Care Home: Chapel Lane, 4

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What the care home does well The home provides a good range of information to people thinking of coming to the home, so they and their representatives can make an informed decision.The home makes a full assessment of a person`s needs before deciding if it can meet all those needs. The home draws up plans to meet the care needs of its service users. Service users health care needs are also fully assessed and properly met. The home stores medicines safely, and administers them correctly and safely. Service users say that staff treat them well and treat them with respect. The home is working hard to provide a stimulating atmosphere both inside and outside the home, with appropriate social activities for service users. All are encouraged to keep in regular contact with family and friends. Service users are also encouraged to take as much control over their own lives as they are able, and make their own decisions. Service users are very complimentary about the food, and they help to prepare meals. Complaints and concerns are taken very seriously and are responded to properly. The home is kept clean, hygienic and free from odours. The home has enough staff to meet the needs of service users. The home is very careful as to how it recruits new staff, and runs all the necessary checks on them to protect its service users. The manager is experienced and is providing very positive leadership to the home. The home is being run in the best interests of the service users. Service users` finances are protected by the home`s policies and accounting systems. The health and safety of the service users and of the staff are protected by the home`s policies and systems. One service user said that "I love this place, I receive all the support I need, and I am very independent because I get lots of support from all the staff here. One day I may move into a flat of my own, but I would probably miss this place to much". "DS0000000351.V364641.R01.S.docVersion 5.2Page 7 What has improved since the last inspection? The home continues to provide high standards of care. The staff team have all achieved NVQ level 2/3 training in care. What the care home could do better: The homes quality assurance system should include feedback from service users, their relatives and professionals involved with service users, and then devise an annual development plan. To improve outcomes for service users, each individual`s needs, aspirations and goals should be recorded. To improve outcomes for service users, equality and diversity procedures should be implemented, and training for staff will improve their understanding of these issues. CARE HOME ADULTS 18-65 Chapel Lane, 4 4 Chapel Lane Monkseaton Whitley Bay Tyne And Wear NE25 8AD Lead Inspector Jim Lamb Unannounced Inspection 20th May 2008 11:00 DS0000000351.V364641.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 DS0000000351.V364641.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. DS0000000351.V364641.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chapel Lane, 4 Address 4 Chapel Lane Monkseaton Whitley Bay Tyne And Wear NE25 8AD 0191 2518734 F/P 0191 2518734 No Email www.care-ltd.co.uk CARE (Cottage and Rural Enterprises Ltd) 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) Miss Sylvia France McKenzie Care Home 6 Category(ies) of Learning disability (6) registration, with number of places DS0000000351.V364641.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd August 2006 Brief Description of the Service: Chapel Lane was built within the last few years to provide a home for up to six adults who have a learning disability and who need residential care. Nursing care is not provided. It is within walking distance of local shops and other facilities. The house is detached and has three storeys. The home provides single bedrooms on the ground and first floor. The staff facilities are on the second floor. A staircase reaches the first and second floors. There are a suitable number of bathrooms and toilets. A yard is available to the rear of the building and a small paved garden area to the front. Fees for the home range from £ 495 to £582. Information about the home and inspection reports are both available in the home. DS0000000351.V364641.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means that the people who use the service experience good quality outcomes. How the inspection was carried out Before the visit: We looked at: • Information we have received since the last visit. • How the service dealt with any complaints & concerns since the last visit. • Any changes to how the home is run. • The provider’s view of how well they care for people. • The views of people who use the service & their relatives, staff & other professionals. The Visit: An unannounced visit was made on date 20/05/08. During the visit we: • • • • • • Talked with people who use the service, relatives, staff, the manager & visitors. Looked at information about the people who use the service & how well their needs are met, Looked at other records which must be kept, Checked that staff had the knowledge, skills & training to meet the needs of the people they care for, Looked around the building/parts of the building to make sure it was clean, safe & comfortable, Checked what improvements had been made since the last visit. We told the manager/provider what we found. What the service does well: The home provides a good range of information to people thinking of coming to the home, so they and their representatives can make an informed decision. DS0000000351.V364641.R01.S.doc Version 5.2 Page 6 The home makes a full assessment of a person’s needs before deciding if it can meet all those needs. The home draws up plans to meet the care needs of its service users. Service users health care needs are also fully assessed and properly met. The home stores medicines safely, and administers them correctly and safely. Service users say that staff treat them well and treat them with respect. The home is working hard to provide a stimulating atmosphere both inside and outside the home, with appropriate social activities for service users. All are encouraged to keep in regular contact with family and friends. Service users are also encouraged to take as much control over their own lives as they are able, and make their own decisions. Service users are very complimentary about the food, and they help to prepare meals. Complaints and concerns are taken very seriously and are responded to properly. The home is kept clean, hygienic and free from odours. The home has enough staff to meet the needs of service users. The home is very careful as to how it recruits new staff, and runs all the necessary checks on them to protect its service users. The manager is experienced and is providing very positive leadership to the home. The home is being run in the best interests of the service users. Service users’ finances are protected by the home’s policies and accounting systems. The health and safety of the service users and of the staff are protected by the home’s policies and systems. One service user said that “I love this place, I receive all the support I need, and I am very independent because I get lots of support from all the staff here. One day I may move into a flat of my own, but I would probably miss this place to much”. ” DS0000000351.V364641.R01.S.doc Version 5.2 Page 7 What has improved since the last inspection? 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. DS0000000351.V364641.R01.S.doc Version 5.2 Page 8 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 DS0000000351.V364641.R01.S.doc Version 5.2 Page 9 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): 1 2 3 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users are properly assessed and are provided with enough information about the service to enable them to make a choice about where they want to live. EVIDENCE: The care records for two service users were examined. These showed that the manager makes sure that a full assessment of a new service users needs is carried out by the person’s social worker before they come into the home. The manager also carries out her own assessment, to be doubly sure that the home can meet all of the new person’s needs. However admissions to the home are rare. The last admission was over two years ago. More detailed assessments are carried out once the new service user has come into the home. These include assessments of risk; of nutritional needs; of social needs; and of behavioural needs. As a result of all these levels of assessment, the manager can clearly demonstrate that all her service users are in a home that can give them the care that they need. DS0000000351.V364641.R01.S.doc Version 5.2 Page 10 All are provided with a contract explaining the homes terms and conditions, and fees. The service users guide is available in clip art; this helps service users understand it’s content. DS0000000351.V364641.R01.S.doc Version 5.2 Page 11 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): Quality in this outcome area is (excellent, good, adequate or poor) This judgement has been made using available evidence including a visit to this service.6 7 9 Quality in this outcome area is good. EVIDENCE: Each person’s assessed needs are met in an appropriate range of systems. All have clear care plans (or ‘goal plans’). Other assessed needs are met using appropriate formats. For example, the nutritional needs of individuals, their monthly weight is recorded, and their health needs. It was apparent that care/goal plans are looked at closely in regularly monthly reviews, and they are updated as necessary. Although quite thorough, the care plan formats are the same for each person they are not unique to each individual. The manager said that she intends to address this issue; she will ensure that the plans reflect the personal needs, aspirations and goals of each person. DS0000000351.V364641.R01.S.doc Version 5.2 Page 12 The staff member on duty said that they are always given up to date information about the service users and their needs. The service users said that they make decisions about what they do each day, and that they can do what they want to do during the day, evenings and at weekends. The people living in the home have a wide range of opportunities for choice. These include meals and cooking, activities, trips out, what to wear, and toiletries. Holidays are negotiated individually with each person, and they can choose where to go, when, and who with. The interactions between staff and the people who live in the home were observed to be based on mutual respect and affection. Risk assessments are carried out, and staff ensure that service users understand there content. Assessments seen were comprehensive and appropriately detailed. They are reviewed regularly and updated as necessary. The home’s policy is to accept that risk is part of the normal experience of daily living, and is properly managed. DS0000000351.V364641.R01.S.doc Version 5.2 Page 13 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): 11 12 13 14 15 16 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The service users are offered a good quality lifestyle, which includes social contact, activities and choice. EVIDENCE: Each service user has a social skills assessment carried out. This is reviewed and updated on a regular basis. All service users participate in this process. Service users are supported and encouraged to be in control of their own lives, to enjoy their own interests and hobbies. There are daily activities available, and service users have a choice of activities they want to do. All are provided with opportunities to further education and supported employment schemes. DS0000000351.V364641.R01.S.doc Version 5.2 Page 14 Outings and activities are planned. There are meals out, visits to cafes, shops, pubs, and trips to local theatres, etc. All service users are supported to maintain very close links with their families and friends. They can choose who they want to see and when. The Home’s menus are based on the known likes and dislikes of the service users. At least two hot meals are provided each day. Service users help staff with the food shopping, and preparing meals. The service users said that the meals were very good and that they were always offered a choice. Service users are supported to attend weekly Religious services of their choice. DS0000000351.V364641.R01.S.doc Version 5.2 Page 15 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): 18 19 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health of the service users is met and there is good multi disciplinary working taking place. The promotion of health care is taken seriously, and service users have their personal needs met in the way that they prefer. EVIDENCE: Service users do not have any moving and handling needs. Service users need minimal help with personal care tasks, such as bathing and dressing. Privacy and dignity are respected at all times. Service users care records showed that they have access to external health care services. DS0000000351.V364641.R01.S.doc Version 5.2 Page 16 G.Ps visit when necessary. Service users are referred for specialist health care if appropriate. All service users receive regular health care checks. Staff who have completed relevant training administers medication. A sample of medication records was examined. These include photographs for identification purposes. Clear directions were recorded and each dose of medication was signed for, or a code entered to verify the reason not given. The Controlled Drugs register was appropriately recorded. Safe handling of medication training is arranged for July 2008. Privacy and dignity issues are built into the home’s policies and procedures and staff training. All personal care and medical examination/treatment is carried out in private. DS0000000351.V364641.R01.S.doc Version 5.2 Page 17 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 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has good, clear, user-friendly complaint and protection system, service users are safe and their views are listened to and acted upon. EVIDENCE: There is a complaints procedure. The procedure is written in a way that ensures service users fully understand its contents. One service user said that she had been given a copy of the procedure and that staff always listened to any concerns and always dealt with them fairly. The home keeps a record of complaints. The home has a Whistle Blowing policy, the Local Authorities Vulnerable Adults procedures, and a copy of the Department of Health’s document, “NO SECRETS”. Staff are aware of these procedures and have easy access to them. Since the last inspection visit, there have been no complaints received. Safeguarding adults training is ongoing for all staff. Service users can deposit cash for safe keeping in the home’s safe and records are kept of accounts. A sample of personal finances records was examined. Transactions were appropriately recorded and had two signatures for each entry. There was plenty of evidence of personal spending. Receipts are DS0000000351.V364641.R01.S.doc Version 5.2 Page 18 obtained for purchases and numbered to cross-reference to the transaction. Weekly checks of balances and cash are carried out. DS0000000351.V364641.R01.S.doc Version 5.2 Page 19 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 25 26 27 28 29 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a comfortable, clean, safe and pleasant environment for those living there. EVIDENCE: The home was clean, very well decorated and well maintained. The home has an appropriate amount of sitting, recreational and dining space. There are enough rooms for a variety of activities to take place. Service users can see visitors in private in their own rooms. Furnishings and fittings were domestic in design and in very good condition. Lighting was bright and domestic in design. All doors have privacy locks and room sizes meet the minimum required. DS0000000351.V364641.R01.S.doc Version 5.2 Page 20 Service users’ bedrooms have opening windows and restrictors are in place where needed. All bedrooms are spacious, well decorated and highly personalised. The rooms were centrally heated and the heating level could be controlled within each bedroom. Radiators and pipes were guarded. There was emergency lighting throughout the home. Water is stored at over 60°C. Valves at water outlets ensure water is provided close to 43°C to prevent scalding. The home was clean and free from offensive odours. The laundry facilities are well organised. The washing machine has the specified programme to meet disinfection standards. DS0000000351.V364641.R01.S.doc Version 5.2 Page 21 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 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a good match of well-qualified staff, who are appropriately recruited and supervised and who offer consistency of care within the home. EVIDENCE: Staff levels on the day of the inspection met the agreed level. The required numbers of staff were on duty: 1/2 staff between 8am and 10pm with one on sleep-in staff between 10pm and 8am. All staff were over 18 years of age and those left in charge were at least 21. The training needs of the staff are identified in supervision and appraisal sessions. Staff still need equality and diversity training, and the service should develop equality and diversity procedures. This is an outstanding recommendation. The homes training programme meets the National Training Organisation requirements for the first six months. DS0000000351.V364641.R01.S.doc Version 5.2 Page 22 Staff receive at least three days paid training each year. The service has a rigorous staff recruitment and selection process to ensure that all appropriate checks and references are in place prior to employment. The service has a good staff training and development programme in place. All statutory training was up to date and 100 of the staff team has completed NVQ level 2/3. DS0000000351.V364641.R01.S.doc Version 5.2 Page 23 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 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is supported by the organisation in providing clear leadership throughout the home with all staff demonstrating an awareness of their roles and responsibilities, and service users best interests being promoted. EVIDENCE: The manager has many years experience in senior management. She has the appropriate qualifications, experience and skills necessary to manage the service. Staff spoken to were clear about their responsibilities and the service users care needs. DS0000000351.V364641.R01.S.doc Version 5.2 Page 24 Service users are told when inspections take place and they are shown inspection reports. These are also summarised and discussed in service user meetings. Copies of reports are available for relatives and others to see. The organisation has continued to develop policies and procedures which have been linked to the National Minimum Standards. A better quality assurance system needs to be in place to monitor the quality of the service provided. This should involve gaining feedback from service users, relatives and professionals involved with the home. The outcomes should be published and made available to all prospective service users. The home will then need to implement an annual development plan. The records inspected were found to be appropriately completed. These included the fire log book, accident records and personal allowance records. There is a health and safety policy and a range of associated procedures. Staff receive training in safe working practices. There are appropriate maintenance contracts in place for the home. Water storage tanks, gas and electrics are checked annually. DS0000000351.V364641.R01.S.doc Version 5.2 Page 25 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 3 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 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 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 4 12 4 13 4 14 4 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 3 X DS0000000351.V364641.R01.S.doc Version 5.2 Page 26 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. Refer to Standard YA40 Good Practice Recommendations Provide staff with equality and diversity training and implement specific policies and procedures. (Outstanding since the last inspection visit). 2. YA39 The homes quality assurance system must be improved to include the views of service users their relatives and professional involved with the home. An annual development plan must also be implemented. Develop service users care plans to ensure that they reflect each person’s holistic needs, aspirations and goals. 3. YA6 DS0000000351.V364641.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 DS0000000351.V364641.R01.S.doc Version 5.2 Page 28 - 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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