Inspection on 09/10/07 for York House

This inspection was carried out on 9th October 2007.

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

York House 23/05/06

York House 14/10/05

York House 10/09/04

York House 27/04/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 York House Glebe Road Bayston Hill Shrewsbury Shropshire SY3 0PZ Lead Inspector Sue Woods Key Unannounced Inspection 9th October 2007 09:30 York House DS0000020660.V347019.R01.S.doc Version 5.2 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 York House DS0000020660.V347019.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. York House DS0000020660.V347019.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service York House Address Glebe Road Bayston Hill Shrewsbury Shropshire SY3 0PZ 01743 874442 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) manager.yhs@prospects-uk.org Prospects Mrs Fiona Mary Craig Care Home 10 Category(ies) of Learning disability (10) registration, with number of places York House DS0000020660.V347019.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd May 2006 Brief Description of the Service: York House is a Care Home, registered with the Commission for Social Care Inspection to provide accommodation and personal care for up to ten Adults with Learning Disabilities. The home is operated by the registered charity Prospects, a Christian Voluntary organisation that provide a block contract for the provision of this service to Shropshire County Council. The home is located in Bayston Hill, some three miles from Shrewsbury town centre. It stands in its own spacious grounds, adjacent to a church with which it maintains strong links. The home consists of three individual bungalows that are interlinked and domestic in scale. The aims of the home are included in the Statement of Purpose that says: Prospects is a Christian voluntary organisation which values and supports people with learning disabilities so that they live their lives to the full. The home is managed by Ms Fiona Craig. Information is shared with people who live at York House in the Service User Guide and informally on a daily basis. A formal quality assurance system is currently being implemented that takes the form of an audit. Surveys are currently used. Fees are on a block contract basis and range from £953.69 to £1,320.35 a week. York House DS0000020660.V347019.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection of York House took place on 9th October 2007 with a return visit to meet with the manager on 16th October 2007. In total the inspection lasted nine hours. During the first visit the inspector was joined by an expert by experience who produced a report of his findings. The inspection reviewed all 22 key standards and information to produce this report was gathered from the findings of the visits and also by review of information received by CSCI prior to the inspection date. A quality rating based on each outcome area for service users has been identified. These ratings are described as excellent/good/adequate or poor based on findings of the inspection activity. As part of the fieldwork activity the inspector met with people who live at the home, staff on duty and the registered manager. Prior to the inspection visit the registered manager completed and returned an Annual Quality Assurance Assessment (AQAA). Information contained within this document was seen to reflect the service offered by the home. What the service does well: What has improved since the last inspection? Since the time of the last inspection York House has a new manager who has been described as ‘excellent’ by the staff team. She has completed her NVQ Level 4 in Health and Social Care and has attended numerous short courses in order to develop her skills. York House DS0000020660.V347019.R01.S.doc Version 5.2 Page 6 The home’s AQAA says that over the last twelve months improvements have been made to risk assessment formats and health action plans and pen pictures have been developed. Menu planning has improved and fundraising has resulted in the purchase of a summerhouse. 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. The summary of this inspection report can be made available in other formats on request. York House DS0000020660.V347019.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection York House DS0000020660.V347019.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home has an appropriate admissions policy in place should the need arise and the Statement of Purpose is kept up to date. EVIDENCE: At the time of the last key inspection of the home it was found that although only one admission has taken place over the last fifteen years the home has an appropriate admissions policy in place should the need arise. There have been no admissions within the last twelve months therefore the judgement made at the time of the last inspection will be carried forward. The home’s Statement of Purpose is kept up to date. York House DS0000020660.V347019.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 6,7 and 9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Person centred care and support plans enable staff to offer the people who live at York House the opportunities to make choices and assist with decision making as well as delivering care in a way that they prefer. Risk assessments ensure that support is given in a safe manner but the manager must make sure that they are updated as people’s needs change. EVIDENCE: The inspector spoke with five of the people who live at York House and reviewed the care plans of two people. Care plans are written in an easy to read way with pictures to support different sections. One man showed the inspector his ‘All About Me’ file and it contained a lot of information about his likes and dislikes. The second plan seen was not up to date although following the first inspection visit the manager reviewed York House DS0000020660.V347019.R01.S.doc Version 5.2 Page 10 the plan and updated it. She has also organised a review to look at the person’s changing support needs. Information seen in both files supported conversations with people living at the home and the staff team. People told the inspector that they make decisions about what they do with their lives and photos and care plans supported that people enjoy hobbies of their choice. People are also consulted about the décor of the home and choose their own bedroom furniture. Risk assessments were seen on files reviewed although some did not reflect recent changes in behaviours. Again, prior to the second inspection visit these had been reviewed and updated. York House DS0000020660.V347019.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 12, 13, 15, 16 and 17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who live at York House lead active lives with opportunities to enjoy leisure activities of their choice. People may become more independent if they do more household tasks. People who live at York House benefit from a balanced and varied diet. EVIDENCE: People who spoke with the inspector gave examples of leisure activities that they enjoy. One man likes snooker and has a snooker table in his room. He also enjoys barge holidays with his family and again pictures on the wall supported this. The manager and the staff who spoke with the inspector said that people had good family contact and gave examples of holidays people have taken with their families as well as visits, letters and phone calls. York House DS0000020660.V347019.R01.S.doc Version 5.2 Page 12 One person enjoys work experience at a local DIY Centre and one man is an honorary churchwarden at the local church. The home has very strong links with the church and staff promote Christian values. At the time of the inspection two people who live at York House were on holiday. The expert by experience had the opportunity to visit people who live at York House at their day service. He was pleased to hear that people are supported to have family relationships and regular visits. One person told him that he enjoyed sitting in the sunshine. Other people were seen to be playing snooker and darts. A staff member said that a friendship for one man living at the home had faded away due to the distance between their homes. The manager later told the inspector that she would look to help redevelop this friendship. The manager stated that people help to do laundry and cleaning around the home although people who spoke with the expert by experience and the inspector suggested that they did not. Again the manager will look at this arrangement as she recognised people may become more independent if they take part in household tasks. Menus were seen to reflect a varied and nutritious diet. People told the inspector that they liked the food at York House. York House DS0000020660.V347019.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 18, 19 and 20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The people who live at York House have their support needs met by a dedicated staff team who use outside agencies to ensure individual needs are met. People are safeguarded by the home’s system for handling, storing and administering medication. EVIDENCE: The care-planning format is very person centred and is divided into sections that clearly identify care and support needs. The care plan for one person who spoke with the inspector reflected his likes and preferences. The support plan for a second person living at York House however did not accurately reflect his support needs. The inspector acknowledged that the ethos of the organisation is to promote people in a positive light but it is also necessary to provide staff with clear information as to identified behaviours and responses required. York House DS0000020660.V347019.R01.S.doc Version 5.2 Page 14 Since the time of the first inspection visit the manger acknowledged shortfalls and has reviewed and updated care and support plans and sought professional input to review reactive management plans. Health action plans are now used within the home although have not yet been completed for everyone. The home seeks support from health and social care professionals although the manager stated that the home is not always involved with reviews from outside agencies. She is currently requesting a needs reassessment for a number of people living at the home. One person living at York House has been provided with a bed that supports his mobility in a morning following an assessment by an Occupational Therapist. Other mobility needs are being closely monitored by the home. York House DS0000020660.V347019.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 22 and 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who live at York House are protected by a user-friendly complaints procedure and systems are in place to safeguard people’s money. EVIDENCE: Everyone living at York House has a copy of the homes complaints procedure that is written in an easy read format. The manager plans to develop this further using pictures. One man who spoke with the inspector said that he knew who to talk to if he was unhappy about anything. The manager reported that no complaints have been received about the service provided at York House and that ‘Virtually all’ staff have now completed the Adult Protection course offered by the local authority. The subject is also covered at Induction. All staff who spoke with the inspector were aware of complaints and whistle blowing procedures. The manager gave examples of how advocates are used to support people living at York House. Financial arrangements were discussed briefly and the manager stated that she is happy that a robust system is in place. Each transaction requires two signatories and all records are then monitoring by the manager before external audits take place. The Manager keeps records to demonstrate that people living at the home receive their personal allowance. York House DS0000020660.V347019.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 24 and 30 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. York House provides a clean and safe environment for the people living there and the manager is keen to make further improvements to ensure the home is able to meet people’s changing needs. EVIDENCE: The inspector and the expert by experience were shown around York House by a senior member of staff. The inspector was also shown two bedrooms. All areas of the home was seen to be clean. The inspector spoke with the domestic staff member on duty who was knowledgeable about her role and said that she was supplied with personal protective clothing in order to do her job. She was aware of risk assessments and data sheets in place for the products she used. Some minor repairs noted during the tour of the home are in the process of being repaired. York House DS0000020660.V347019.R01.S.doc Version 5.2 Page 17 The home is separated into three bungalows. The entrance to the one bungalow is via the middle one. This was discussed with the manager following observations made by the expert by experience and she demonstrated that the home’s business plan makes reference to this and funding has been requested to have a new entrance to the one bungalow. Unfortunately funding is currently on hold but the manager is pursuing this further. It was also established that the man who uses a wheelchair has difficulty moving around his home and his bedroom is quite small. The manager has requested an assessment for this person to ensure the home can continue to meet his needs. The manager also agreed to look at making further changes to the environment to assist a man without sight. Arrangements for the disposal of clinical waste are in place but staff feel that this arrangement could be further improved. The manager will review this. Records show that bath temperatures are checked and the assisted bath and portable electrical equipment is tested as required. York House DS0000020660.V347019.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 32, 33, 34 and 35 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. People living at York House are supported by a knowledgeable, enthusiastic and committed core staff team who work hard to meet the needs of the people they support. People are protected by robust recruitment and selection procedures although the difficulty in recruiting permanent staff means a high use of agency within the home. EVIDENCE: Staff who spoke with the inspector really like working at York House. All felt that they had good training opportunities although some gaps in mandatory training have been identified by the manager who has taken action to address this. Staff files reviewed contained all required information to demonstrate a robust recruitment process although the home has a high use of agency staff. Discussions with the manager identified possible reasons for this. The homes York House DS0000020660.V347019.R01.S.doc Version 5.2 Page 19 AQAA identified that a high number of agency staff hours are used within the home although consistency is generally achieved. The manager also stated that she would like to increase staffing levels to enable more activities. The manager reported that sometimes staff volunteer their services to support an activity. The rota seen reflected staff on duty. Good support is available for staff in general and following incidents although the manager is to implement a procedure to support staff working with people after and incident. York House DS0000020660.V347019.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 37,39 and 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. York House is managed by a competent manager who creates an open and positive atmosphere from which people who live at the home benefit. Peoples health and safety is promoted and protected within the home. EVIDENCE: The manager of York House has been registered with CSCI since May 2007. She has now completed her NVQ 4 in Health and Social Care (certificate seen) and has done numerous short courses relevant to her role. Staff have described the new manager as ‘excellent’. The manager acknowledges the strengths and needs of the service and these are also reflected in the business plan and the AQAA. She has acknowledged for York House DS0000020660.V347019.R01.S.doc Version 5.2 Page 21 example that ‘the paperwork has slipped’ and has begun addressing this. She also demonstrated her commitment to meeting standards by immediately actioning requirements made following the first inspection visit and took on board all suggestions made by the expert by experience. The manager stated that staff support is ‘brilliant’ and a strength of the home is that staff ‘go the extra mile for the people they support’. The homes Health and safety monitoring form was seen for September. It reflected that routine health and safety checks have been carried out. The manager is currently implementing the organisation’s new Accident and Incident Reporting and Recording policy. York House DS0000020660.V347019.R01.S.doc Version 5.2 Page 22 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X York House DS0000020660.V347019.R01.S.doc Version 5.2 Page 23 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. 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 Refer to Standard YA16 YA24 YA33 Good Practice Recommendations It is recommended that people who live at York House should be involved in cooking and cleaning tasks within the home wherever possible. It is recommended that the manager take action to ensure that the home is not only suitable but also stimulating for the people who live there. It is recommended that the manager review recruitment practice within the home to identify why the home is having difficulty recruiting permanent staff. 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