CARE HOME ADULTS 18-65
36 West Farm Road Howdon Wallsend Tyne & Wear NE28 7AY Lead Inspector
Glynis Gaffney Unannounced 15 May 2005 13:30 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. 36 West Farm Road B53-B03 S33090 West Farm V221238 150505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION
Name of service 36 West Farm Road Address Howdon Wallsend Tyne & Wear NE28 7AY 0191 200 7161 N/A Susan.Redpath@northtyneside.gov.uk North Tyneside Council 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) Mrs Susan Redpath CRH 6 Category(ies) of LD Learning Disability (6) registration, with number of places 36 West Farm Road B53-B03 S33090 West Farm V221238 150505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION
Conditions of registration: The home may provide respite care at any time for up to three adults with a learning disability who are also wheelchair users. The maximum number of people cared for at any time must not exceed 6. Date of last inspection 30/11/04 Brief Description of the Service: West Farm Road is set in a residential street in the village of Howden. It consists of a single storey building which has been designed to meet the needs of adults with learning and physical disabilities. The Home provides short stay residential care breaks for about 50 adults and their families. Nursing care is also provided to a small group of residents. A bus route, pub and local shops are within easy walking distance. Residents are able to access all parts of the premises, including a small garden area to the rear of the building containing a selection of garden furniture. The Home has a kitchen, a laundry, a lounge, a dining area, a sit-down shower/toilet and an assisted bath/toilet. There are six single bedrooms some of which contain adjustable beds. There is a ramp to the front entrance of the Home and a small front garden. Street parking is available. 36 West Farm Road B53-B03 S33090 West Farm V221238 150505 Stage 4.doc Version 1.20 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over five and a half hours. The premises were inspected as were a sample of care records and a selection of other records. Three of the staff on duty and three residents were spoken to. The Home’s Manager was also interviewed. What the service does well: What has improved since the last inspection?
Staff have been provided with opportunities to familiarise themselves with the National Minimum Standards relating to adults who require care and support. Each member of staff has been asked to research particular areas of good practice, to share their learning with other members of the care team and, to improve the Home’s policies and procedures. For example, since the last inspection visit, guidance on the use of the Complaints Procedure has been prepared. The Home has been redecorated throughout and new furniture and fittings provided. 36 West Farm Road B53-B03 S33090 West Farm V221238 150505 Stage 4.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 36 West Farm Road B53-B03 S33090 West Farm V221238 150505 Stage 4.doc Version 1.20 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 36 West Farm Road B53-B03 S33090 West Farm V221238 150505 Stage 4.doc Version 1.20 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) Standards 1 to 5 not assessed on this occasion. EVIDENCE: 36 West Farm Road B53-B03 S33090 West Farm V221238 150505 Stage 4.doc Version 1.20 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) Standards 6 to 10 not assessed on this occasion. EVIDENCE: 36 West Farm Road B53-B03 S33090 West Farm V221238 150505 Stage 4.doc Version 1.20 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) 15 and 16. Residents are supported to form friendships with each other and, to take part in activities, both within and outside of the Home, which enrich their social life and allow opportunities for learning and personal development. Residents’ rights are respected and their involvement in the Home’s daily routines encouraged. EVIDENCE: Staff visit each resident and their carer on a twice yearly basis to ensure that the plan of care includes any changes in care needs that have taken place between visits to the Home. Residents and/or their carers are consulted about the quality of care provided at each home visit. The Manager explained that the involvement of service users and their carers in these twice yearly meetings was an important way of obtaining their opinions about the daily routines and activities provided at the Home. She also stated that it allowed staff to develop good working relationships with carers. Two residents said that staff helped them to make friends with, and get to know, other people visiting the Home. One resident said that she ‘got on well with all of the staff’ and other people she met when visiting the Home. Another resident told the inspector that she could have friends in her bedroom if she wanted.
36 West Farm Road B53-B03 S33090 West Farm V221238 150505 Stage 4.doc Version 1.20 Page 11 One resident explained that staff respected her privacy and always knocked on her bedroom door before entering. This person also said that she was always addressed in a polite and respectful manner. Another resident felt able to spend time alone in bedroom and had been given the key to her door. It was clear that she was very proud of this. Opportunities are available for residents to join in everyday household chores. A resident stated that she enjoyed helping with the laundry and keeping her bedroom clean. She also said that she ‘loved helping out’. 36 West Farm Road B53-B03 S33090 West Farm V221238 150505 Stage 4.doc Version 1.20 Page 12 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) Standards 18, 19 and 20 not assessed on this occasion. EVIDENCE: 36 West Farm Road B53-B03 S33090 West Farm V221238 150505 Stage 4.doc Version 1.20 Page 13 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 and 23. The Home has a satisfactory complaints procedure and there was evidence that service users felt their views and opinions were listened to. A satisfactory Adult Protection Policy was in place to ensure an appropriate response to any suspicion or allegation of abuse received by the Home. EVIDENCE: The Home has a detailed complaints procedure and a helpful complaints leaflet. Residents spoken with said that they would be happy to raise concerns with any member of staff. No complaints had been received by either the Home, or the Commission, since the last inspection. Staff had recently undertaken work to ensure that the Home’s complaints procedure and related information covered the recommended areas. The Home’s Adult Protection Policy complied with the relevant guidance and legislation. No adult protection concerns had been raised with the Commission since the last inspection. 36 West Farm Road B53-B03 S33090 West Farm V221238 150505 Stage 4.doc Version 1.20 Page 14 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, 26, 27, 28, 29, 30. The standard of the environment within this Home is good providing residents with an attractive and homely place to live. The overall quality of the furnishings and fittings is good although additional equipment is still needed to complete the refurbishment of the bedrooms. The necessary aids and adaptations have been provided enabling residents to be safely cared for. EVIDENCE: Residents live in a safe and comfortable Home. It is bright, cheerful, airy, clean and free from offensive odours. One resident said that West Farm was always warm and clean and, that she ‘felt at home’. The Home is located in a residential area and local transport links are close by. A member of staff told the Inspector that buses, the Metro and staffs’ own cars are used to ‘help residents get out and about during their stay at the Home’. The outward appearance of the Home is in keeping with the local area and it did not have any signs publicising its status as a care home. The Home’s decoration, furniture and fittings are of a good standard and quality following its recent
36 West Farm Road B53-B03 S33090 West Farm V221238 150505 Stage 4.doc Version 1.20 Page 15 refurbishment. The building met with the requirements of the local Fire Service and Environmental Health Department. Residents said that they were very happy with their bedrooms and ‘loved having a TV’. However, the bedrooms visited did not contain all of the recommended furniture. One resident spoke about how she was encouraged to bring her personal belongings with her when visiting the Home. Another resident felt that staff respected her privacy when taking a bath and said that she was able to lock the bathroom door. Residents and staff have access to a range of specialist aids to promote independence. For example, grab rails and hoisting equipment had been fitted in the bathing areas. The Manager felt that the Home had been fitted with the aids and adaptations required to enable staff to safely care for residents. 36 West Farm Road B53-B03 S33090 West Farm V221238 150505 Stage 4.doc Version 1.20 Page 16 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) 32 and 33. The numbers of staff provided is sufficient to ensure that residents’ care and support needs are met and that they are not placed at risk of harm. Staff morale is high resulting in an enthusiastic care team that works positively with residents to improve the quality of care they receive. Staff have the opportunity to develop the skills and knowledge required to effectively meet residents’ care needs. EVIDENCE: Staff have obtained, or are in the process of obtaining, vocational qualifications which will provide them with the skills and knowledge required to meet residents’ care needs. More than half of the staff team have already obtained a vocational qualification. The staff team meets on a regular basis to discuss how they can give residents a better service. One resident said that staff looked after her ‘very well’ and she was ‘very happy’ with this. An examination of the previous week’s staff rota confirmed that satisfactory levels of staffing are provided. The rota is planned in advance and around the
36 West Farm Road B53-B03 S33090 West Farm V221238 150505 Stage 4.doc Version 1.20 Page 17 individual needs of residents visiting the Home. Although a minimum of two staff is provided between 7.00am to 10.00pm, up to four staff may be scheduled on duty to assist residents both within and outside of the Home. Although the night-time period is usually covered by a single carer on ‘sleep over’ duty, a ‘waking night’ staff is provided where residents have more complex care needs. Community nurses also work shifts in the Home where residents have specific health care needs. 36 West Farm Road B53-B03 S33090 West Farm V221238 150505 Stage 4.doc Version 1.20 Page 18 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) 37, 41 and 42. The health, safety and welfare of residents is promoted and protected. Although action has been taken to provide a safe environment for residents, additional risk assessments need to be completed. EVIDENCE: Residents spoken with stated that they ‘felt safe in the Home’ and ‘had no worries’. Assessments had been completed by the Occupational Therapy Service to ensure that residents requiring assistance with transfers were moved in a safe manner. Staff had recently received certificated fire training and regular fire drills are held. However, the names of staff receiving fire training and, taking part in fire drills, was not recorded. Also, community nursing staff working shifts in the Home had not received in-house fire prevention training. Maintenance contracts to ensure the safe working of the Home’s hoisting equipment and fire alarm system were in place. Regular service checks had taken place. Certificates confirming the safe working of electrical equipment were available. A range of workplace risk assessments had been completed.
36 West Farm Road B53-B03 S33090 West Farm V221238 150505 Stage 4.doc Version 1.20 Page 19 For example: one of the risk assessments examined set out the actions to be taken by the Home to prevent residents being seriously scalded. However, the selection of risk assessments checked had not been signed or dated. There was also no indication given of when each risk assessment would next be reviewed. Risks assessments had not been completed in all of the recommended areas such as: the security of the premises; use of the garden area and equipment. 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x x x x Standard No 22 23
ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
36 West Farm Road Score x x x x x Standard No 24 25 26 27 28 29 30
STAFFING Score 3 2 3 3 3 3 3 B53-B03 S33090 West Farm V221238 150505 Stage 4.doc Version 1.20 Page 20 LIFESTYLES Standard No 11 12 13 14 15 16 17 Score x x x x 3 3 x Standard No 31 32 33 34 35 36 Score x 3 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x x x Standard No 37 38 39 40 41 42 43 Score 3 x x x 3 2 x 36 West Farm Road B53-B03 S33090 West Farm V221238 150505 Stage 4.doc Version 1.20 Page 21 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard 25 42 42 42 Good Practice Recommendations Ensure that the recommended furniture is provided in residents bedrooms. Ensure that the names of staff receving fire instruction and, participating in fire drills, is recorded. Ensure that community nurisng staff working shifts in the Home have received fire prevention training. Ensure that all risk assessments are signed and dated. Each assessment should state when the next review will take place. Ensure that risk assessments covering the following areas are completed: the security of the premises; use of the garden area and equipment. 36 West Farm Road B53-B03 S33090 West Farm V221238 150505 Stage 4.doc Version 1.20 Page 22 Commission for Social Care Inspection 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
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