Care Home: Cleveland Road

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What the care home does well People are properly assessed and consulted prior to moving into the home. People`s needs are set out in a clear plan of care. People are supported to participate in appropriate activities and are supported to maintain contact with families and friends. The home is maintained to a good standard. What has improved since the last inspection? Care documentation is now dated and signed by the member of staff who wrote it. The Kirklees Protection of Vulnerable Adults Policy has been replaced with up to date documentation. Staff have received movement and handling training. What the care home could do better: Accurate records of medication must be kept to ensure the safety of people living in the home. All staff must be suitably trained in fire safety to ensure staff are aware of what action to take in the event of a fire. A daily record of exactly what care and support has been delivered should be documented. The carpet in the small lounge should be replaced. CARE HOME ADULTS 18-65 Cleveland Road 5 Cleveland Road Edgerton Huddersfield West Yorkshire HD1 4PP Lead Inspector Helen Battle Key Unannounced Inspection 24th October 2007 12.15 Cleveland Road DS0000026323.V343158.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 Cleveland Road DS0000026323.V343158.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. Cleveland Road DS0000026323.V343158.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cleveland Road Address 5 Cleveland Road Edgerton Huddersfield West Yorkshire HD1 4PP 01484 515865 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) Bridgewood Trust Limited Care Home 13 Category(ies) of Learning disability (13) registration, with number of places Cleveland Road DS0000026323.V343158.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th September 2006 Brief Description of the Service: Cleveland Road is owned and managed by Bridgewood Trust, and it is an organisation that specialises in providing accommodation for younger adults with a learning disability. The home is registered to provide accommodation and care for up to thirteen people, and all bedrooms are for single occupancy. The establishment is a Victorian property and is situated in a residential area, close to the town centre of Huddersfield. The property is spacious and well maintained throughout, and is indistinguishable from neighbouring houses. All the people living in the home live active and varied lifestyles and are encouraged and enabled to participate in all aspects of daily living activities. The provider informed the Commission for Social Care Inspection on 24th October 2007 that the fees range from £395.80 - £936.16 per week. Items not covered by fees include: Toiletries, outings and holidays. Information about the home and the services provided are available from the home in the Statement of Purpose and Service User Guide. Cleveland Road DS0000026323.V343158.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. As part of this full inspection, a visit to the home took place. The inspector, Helen Battle, visited the home unannounced from 12.15 pm to 5.15 pm. Whilst at the home, key documents such as care assessments, care plans, daily records and staff records were looked at, and so was the accommodation. Two members of staff were spoken with along with the acting manager. Four people living at the home were spoken with. The manager had been asked to complete a questionnaire with information about the service, the people who live at Cleveland Road, and the staff working at the home. This was returned to the Commission prior to the visit taking place. Surveys were sent to ten people living at the home, their families and GPs. Six surveys were returned from people living in the home, one was returned from a relative and one from a GP. These were generally positive. Comments included: “Every need that my daughter requires is attended to in great detail and by consultation at my level. The Bridgewood Trust is first class to deal with from the executive down to the cleaning lady.” “Staff usually want to listen when I am upset and praise me when I do good”. “I am happy with the staff.” “I love living at Cleveland Road but I like going home to see my family too”. The inspector would like to thank the people living in the home and the staff for their warm welcome, co-operation and hospitality during the visit. What the service does well: People are properly assessed and consulted prior to moving into the home. People’s needs are set out in a clear plan of care. People are supported to participate in appropriate activities and are supported to maintain contact with families and friends. The home is maintained to a good standard. Cleveland Road DS0000026323.V343158.R01.S.doc Version 5.2 Page 6 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. Cleveland Road DS0000026323.V343158.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 Cleveland Road DS0000026323.V343158.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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are properly assessed before moving into the home with the assurance that their needs will be met. EVIDENCE: The care records of three people living in the home were examined and all were found to have appropriate community care assessments, which are carried out by Social Services, prior to admission and provided the information the home needed about these people. There was clear evidence in the records of one person, who recently moved into the home, that they were consulted about moving in and were given the opportunity to visit the home on a number of occasions to meet staff and the other people who live in the home. Cleveland Road DS0000026323.V343158.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, 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Plans of care are in place, which reflect the current needs of the people living in the home. People make decisions about their lives and take risks as part of a more independent lifestyle where possible. EVIDENCE: The care plans of two people living at the home were examined. These were generally well detailed and did reflect the current needs of the individuals. There was good evidence in care records of the involvement of families in the lives of people and good detail about people being supported in making their own decisions about their lives. Cleveland Road DS0000026323.V343158.R01.S.doc Version 5.2 Page 10 Specific detail was in place regarding the management of risk and challenging behaviour. Entries in the daily records were not consistent. There were gaps in information recorded and, on occasions, there had been a gap of 5 days where there had been no entries made about how an individual was or how they had spent their day. Three people living at the home were spoken with and generally were satisfied with the care and support provided. All stated that the staff are very good to them and that they are kind and patient. Responses from surveys indicated that relatives, health professionals and people living in the home are all very satisfied with the service provided. The support given by the staff working at the home to enable people to make choices and take risks was good. This was evident on the day of the visit in observing staff interaction and activities with people living in the home. People living in the home stated that they were given choices and consulted about life in the home. Cleveland Road DS0000026323.V343158.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, 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home take part in appropriate activities and are part of the local community. Appropriate relationships are maintained and people’s rights and responsibilities are respected. Meals provided at the home are of a good standard. EVIDENCE: People living at the home take part in a variety of activities and attend day centres suitable for their needs. These include day centres, going out to do their own shopping, going to local groups and clubs. The people living in the home chose to go on holiday to Filey this year and evidently enjoyed their two weeks away. Cleveland Road DS0000026323.V343158.R01.S.doc Version 5.2 Page 12 People living in the home are supported to go to local hairdressers, GPs, optician and chiropody appointments. On the day of this visit, one person was supported to go to the local newsagents and another person spoke about going out to town shopping. During this visit, one person was seen to be doing their ironing and another person was sitting with a member of staff enjoying a warm drink. Others were seen to return home at teatime from various day centres and activities. People were seen to be treated with respect and their privacy and dignity maintained by staff during this visit. People living in the home are supported to maintain links and relationships with friends and family where possible. People said that they are allowed to see visitors at any time and the home has evidently worked hard with people to support them with maintaining relationships. The meals provision at the home is of a good standard. Feedback from people living in the home, and visitors, was very positive and the meal served on the day of the visit looked appetising. Cleveland Road DS0000026323.V343158.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): 18, 19, 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People receive support in a way they prefer and require with their emotional and health needs being met. People living in the home are protected by the home’s policy and procedure for dealing with medication. EVIDENCE: People spoken to stated that the staff are kind and provide personal assistance in a discreet manner, which promotes privacy and dignity. People living in the home stated that they are able to choose what times they get up and go to bed. It was evident that people choose their own clothes, hairstyles and makeup. There was evidence in people’s records that support is also provided from specialist nurses and support from the hospital. Cleveland Road DS0000026323.V343158.R01.S.doc Version 5.2 Page 14 The medication of two people was checked and generally was found to tally with the records held. One amount of medication prescribed on an “as required” basis did not tally with the records held. Some staff had recorded whether they had administered one or two tablets, however others had not, therefore the records were not accurate. This was discussed with the acting manager at the time of the visit and ways to manage this discussed. The acting manager agreed to address the issue straightaway with staff. Procedures are in place to safeguard people living in the home regarding medication. Cleveland Road DS0000026323.V343158.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): 22, 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Generally, people feel their views are listened to and acted on. People are protected from abuse, neglect and self-harm. EVIDENCE: People spoken to felt that they could speak to any member of staff and that they would be listened to. There have been no complaints made to the home since the last inspection. The complaints procedure is available in symbol form for people living in the home. Safeguarding (Adult Protection) training has been given to all staff but two who have been off sick during August /September 2007. Staff spoken to during the visit demonstrated a good understanding of safeguarding (adult protection) issues and procedures. Prior to this visit, there had been a safeguarding referral made in relation to risk assessment and an investigation has taken place. The senior management of Bridgewood Trust have taken action regarding improving practice in relation to safeguarding issues in recent months. The personal monies of two people were checked and were found to reconcile with the records held. Cleveland Road DS0000026323.V343158.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): 24, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people live in a comfortable and safe environment and the home is clean and hygienic. EVIDENCE: The accommodation at the home is of a good standard. People living in the home have been encouraged to take their own items into the home to personalise their rooms and people also said that they had been involved in choosing furniture and other items. Whilst people were on a two-week holiday this summer, the kitchen in the home has been refurbished to a high standard with new fixtures, fittings and appliances. New furniture and a wide screen television have also been purchased for the main lounge. Cleveland Road DS0000026323.V343158.R01.S.doc Version 5.2 Page 17 The smaller lounge is also furnished to a good standard, however the carpet is stained and should be replaced. The home is set in nicely maintained gardens. The home was clean and free from any offensive odours on this visit. Cleveland Road DS0000026323.V343158.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): 32, 34, 35. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People are supported by competent and qualified staff, and are protected by the home’s recruitment practices. Staff are receiving mandatory training within recommended timescales. EVIDENCE: All the staff working at the home have received movement and handling training within the last 12 months. The majority of staff have also had updated safeguarding training (adult protection) in recent weeks. Training records indicated that staff have also had Health and Safety training, and medication training. Most staff have had one fire safety training session this year, and are due to have a second by the end of the year. Two members of staff have not had fire safety training at all this year and this needs to be addressed quickly to ensure the safety of the people living in the home. Staff also complete training regarding supporting people who have a learning disability. Cleveland Road DS0000026323.V343158.R01.S.doc Version 5.2 Page 19 The recruitment process at the home protects the people living there. The records for two members of staff were examined. Both of these records were complete. Staffing levels are provided to meet the needs of the people living in the home. There are always three members of staff on duty during the day and this is increased, when needed, to support people to take part in specific activities. Two members of staff sleep in at night. Cleveland Road DS0000026323.V343158.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): 37, 39, 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People benefit from a well run home, and their views underpin development at the home. The health, safety and welfare of people are protected. EVIDENCE: There has been a recent change in the management arrangements at Cleveland Road. The registered manager has taken up post elsewhere and the person identified to be acting manager has been off sick for a time. In her absence, another senior member of staff has been overseeing the running of the home. These arrangements appear to have ensured some consistency for the people living in the home. The acting manager returned to work the week of this visit and is hoping to settle back into her new role. Cleveland Road DS0000026323.V343158.R01.S.doc Version 5.2 Page 21 People’s views are listened to and underpin any development of the home’s policies and practices. Monthly management visits are carried out. Quality assurance processes should be developed by the acting manager to continue to ensure a good service provision. There were no apparent health and safety issues observed during this visit. Weekly tests of the emergency lighting and fire alarm systems are recorded. Cleveland Road DS0000026323.V343158.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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 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 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 2 X Cleveland Road DS0000026323.V343158.R01.S.doc Version 5.2 Page 23 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard YA20 YA42 Regulation 13.- (2) 23(4) d,e Requirement Accurate records of medication must be kept. All staff must be suitably trained in fire safety. Timescale for action 31/10/07 30/11/07 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. Refer to Standard YA6 YA24 Good Practice Recommendations A daily record of exactly what care and support has been delivered should be documented. The carpet in the small lounge should be replaced. Cleveland Road DS0000026323.V343158.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Brighouse Area Team First Floor St Pauls House 23 Park Square Leeds LS1 2ND 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 Cleveland Road DS0000026323.V343158.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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