Care Home: Barkerhouse Road (123)

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What the care home does well Members of staff the resident knew and trusted provided support. The resident said his key worker was "A good lady." The resident said, "I`m happy, I go shopping and to the Mosque. In my spare time I clean the house." The resident knew that help was always available and could ring the core house, Pendleview, at anytime. The house was comfortable, homely, well maintained and very clean. What has improved since the last inspection? The resident had attended fire awareness training with members of staff. A certificate of attendance was displayed in the home. To ensure the needs of the resident were fully met before moved to the house the walls had been painted in the resident`s chosen colour. What the care home could do better: It was evident during the inspection that the management was constantly looking to improve the quality of the service provided. This is good practice and should be continued. CARE HOME ADULTS 18-65 Barkerhouse Road (123) 123 Barkerhouse Road Nelson Lancashire BB8 OJL Lead Inspector Mrs Susan Hargreaves Unannounced Inspection 31st May 2007 11:30 Barkerhouse Road (123) DS0000043990.V332792.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 Barkerhouse Road (123) DS0000043990.V332792.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. Barkerhouse Road (123) DS0000043990.V332792.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Barkerhouse Road (123) Address 123 Barkerhouse Road Nelson Lancashire BB8 OJL 01204 594550 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) Pendle Residential Care Limited Mrs Ann Suleman Care Home 2 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (2) of places Barkerhouse Road (123) DS0000043990.V332792.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service should employ a suitably qualified and experienced person who is registered with the Commission for Social Care Inspection. Either one younger adult or a co-habiting couple who have a mental health problem may be accommodated. 5th September 2005 Date of last inspection Brief Description of the Service: 123, Barkerhouse Road (accommodating 1 younger adult) is part of a residential dispersed homes scheme in Nelson. This is a semi-independent living scheme for younger adults who have mental health problems. This dispersed house has staff support according to the assessed need of the resident. A designated house key worker visits at least once a day and care support is available in the evening and at weekend as needed. A senior member of staff is on call at night and 24-hour emergency support is provided from the core house at Pendleview. Further support is provided by visits from the registered manager and provider. 123, Barkerhouse Road is a terraced house, located in a residential area near to local shops. Nelson town centre shops and other amenities are a short distance away. The house has small front and back gardens. Upstairs there is one good-sized single bedroom, with a further bedroom, currently used as office storage, and a house bathroom. There is a kitchen/dining room, utility area and living room on the ground floor. The house has on-street parking. There are good local transport links, or transport in staff cars is provided for the resident. The current fees charged at Beaufort Street are £390 per week. There are no additional charges. A statement of purpose and service user guide was available to prospective residents and their relatives on request. Barkerhouse Road (123) DS0000043990.V332792.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key unannounced inspection, which included a visit to the home, was conducted at 123, Barkerhouse Road on the 23rd May 2007. No additional visits have been made since the last inspection. At the time of this inspection 1 resident was living at the home. During this visit the resident discussed the support he received from members of staff and his lifestyle. Care records and the premises were inspected. A visit was also made to Pendleview, the core home, where staff files and records were inspected. Discussions also took place with the deputy manager who was the resident’s key worker and responsible for carrying out some visits to the resident at Beaufort Street. The resident also completed a survey expressing his overall satisfaction with the care and services provided. What the service does well: What has improved since the last inspection? The resident had attended fire awareness training with members of staff. A certificate of attendance was displayed in the home. To ensure the needs of the resident were fully met before moved to the house the walls had been painted in the resident’s chosen colour. Barkerhouse Road (123) DS0000043990.V332792.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. Barkerhouse Road (123) DS0000043990.V332792.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 Barkerhouse Road (123) DS0000043990.V332792.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): 2 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A comprehensive assessment ensured the needs of the resident were identified and met. EVIDENCE: The current resident has been living at 123, Barkerhouse Road for several months. Prior to that he was resident at the core house Pendle View. When the decision was made to support the resident in a dispersed house he was invited to look round the house with a care worker. Before moving into the house the resident asked for the walls to be painted white and he chose new bed linen. The care records for the resident contained a detailed assessment based on the mental health Care Programme Approach. This provided useful information for the care plan. The resident had signed a contract, which contained detailed information about the terms and conditions of residency at the home. Barkerhouse Road (123) DS0000043990.V332792.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): 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. Independence was encouraged and the resident was supported by designated care workers to make decisions about his lifestyle. EVIDENCE: The resident gave his permission for the inspection of his care plan. This plan contained detailed information about the needs of the resident and explained how these needs were to be met. A diary sheet was included in the records, which was completed by the support worker at the morning visit everyday. The resident had signed the care plan to indicate his agreement and involvement in developing this plan. The resident was able to manage his own finances although Support was required from members of staff when claiming benefits. Barkerhouse Road (123) DS0000043990.V332792.R01.S.doc Version 5.2 Page 10 Information about advocacy services was available. Appropriate risk assessments had been completed in relation to medication and safety in the home. Risk management plans were also in place. Barkerhouse Road (123) DS0000043990.V332792.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): 12, 13, 15, 16 and 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The resident was supported to have an active and fulfilling lifestyle. Healthy eating and independent living skills were promoted. EVIDENCE: It was evident from discussion with the resident that he was encouraged and supported to have an independent lifestyle. The resident explained that he had a shower every morning, visited the mosque three times a day, went shopping on a Friday or Saturday and in his spare time cleaned the house. The resident had recently travelled independently to visit his family for a holiday. The resident described his key worker as a ‘good lady’ and said, “I’m happy.” Barkerhouse Road (123) DS0000043990.V332792.R01.S.doc Version 5.2 Page 12 Visiting was unrestricted but the deputy manager explained that the resident would not let anyone he did not know into the house. Although the resident was responsible for preparing and cooking all meals healthy eating was encouraged. Barkerhouse Road (123) DS0000043990.V332792.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Members of staff supported the resident to meet his own personal and healthcare needs. EVIDENCE: Personal care was monitored by staff. The resident said his key worker asked if he had showered when she visited each morning. The resident was registered with a GP and seen regualrly by a psychiatrist. The deputy manager explained that appointments with healthcare professionals were arranged for the resident. She also said with the exception of the psychiatric appointmnets he attended these by himself. The resident is responsible for taking his own medication. A risk assessment and risk management plan was in place. A medication administration record was seen to be up to date. Compliance with medication was monitored daily by staff. Members of staff were also responsible for ordering medication. Barkerhouse Road (123) DS0000043990.V332792.R01.S.doc Version 5.2 Page 14 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): 22 and 23 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents felt able to express their concerns. Staff had a good understanding of protection issues. EVIDENCE: No complaints have been made to the manager or the commission since the last inspection. The deputy manager who was also the resident’s key worker explained that the resident would be given any help he needed to make a complaint. The resident had been given a copy of the complaints procedure. The deputy manager said all members of staff had received training in safeguarding vulnerable adults earlier in the year. Training is also included in the induction programme for all new members of staff. A Whistle Blowing policy is in place to enable members of staff to report poor practice. Barkerhouse Road (123) DS0000043990.V332792.R01.S.doc Version 5.2 Page 15 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): 24 and 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The house was well maintained, very clean and provided a comfortable and ‘homely’ environment for the resident. EVIDENCE: The house is near to local transport, shops and other amenities. Accommodation is spacious and well maintained. The resident kept the home very clean and tidy. The kitchen had suitable equipment including a domestic style washing machine. The resident was responsible for doing his own laundry. An infection control policy was available at the core house. Barkerhouse Road (123) DS0000043990.V332792.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Members of staff had the skills and knowledge necessary in order to meet the needs of the resident. Recruitment procedures were thorough. EVIDENCE: The key worker who was also the deputy manager usually visited the home every morning. When the key worker had days off or holidays another member of staff who the resident knew and trusted visited the home. The deputy manager explained that the resident could ring the core house at anytime of day or night if he needed help. The files of three members of staff employed since the last inspection indicated that all the required pre-employment checks had been completed prior to appointment. Training for all members of staff was actively encouraged. An organisational Barkerhouse Road (123) DS0000043990.V332792.R01.S.doc Version 5.2 Page 17 training plan was displayed in the office at the core house. Training included, basic food hygiene, health and safety, first aid, de-escalation and break away, fire safety and medication. In addition to this four out of seven staff had NVQ qualifications at level 2 or above. Induction training was in place for all new employees. This programme took three months to complete and followed the skills for care syllabus. Mental health problems were also included in induction training and members of staff were made aware of the signs of deteriorating mental health for each resident. The manager was responsible for induction training but external training providers were used for health and safety and first aid training. Barkerhouse Road (123) DS0000043990.V332792.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home was effectively managed and provided person centred care for the resident. EVIDENCE: At the time of the inspection the registered manager was on leave and the deputy manager had responsibility for managing the dispersed housing scheme. The deputy manager had several years experience of caring for people with mental health problems. She had completed the NVQ level 4 qualification in care and was preparing to start training for the NVQ ‘assessor award’. The deputy manager also kept up to date with current trends and practice by using the Internet. The home has achieved the nationally accredited Investors in People award. Barkerhouse Road (123) DS0000043990.V332792.R01.S.doc Version 5.2 Page 19 Questionnaires were distributed to residents annually. An annual development plan was in place and due to be up dated. The proprietor visited the home monthly to check if the resident needed anything or had any problems. The resident was also encouraged to express his views about the home to his key worker at any time. Policies and procedures for safe working practices were in place. A fire risk assessment was in place and reviewed annually or when necessary. The resident had attended fire awareness training with members of staff. A certificate of attendance was displayed in the home. Records of the routine servicing of equipment were seen. This included the testing of small electrical appliances and up to date gas safety and electrical installation certificates. The kitchen was clean and tidy. The temperatures of the fridge and freezer were checked and recorded daily. Barkerhouse Road (123) DS0000043990.V332792.R01.S.doc Version 5.2 Page 20 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 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 3 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 4 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 4 14 X 15 3 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 X 3 X X 3 X Barkerhouse Road (123) DS0000043990.V332792.R01.S.doc Version 5.2 Page 21 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. Refer to Standard Good Practice Recommendations Barkerhouse Road (123) DS0000043990.V332792.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 Barkerhouse Road (123) DS0000043990.V332792.R01.S.doc Version 5.2 Page 23 - 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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