good and works hard to make sure service users get an excellent service. What has got better from the last inspection This was the homes first inspection. What the care home could do better We have only made 2 recommendations for the manager to look at: Special locks for bedroom doors so that service users can use their bedrooms without first having to ask staff And for prescribed creams to be stored separately to tablets. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Nicola Shaw 33 Greycoat Street London SW1P 2QF 02079792000 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Service users are provided with good information about what they can expect once they have moved into Wensleydale. This ensures that their rights are protected. Good assessment processes ensure that potential service users needs can be met at Wensleydale. Evidence: There is a Statement of Purpose and Service User Guide which give clear relevant information about the home. These are available with pictures to help service users understand the information. The people living in Wensleydale have lived here for a number of years before the home registered as a care home with us in May 2008. The manager told us, however, should there be a vacancy in the home, then a full assessment would be obtained from the prospective service users social worker before their admission. She told us that potential service users would be given the opportunity for day visits, overnight stays and a settling in period. Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Service users support plans provide staff with good information about how each individuals care needs are to be met. Service users are supported to take risks and make choices in their daily lives. This enables service users to lead independent lifestyles. Evidence: The support plans have been developed based upon a detailed up-to-date assessment. They include reference to equality and diversity issues, such as sexuality and religious beliefs. The support plans are person centered and focus upon the individuals strengths and personal preferences. They include information about what is important to each individual, for example, for one person their love of horse riding and for another their joy at having a relaxing bath. The people who live at Wensleydale have complex communication needs. Excellent information about each service users communication needs is included in the support plans, which is important so staff know the best way to help people to make choices for themselves. All support plans are reviewed every 6 months or sooner if there are any changes. Staff recognize that service users may make choices, for example to go horse riding or to bathe alone, which have a degree of risk. In such situations detailed risk assessments have been developed, which are also reviewed every 6 months. Wensleydale has a can do attitude. This was evident in the way the support plans are Evidence: written with an emphasis upon each persons strengths and how staff should support and encourage independence. For example; in one persons plan it was recorded in detail what they are able to do for themselves when preparing for a bath. Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Opportunities for service users to take part in a range of activities both inside and outside the home are excellent. Service users are assisted to maintain links with their family and to have a community presence. This enables them to lead a full and enjoyable life. Service users are provided with a healthy, varied diet which helps to promote their general health and well being. Evidence: The deputy manager is in the process of developing an activities timetable for each service user which will show what each person likes to do each day. This will be based upon information about each individuals likes and interests. When we visited there were 4 staff on duty. Staff said that this was because there is a lot going on. One person was supported to visit their relative, a regular weekly activity, 2 service users went to the bowling alley, whilst other people went out for their lunch. Other regular activities service users participate in include trampolining, swimming and horse riding. Although service users have not had a holiday this year, as an alternative, there have been day trips to places such as Lightwater Valley and Wet nd Wild. The manager is arranging for each service user to have a holiday in 2009. Evidence: The home has its own transport and this is payed for by the organization. When we visited staff interacted with service users. Everyone sat together either in the lounge or around the dining table and service users were included in the conversation that took place. The service actively encourages and provides opportunities for service users to develop communication and social skills. For example: in one persons communication support plan, playing games is a strategy used to help them understand and learn about sharing and turn taking. Service users are supported to be independent and are involved in activities such as the weekly food shop as well as food preparation. There is a 4 week menu, which takes account of healthy eating. A dietician visits the service users every 2 months. The dietician is helping the staff to review the menu for the winter months. Although we did not sit through a meal, the support each person needs with their food is clearly recorded in their support plans. The service users who live at Wensleydale have complex needs. In order to address some of these complex behaviours the kitchen is kept locked when not in use. There are risk assessments in place to justify this action. It was good to note, however, that they also emphasize that when this kitchen is being used by staff that service users be encouraged to help. This was observed in practice when we visited. All bedroom doors are also kept locked. And although we observed staff to open these when a service user communicated that they wanted to use their bedroom, this practice prevents service users from independently using their personal space. We spoke to the manager about this who agreed it would be beneficial to look at alternative locking devices which may assist service users to unlock their doors independently. Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The arrangements for meeting the personal and health care needs of people using the service are good. And service users receive the support they need from staff to ensure that their personal, physical and emotional needs are met. The service users are protected by the homes medication policies, procedures and practices. Evidence: There is detailed guidance available in the support plans so that staff know the most appropriate way to support service users in the way they prefer. Personal health care needs, including specialist health and dietary requirements, are clearly recorded in each service users support plan. They give a comprehensive overview of each persons health needs. An OK health check is completed each year. Currently service users have access to dentists ( who carry out home visits ), opticians, speech and language therapists, a lymphoedemea nurse and consultant psychiatrists. Where service users have complex needs, in terms of their behaviour, there are detailed behaviour care plans in place. These are regularly reviewed and up-dated involving other health care professionals. All staff who administer medication have been provided with training in this area. We looked at the Medication Administration Records ( MAR). These were clear with no gaps indicating that service users have received their medication as prescribed. A weekly audit of medication is carried out by the manager and records of this are Evidence: maintained. A random check of medication in stock against records showed no discrepancies. External medication, such as creams, and internal medication are not stored separately, which is good practice. Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Whilst service users communication is limited, arrangements are in place through the complaints procedure to promote their safety and offer protection. Appropriate policies and procedures are in place, supported by staff training, which ensure that service users are protected from abuse and neglect. Evidence: The homes complaints procedure provides service users and relatives with guidance about how to complain. There is an easy read version available for service users called tell us. The manager told us, in information we asked for before the inspection, that there have been no complaints since the home registered. The homes safeguarding policy provides staff with guidance about how to handle adult protection concerns. There have been 2 safeguarding referrals made since the home registered. These show that the manager and staff know when incidents need external input and who to refer the incident to. All staff have been provided with training in safeguarding adults, which has included further awareness training in team meetings. The manager is in the process of arranging for all staff to receive refresher training regarding this. Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Service users live in a safe, clean, well-maintained environment. Evidence: The building throughout was found to be clean with no unpleasant odours. There is a communal lounge/dining area. This is a bright, airy comfortable place, providing service users with plenty of space to spend their time. The carpet in the lounge has recently been renewed. A new lounge suite has also been purchased. All rooms are single occupancy and service users are encouraged to personalize these areas. Aids and adaptations are provided to meet the different needs of service users. These include a mobile hoist, adapted bath and brightly coloured corridors to assist those people with a visual disability. Policies and procedures are available in relation to infection control. Seventeen staff have completed training in relation to this. Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Staff training and staffing levels are excellent and ensure that service users receive person centered care. The staff recruitment policies and procedures fully protect the service users. Evidence: When we arrived there were 4 staff on duty, which is excellent as there are only 6 people living in this home. This meant that on that day one service user could be supported to visit their relative, whilst others could enjoy a trip out for lunch. We spoke to staff who confirmed that such good staffing levels were almost always the case. Staffing levels are also kept under review by the manager. This was evident by the recent provision of an additional nightstaff in order to meet the changing needs of service users during the night. There are 3 staff vacancies, which are currently being advertised. In the meantime the manager is using bank staff to fill any gaps on the rota. She confirmed that she always asks for the same bank staff in order to ensure continuity of care for the service users. All of the staff are completing the NVQ level 2 qualification in care. By the end of November 2008 the manager confirmed that 100 of staff will have achieved this qualification, which is excellent. Staff we spoke to confirmed that training was good. Some staff have completed training in Makaton ( this is the name given to sign language used with people with learning disabilities), and were using this when communicating with one service user. The manager is arranging for all staff to have this training. Other training provided has Evidence: included equality and diversity, risk management and break away training. The manager also uses team meetings to provide staff with additional training. Recently this has included a training session on values and attitudes. The manager confirmed that all staff are provided with a detailed job description so that they clearly understand their roles and responsibilities. Although staff recruitment files are not held in the home she confirmed that recruitment policies ensure that an Enhanced Criminal Records Bureau check is obtained for all staff before they are able to work in the home. This includes ensuring that that the Protection of Vulnerable Adults (POVA) ) list is also checked. The POVA list is a list of people considered unsuitable to work with vulnerable adults. Two written references are also sought. The manager also said that service users are involved in the recruitment procedure through the informal interview process. Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Service users benefit from a well-managed service. There are good quality assurance systems in place to ensure good standards of care are maintained and to assure service users and their relatives that their views are listened to. Evidence: The registered manager has completed the NVQ level 4 qualification in Health and Social Care, NVQ level 4 in Management, the Certificate of Higher Education in Learning Disability Studies and a Diploma of Higher Education in Learning Disabilities. It was evident that the manager communicates a clear sense of direction and an excellent understanding of best practice. She uses the monthly team meetings to provide additional training to staff to ensure they remain aware of best practice and person centered care. Staff said Anne ( the manager ) is good. The Annual Quality Assurance Assessment (AQQA), this is the information we ask for before an inspection, contains clear, relevant information that is supported by a wide range of evidence that clearly supports the claims made. The AQQA lets us know about changes the manager has made and the areas they still need to make improvements. It clearly shows how they are going to do this. For example: in the next 12 months the manager has identified that a sensory room is going to be developed, the kitchen will be up-dated, the care plans will continue to develop and a picture menu will be introduced. Risk assessments are completed in relation to all health and safety issues. These include risk assessments and control measures relating to activities both inside and Evidence: outside the home. All staff have completed training in health and safety, such as first aid, fire safety and moving and handling. This training is regularly up-dated. Monthly reports required by us, known as Regulation 26 reports, are completed by the homes area manager. There is also a good quality assurance system in place. This involves regular internal audits to ensure care standards are maintained and/or improved. For example, the manager completes regular checks of the care plans, not only to help staff develop their confidence and competence in this area, but to ensure high standards of record keeping are maintained. Questionnaires will be sent to relatives to find out what they think about the home, once the service has been registered for one year. Appropriate records are kept of accidents and incidents. The occurrence of these is regularly reviewed in order to identify any themes or trends so that preventative measures can be put in place. Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 16 It is recommended that the provision of alternative locking devices for bedroom doors be considered. This so that service users can independently use their bedrooms without having to ask staff first. Internal and external medication should be stored separately. This is good practice to minimize the risk of cross contamination. 2 20 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web:www.csci.org.uk We want people to be able to access this information. 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