Care Home: An Caladh House

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What the care home does well The home is very well run, with staff that are very well trained and supported. They know residents very well, and have a good relationship with them. The staff work well together, and enjoy working at the home. They provide good support for the people living there. The home is clean and well decorated, with plenty of space for residents to enjoy. Resident`s records provide staff with all the information they need to give good support. There are plenty of activities for residents to join in, with residents able to go on outings regularly. Staff involve them in the running of the home at every opportunity, and encourage them to become more independent, whilst at the same time, making sure that they are safe. There are good arrangements to ensure that residents are protected from abuse. Residents indicate that they like living at An Darach, and enjoy the food and outings. What has improved since the last inspection? What the care home could do better: No requirements were made as a result of this visit. It was recommended that a risk assessment was carried out on the four steps leading from the care park, which at present have no handrail, to prevent accidental falls. It was also recommended that up to date photographs of staff members were included in staff files. CARE HOME MIXED CATEGORY MAJORITY OLDER PEOPLE An Caladh House 4 Church Hill Washingborough Lincoln LN4 1EH Lead Inspector Julie Western Unannounced Inspection 17th January 2008 09:30 X10029.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 An Caladh House DS0000070572.V355831.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 Older People and 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. An Caladh House DS0000070572.V355831.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service An Caladh House Address 4 Church Hill Washingborough Lincoln LN4 1EH 01522 866010 01522 866001 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) Kisimul Group Ltd Adam Wilkins Care Home 6 Category(ies) of Learning disability (6) registration, with number of places An Caladh House DS0000070572.V355831.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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 folowing categories: Learning Disability - Code LD The maximum number of service users who can be accommodated is: 6 N/a 2. Date of last inspection Brief Description of the Service: An Caladh House is situated in the village of Washingborough, 3 miles East of the city of Lincoln. Washingborough has a good range of facilities and there is public transport into Lincoln; the home also has its own transport. It is registered for up to six residents with a learning disability and is managed by the Kisimul Group Ltd. The present five residents previously lived at the Kisimul School, which is managed by the same organisation. There is a close link between An Caladh House and the school, with residents sharing some of the school’s facilities. The home is a formerly privately owned, modern two-storey house, comprising six bedrooms, all with en-suite facilities, two lounges, a dining area, kitchen and laundry. All bedrooms are on the first floor. The home set in its own grounds with plenty of parking to the front and rear. The weekly fees currently range from £2445 to £3500 and information about these and the home’s other facilities are available in the office. The home’s stated principal aim is to provide a home in the community in which young adults with a learning disability can be assisted to reach their full potential and to live as rich and rewarding a life as possible. An Caladh House DS0000070572.V355831.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was undertaken using a review of all the information available to the inspector regarding the service history of An Caladh, and through undertaking a visit to the home. The fieldwork visit took place over 3 hours. The Registered Manager was present during the visit. The main method of inspection used was called case tracking which involved selecting people who live at the home, and tracking the care they receive through the checking of their records, discussion with the care staff and observation of care practices and interactions. A tour of the premises was conducted with the Manager. Documents connected with the running of the care home were also inspected. The manager completed a pre-inspection questionnaire. What the service does well: What has improved since the last inspection? Not applicable – new service. An Caladh House DS0000070572.V355831.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. An Caladh House DS0000070572.V355831.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Health and Personal Care Daily Life and Social Activities Complaints and Protection Environment Staffing Management and Administration Scoring of Outcomes Statutory Requirements Identified During the Inspection Older People (Standards 1–6) (Standards 7-11) (Standards 12-15) (Standards 16-18) (Standards 19-26) (Standards 27-30) (Standards 31-38) Adults 18 – 65 (Standards 1–5) (Standards 6, 9, 16 and 18–21) (Standards 7, 15 and 17) (Standards 22–23) (Standards 24–30) (Standards 31–35) (Standards 8, 10 and 37–43) An Caladh House DS0000070572.V355831.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 (Older People) and Standards 1 – 5 (Adults 18 – 65) are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. (YA NMS 1) Each service user has a written contract/ statement of terms and conditions with the home. Each Service User has an individual contract or statement of terms and conditions with the home. (YA NMS 5) No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Prospective Service Users’ individual aspirations and needs are assessed. (YA NMS 2) Service users and their representatives know that the home they enter will meet their needs. Prospective Service Users know that the home they choose will meet their needs and aspirations. (YA NMS 3) Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Prospective service users have an opportunity to “test drive” the home. (YA NMS 4) Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. 6. The Commission considers Standards 3 and 6 (Older People) and Standard 2 (Adults 18-65) the key standards. JUDGEMENT – we looked at outcomes for the following standard(s): 2,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service have very good information about whether the home in order to make an informed decision about whether the home is right for them EVIDENCE: The five residents currently living at An Caladh previously lived at Kisimul school They transferred as a group from there with detailed assessments and care plans. There have been no new admissions. The manager outlined the process he would follow for a new admission. The statement of purpose was An Caladh House DS0000070572.V355831.R01.S.doc Version 5.2 Page 9 comprehensive and clear. There are two house guides, one with pictures. All other admission documents gave full details of the admission process and relatives/carers were sent a pre-admission form to complete. The manager said that trial periods would last as long as they needed to and staff confirmed this. An Caladh House DS0000070572.V355831.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 (Older People) and Standards 6, 9, 16, 18 –21 (Adults 18-65) are: 7. The service user’s health, personal and social care needs are set out in an individual plan of care. Service Users know their assessed and changing needs and personal goals are reflected in their individual plan. (YA NMS 6) Also Service Users are supported to take risks as part of an independent lifestyle. (YA NMS 9) Service users’ health care needs are fully met. Service Users physical and emotional health needs are met. (YA NMS 19) 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, retain, administer and control their own medication where appropriate and are protected by the home’s policies and procedures for dealing with medicine. (YA NMS 20) Service users feel they are treated with respect and their right to privacy is upheld. Service Users rights are respected and responsibilities recognised in their daily lives. (YA NMS 16) Also Service Users receive personal support in the way they prefer and require. (YA NMS 18) Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The ageing, illness and death of a Service User are handled with respect and as the individual would wish. (YA NMS 21) 8. 9. 10. 11. The Commission considers standards 7, 8, 9 and 10 (Older People) and Standards 6, 9, 16, 18, 19 and 20 (Adults 18-65) are the key standards. JUDGEMENT – we looked at outcomes for the following standard(s): 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans give a very clear picture of residents’ needs. The staff group meets these needs with sensitivity and regard for residents’ privacy and dignity. EVIDENCE: The three care plans inspected all contained concise but comprehensive information that accurately reflected the needs of the residents. Staff An Caladh House DS0000070572.V355831.R01.S.doc Version 5.2 Page 11 members said they were easy to understand and quickly gave a profile of the residents’ needs, including triggers to behaviours and risk assessments on how to manage these. Care plans were regularly reviewed and minutes of the weekly review meeting with the manager and senior staff were seen. All residents have a severe learning difficulty and are unable to take part in the review process but the views of parents/carers and other professionals such as placing authorities were sought. The current residents have autism with severe communication difficulties and staff members were seen to use a wide range of communication methods to gain residents’ needs and choices during the inspection. Residents seen were relaxed and cheerful and had a good relationship with staff members. An Caladh House DS0000070572.V355831.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 (Older People) and Standards 7, 11– 15 and 17 (Adults 18-65) are: 12. 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 have opportunities for personal development. (YA NMS 11) Also Service Users are able to take part in age, peer and culturally appropriate activities. (YA NMS 12). Also Service users engage in appropriate leisure activities. (YA NMS 14) Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service Users are part of the local community. (YA NMS 13) Also Service Users have appropriate personal, family and sexual relationships. (YA NMS 15) Service users are helped to exercise choice and control over their lives. Service Users make decisions about their lives with assistance as needed. (YA NMS 7) Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. Service Users are offered a healthy diet and enjoy their meals and mealtimes. (YA NMS 17) 13. 14. 15. The Commission considers standards 12, 13, 14 and 15 (Older People) and Standards 12, 13, 15 and 17 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There is a wide range of activities for residents to participate in, led by the residents’ wishes. Meals are flexibly arranged to suit residents’ choices and preferences EVIDENCE: An Caladh House DS0000070572.V355831.R01.S.doc Version 5.2 Page 13 The timetable of weekly activities was displayed on a wall and had movable symbols that residents could understand and use to show their preferences. Activities included swimming, horticulture, animal husbandry on the Kisimul school site and various outings. Residents have the sole use of a minibus and there is a pool car. The manager said he was arranging a holiday for all residents, probably with the Glyn Davies Trust holiday home in Wales. Residents still return to the Kisimul site for Klub AC, a weekly evening club for the residents where they meet with their old friends from the school and the sister home, An Darach. The home is an accredited centre for the provision of the Award Scheme Development and Accreditation Network Towards Independence [ASDAN]; this enables residents to work towards specific goals and awards. One resident had two such awards displayed in his bedroom. One resident attends college. Residents are supported to have regular contact with their relatives, either by telephone or visits, according to the residents’ wishes. Records of contacts are kept in care plans. The staff members prepare all food for the residents, with their assistance on occasions. The kitchen and dining room are domestic in nature. Attention is paid to where and how residents want to sit to eat their meals. On the day of the inspection one resident made tea for everybody and assisted in cooking the mid-day meal with his one-to-one carer. One resident went shopping with a carer and another was relaxing in the quiet room. Residents indicated that they enjoyed the meals and were seen enjoying the mid-day meal. An Caladh House DS0000070572.V355831.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 – 18 (Older People) and Standards 22 – 23 (Adults 18-65) 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 feel their views are listened to and acted on. (YA NMS 22) Service users’ legal rights are protected. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Service users are protected from abuse. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) The Commission considers standards 16 and 18 (Older People) and Standards 22 and 23 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure is clear and gives residents and their supporters the confidence that complaints and comments will be listened to. Residents are kept safe from harm by clear policies and procedures concerning safeguarding adults and EVIDENCE: Records show that there have been no complaints since the home opened in August 2007. The manager said that all staff had received training in safeguarding adults and staff confirmed this and staff spoken with confirmed this. The home uses the Local Authority guidelines for safeguarding adults. There are clear procedures for the recording and management of accidents or injuries. The manager said that all care staff are trained in restraint should it be needed. Any physical intervention is recorded in residents’ care plans. An Caladh House DS0000070572.V355831.R01.S.doc Version 5.2 Page 15 An Caladh House DS0000070572.V355831.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 (Older People) and Standards 24 – 30 (Adults 18-65) are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) Service users have access to safe and comfortable indoor and outdoor communal facilities. Shared spaces complement and supplement service users’ individual rooms. (YA NMS 28) Service users have sufficient and suitable lavatories and washing facilities. Service Users toilets and bathrooms provide sufficient privacy and meet their individual needs. (YA NMS 27) Service users have the specialist equipment they require to maximise their independence. (YA NMS 29) Service users’ own rooms suit their needs. Service Users’ own rooms suit their needs and lifestyles. (YA NMS 25) Service users live in safe, comfortable bedrooms with their own possessions around them. Service users’ bedrooms promote their independence. (YA NMS 26) Service users live in safe, comfortable surroundings. Service Users live in a homely, comfortable and safe environment. (YA NMS 24) The home is clean, pleasant and hygienic. The home is clean and hygienic. (YA NMS 30) The Commission considers standards 19 and 26 (Older People) and Standards 24 and 30 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,24,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. An Caladh offers a very comfortable and homely place for residents to live and where they are can work towards independence in safety. The needs of residents with a physical disability are met EVIDENCE: An Caladh House DS0000070572.V355831.R01.S.doc Version 5.2 Page 17 An Caladh is a former private home that has been adapted to suit the needs of the resident; it has a homely atmosphere. The building is very well maintained both externally and internally; the manager said that any repairs needing to be done are sent to the maintenance team at Kisimul school and are addressed quickly. The only repair visible was to a bedroom wall that the occupant had smashed holes in; this was due to be repainted and the bed had been moved to prevent the occupant repeating the damage. A set of four steps leading from the car parking area to the main door had no rails and although all residents are currently mobile, it was suggested that a risk assessment was completed on these steps to ensure that there were no accidents. Residents indicated that they enjoyed living in the home – one held their arms out wide to indicate how much they liked it. Residents’ rooms were all en-suite and were well personalised. Care plans indicated that some had chosen the colours for the decoration of their rooms. Staff said that they cleaned residents’ rooms, with assistance from the residents. The home was clean and smelled fresh throughout. An Caladh House DS0000070572.V355831.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 (Older People) and Standards 31 – 35 (Adults 18-65) are: 27. 28. 29. Service users needs are met by the numbers and skill mix of staff. Service users are supported by an effective staff team. (YA NMS 33) Service users are in safe hands at all times. Service Users are supported by an effective staff team. (YA NMS 32) Service users are supported and protected by the home’s recruitment policy and practices. Service Users benefit from clarity of staff roles and responsibilities. (YA NMS 31) Also Service Users are supported and protected by the home’s recruitment policy and practices. (YA NMS 34) Staff are trained and competent to do their jobs. Service Users individual and joint needs are met by appropriately trained staff. (YA NMS 35) 30. The Commission considers standards 27, 28, 29 and 30 (Older People) and Standards 32, 34 and 35 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff numbers are in sufficient quantity for them to be able to care for the residents. Staff members are suitably trained, qualified and competent. EVIDENCE: Staff members work in three teams of four [one Senior staff member plus three carers] at all times during the day. At night there are two staff members. Most present staff came from Kisimul school; this gave added stability and support for residents as well as a good depth of knowledge of each resident, during the move to An Caladh. The manager said that there was a good list of bank staff and there were also back-up staff available in emergencies from Kisimul school. An Caladh House DS0000070572.V355831.R01.S.doc Version 5.2 Page 19 A training co-ordinator oversees the training programme, with all staff having a training day every three weeks to keep mandatory training up to date. The manager said that all staff members either have National Vocation Qualifications [a nationally recognised award] at level 2 or are working towards them. Staff recruitment and selection procedures, including CRB checks, were managed from the head office. Staff files seen contained all the necessary information required, although it was suggested that photographs of all staff members were put on the files. An Caladh House DS0000070572.V355831.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 (Older People) and Standards 8, 10, 23, 37 – 43 (Adults 18-65) are: 31. 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 a well run home. (YA NMS 37) Service users benefit from the ethos, leadership and management approach of the home. (YA NMS 38) The home is run in the best interests of service users. Service Users are consulted on and participate in, all aspects of life in the home. (YA NMS 8) Also Service Users are confident their views underpin all selfmonitoring, review and development by the home. (YA NMS 39) Service users are safeguarded by the accounting and financial procedures of the home. Service Users benefit from competent and accountable management of the service. (YA NMS 43) Service users’ financial interests are safeguarded. Service Users are protected from abuse, neglect and self-harm. (YA NMS 23) Staff are appropriately supervised. Service Users benefit from well supported and supervised staff. (YA NMS 36) Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. Service Users know that information about them is handled appropriately, and that their confidences are kept. (YA NMS 10) Also Service Users rights and best interests are safeguarded by the home’s policies and procedures. (YA NMS 40) and (YA NMS 41) The health, safety and welfare of service users and staff are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (YA NMS 42) 32. 33. 34. 35. 36. 37. 38. The Commission considers standards 31, 33, 35 and 38 (Older People) and Standards 37, 39 and 42 (Adults 18-65) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,37,38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well managed and the health, safety and welfare of the residents are promoted. The views of residents and their supporters are listened to An Caladh House DS0000070572.V355831.R01.S.doc Version 5.2 Page 21 EVIDENCE: The manager of the home has worked for the Kisimul group since 1997 and has managed An Caladh since it opened. He has NVQ at levels 2 and 3 and is currently working towards the NVQ level 4 Registered Managers’ Award. During the inspection he was seen to have a good working relationship with the staff and an open door policy was maintained. The home’s documentation is very well organised. The Support Manager conducts regular monitoring visits and the information from theses visits is used to identify any actions required by the manager. The manager also conducts weekly checks relating to the daily running of the home and these are well documented. Staff spoken with enjoyed working at the home; most had worked for the Kisimul group for a number of years. Minutes of the last staff meeting were seen. The manager described the bi-monthly supervision process, with himself being supervised by the Support Manager and supervising senior staff, and they in turn supervising junior staff. Annual appraisals are also held. Questionnaires, using symbols, are used to obtain information from residents about how satisfied they are with living at the home. An annual quality assurance survey is being conducted by the Support Manager, who will collate the results and compile an action plan. Maintenance and health and safety checks were not inspected in great detail but there was evidence of risk assessments and checks and a member of the maintenance team was present on the day of the inspection. An Caladh House DS0000070572.V355831.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 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 X 2 3 3 X 4 X 5 X 6 3 HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 ENVIRONMENT Standard No Score 19 3 20 3 21 X 22 X 23 X 24 3 25 X 26 3 STAFFING Standard No Score 27 4 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No Score 31 3 32 X 33 3 34 X 35 X 36 X 37 4 38 4 An Caladh House DS0000070572.V355831.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Not applicable 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 Refer to Standard YA24 Good Practice Recommendations A risk assessment should be carried out on the set of four steps leading from the car park, which do not have a handrail, to ensure that there are no accidents from falling. Staff files should contain up to date photographs. 2 YA41 An Caladh House DS0000070572.V355831.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection East Midland Regional Office Unit 7 Interchange 25 Business Park Bostocks Lane Nottingham NG10 5QG National Enquiry Line: 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 © 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. An Caladh House DS0000070572.V355831.R01.S.doc Version 5.2 Page 25 - 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. 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