Care Home: Colne House

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What the care home does well People using the service have their needs met and staff respect their choices in their daily lives. People get good support to make sure they remain healthy and get appropriate treatment if they are unwell. People’s welfare is safeguarded by the systems, such as staff vetting at recruitment and by a positive approach to making sure people’s voices are heard. The staff team are well qualified and competent in providing a good level of consistent support for people. The home is well managed. What has improved since the last inspection? The reasons for people taking their medicines and information about the drugs is now clearly recorded within the medication file for each individual so that staff are clear about what they are giving and why. The home now only has one shared room and the individuals concerned have been consulted about further possible changes so that they can have individual space. Risk assessments for individuals have been developed to support people accessing activities as safely as possible. What the care home could do better: A storage system for controlled drugs is needed to comply with the regulations relating to these types of drugs. People could be involved more meaningfully in their own planning and review meetings if people who know them well and know how they communicate prepared them for this in advance. The complaints procedure should be simplified to make it easier to understand. If people do not wish to go out much then their usage of the transport should be monitored to make sure they are getting value for money from their contribution. CARE HOME ADULTS 18-65 Colne House 22 Manchester Road Slaithwaite Huddersfield West Yorkshire HD7 5HH Lead Inspector Cathy Howarth Key Unannounced Inspection 5th September 2008 10:00 Colne House DS0000062797.V370493.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 Colne House DS0000062797.V370493.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. Colne House DS0000062797.V370493.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Colne House Address 22 Manchester Road Slaithwaite Huddersfield West Yorkshire HD7 5HH 01484 844775 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) lmacdonald@bridgewoodtrust.co.uk Bridgewood Trust Limited Care Home 8 Category(ies) of Learning disability (8), Learning disability over registration, with number 65 years of age (8) of places Colne House DS0000062797.V370493.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 following categories: Learning disability - Code Ld, Learning Disability - Code LD(E). The maximum number of service users who can be accommodated is: 8 New admissions into the home should be for service users with a learning disability who are under 65 years. 15th August 2007 2. 3. Date of last inspection Brief Description of the Service: Colne House is registered to provide accommodation and personal care for up to eight adults with learning disabilities. The home was taken over by the Bridgewood Trust in December 2004. The Bridgewood Trust is a local voluntary organisation providing a range of services to people with learning disabilities. Colne House is a substantial stone-built, three storey, detached property set in its own grounds on the outskirts of Slaithwaite, a Pennine suburb of Huddersfield. Access to the property is via steps and a steep driveway. Parking is available to the rear of the property. An external lift and external steps with appropriate lighting and handrails enable people with physical disabilities to access the home more easily. The current scale of charges at the home was stated to be £615.00 - £1,540 per week. Information about the home is available from St Paul’s House the Bridgewood Trust’s main offices, from the home itself and inspection reports are also available at both these locations and from the CSCI website at www.csci.org.uk Colne House DS0000062797.V370493.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 the people who use this service experience good quality outcomes. One inspector, using information gathered through a variety of sources, carried out this inspection visit over a period of 7 hours. People living at Colne House were sent surveys, as were staff working with them. The inspector also spoke to a representative of the local authority about the home. The manager submitted a self-assessment and a dataset of information about the service. The inspector visited the home and spent time looking around talking with people who live and work there and looking at documents relevant to the care of individuals and the running of the home. Overall we found that the home has built on the foundation of improvements it had made last year, so that people living there have had significant improvements in their lifestyle. The staff team is well led, motivated and committed to providing a good service. The inspector would like to thank all involved for their welcome and assistance with this inspection. What the service does well: What has improved since the last inspection? Colne House DS0000062797.V370493.R01.S.doc Version 5.2 Page 6 The reasons for people taking their medicines and information about the drugs is now clearly recorded within the medication file for each individual so that staff are clear about what they are giving and why. The home now only has one shared room and the individuals concerned have been consulted about further possible changes so that they can have individual space. Risk assessments for individuals have been developed to support people accessing activities as safely as possible. 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. Colne House DS0000062797.V370493.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 Colne House DS0000062797.V370493.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 No judgement was made in respect of this outcome area. EVIDENCE: This standard was not assessed at this inspection as no new admissions have been made to the home. Colne House DS0000062797.V370493.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 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. People using the service have benefited from a more structured approach to their support by staff. EVIDENCE: During this visit case files for individuals were examined and showed that planning for individual needs is generally good within this service. Support plans now have more detail about the type of support needed in all areas of personal care and individual goals are identified at reviews for people to work towards. This has been an improvement since the last inspection and staff have done well to move care planning forward. People living at the home seem to have benefited from this by a more active lifestyle and in good health and settled behaviour from some individuals. Individual plans also included, where appropriate strategies for management of behaviours and risk assessments to enable people to take part in activities and Colne House DS0000062797.V370493.R01.S.doc Version 5.2 Page 10 daily living. Daily records showed that staff are making a good record of what they have done to support people and make sure their needs and goals are met. One area for further development is in identifying a way of meaningfully involving people in their reviews and in setting goals. One person’s goals said he wanted to help out with daily chores but in fact this turned out to be untrue. Staff said that the consultation is usually based on what people know about individuals or the reviewing officer asks people, immediately before the review. The inspector discussed some more imaginative ways of approaching this consultation with the manager. Colne House DS0000062797.V370493.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 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. People are supported to follow their chosen lifestyles. EVIDENCE: People who live at the home have access to a wide range of opportunities for leisure and daytime occupation. Most people living at the home attend a day centre for three days a week but on other days they are supported to take part in local community activities such as attending local shows, pubs, sports events and other days out. People are supported to follow their interests for example one person likes music so activities are often geared towards that interest. Family and friends are encouraged to visit and maintain contacts with people who live at the home. There was evidence on files of people being supported to send birthday and Christmas cards to their family and friends. Each person has a Life Book Colne House DS0000062797.V370493.R01.S.doc Version 5.2 Page 12 which shows through pictures and photos what is important to people and things they enjoy. One of these was seen and was up to date with recent pictures of a holiday earlier this year in a caravan in Fleetwood. People also do jobs around the house. When the inspector arrived unannounced two people were helping prepare vegetables for the evening meal. People were seen to get themselves snacks and drinks throughout the day and to participate in the daily life of the home. It was noted that one person had a note on their support plan indicating that they occasionally exhibit sexual behaviours and that staff should explain it’s not appropriate and redirect them. The behaviours were not outlined in detail and there was no explanation for staff about managing people’s needs in a ways that recognises their rights to be sexual beings and emphasises how to support this rather than giving the impression that it is not allowed. People are able to influence the choices on the weekly menu through discussions with staff and fresh fruit was available in the kitchen for anyone who wanted it. The record of meals served showed a good mixture of styles and always fresh vegetables served. One person has some problems with eating and supplements are served for this person. Colne House DS0000062797.V370493.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 and 20 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. People living at Colne House receive personal care and support with health and medication needs in a way that they prefer. EVIDENCE: People’s preferences and needs in terms of personal care are now recorded on their support plans in a more detailed way than previously. In addition it was seen that where people have specific physical health needs these are addressed, for example regular visits to opticians, chiropodists nutritionists were recorded on files. Similarly where people’s emotional well being was seen to be an important area of support, there was some evidence of this being addressed, particularly where people’s behaviour might cause difficulties for other people living there. Staff demonstrated a good level of awareness of people’s emotional responses and were able to explain these to the inspector. Colne House DS0000062797.V370493.R01.S.doc Version 5.2 Page 14 At the time of this visit one person was experiencing difficulty with their health, which was making them anxious. Staff supported this person sensitively and in a way that helped them to deal with this more calmly. The management of medicines has improved since the last inspections and now there is an information sheet for each person indicating what medication they are taking, why and in the case of ‘as required’ medicines, in what circumstances it is to be given. Storage of ordinary prescribed medicines is adequate but the arrangements for controlled drugs do not meet current requirements as they are stored in a removable ‘cash box’ within the main medication trolley. Colne House DS0000062797.V370493.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 and 23 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. There are good systems in place to safeguard the people who live at Colne House from harm. EVIDENCE: The home has a complaints procedure available to all. The manager said this is a Trust-wide version. For people using the service, it is presented in a symbol form, which should make it easier to understand. However it appeared very dense and difficult to decipher, and it is debatable how helpful it is to people using the service. The manager agreed that most people using the service are supported in different ways to understand their rights. There was evidence on minutes of meetings that people are spoken to in groups and individually about how to raise any worries and concerns. There is also a CD version of the procedure. The service also asked Cloverleaf Advocacy Service to run an advocacy workshop recently for people living at Colne House to help people gain skills in speaking up for themselves. There has been one complaint made in the last year from a relative, but this was dealt with satisfactorily. No complaints have been made to Commission for Social Care Inspection. Safeguarding the welfare of people living at Colne House is a priority for the manager and staff. All staff have had updated training in safeguarding Colne House DS0000062797.V370493.R01.S.doc Version 5.2 Page 16 vulnerable adults. The manager has responded appropriately where there have been concerns about individual welfare. Since the last inspection there have been improvements in the way that one individual’s challenging behaviour has been managed. There have been few incidents of the need for physical intervention as staff have received training and clear guidance on proactive management of the behaviours. This has been a very positive outcome for the individual concerned and staff agreed that it has improved the ambience in the house, which is positive for all the people who live there. People’s individual finances were looked at as part of this inspection. The monies for people are monitored carefully to protect their interests within the house. It was noted that people’s mobility component of their Disability Living Allowance is given over to the Trust to pay for the vehicle allocated to the house. There is no formal means of monitoring whether people get value for money from this arrangement but there are individuals living at Colne House who apparently are reluctant to go out at times. People can opt out of this arrangement if they wish but without anyone monitoring this, it seems unlikely to occur. Advocates could assist with this process and raise it at reviews. Colne House DS0000062797.V370493.R01.S.doc Version 5.2 Page 17 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 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. Colne House is a spacious, clean and comfortable home. EVIDENCE: Since the last inspection, the plans that were in train at that time for refurbishment of the home have been shelved, as they were not cost effective. More recently the Trust has now begun to spend money on redecoration of the existing home to bring it up to scratch. New carpets have been fitted throughout the communal areas and there are plans for major redecoration and new furniture in the dining and lounge areas. The home was clean and tidy throughout with appropriate pictures and other ornamentation. Colne House DS0000062797.V370493.R01.S.doc Version 5.2 Page 18 Since the last visit one of the shared rooms has gone as one person moved out. One person has moved into an attached flat and is enjoying a little extra independence. Two bedrooms have been redecorated. Adequate laundry facilities are available in the basement including commercial washing machine with sluicing facilities and a tumble drier. Colne House DS0000062797.V370493.R01.S.doc Version 5.2 Page 19 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 and 36 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. People living at Colne House have the support of a well-trained and supported staff team. EVIDENCE: The staff team at Colne House is well trained, with all mandatory courses up to date. More than 50 of the staff have NVQ level2 or above qualifications, which is above the National Minimum Standards for this type of home. The manager confirmed that all new staff complete the Learning Disability Award Framework induction and foundation before going on to complete the NVQ. At the time of this inspection there were no vacancies and staff said they felt they have enough staff on duty to meet the needs of people living there. This is positive, particularly as 1:1 staffing is required for one person. Staff recruitment files were seen for three staff. These showed that the Trust carries out thorough checks on all staff before they begin working with vulnerable people. Colne House DS0000062797.V370493.R01.S.doc Version 5.2 Page 20 Support for staff was reported to be good. Staff who responded to the surveys sent out said that they felt the manager listens and supports them well both formally through staff meetings and supervision, and informally on a day to day level. Staff morale and commitment to people living at the home seemed high, from observations throughout this visit. Colne House DS0000062797.V370493.R01.S.doc Version 5.2 Page 21 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 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. The home is well managed in the interests of people who use the service. EVIDENCE: The manager of Colne House is fairly new to post and is in the process of completing his Registered Manager’s Award. The Commission has recently approved him as a registered manager. He has gained the confidence of people who live there and staff in this short time, and has developed good systems to ensure that the home runs smoothly. This was shown in the systems to look after people’s money and in keeping up to date with such things as health and safety checks and fire drill training for staff, where he has implemented easy to use systems that enable Colne House DS0000062797.V370493.R01.S.doc Version 5.2 Page 22 staff to get it right. All the safety checks and certificates were found to be up to date. The manager has begun to develop a plan for how the home may improve in the future and how people may be supported to lead more fulfilled lives. This is positive but needs further work. The manager has held two meetings with people who live there this year. To move ideas forward and to help accustom them to speaking for themselves, ideally these meetings would be more frequent. The Trust monitors the management of the home through Area Mangers who offer support to the manager and who carry out the required monthly visits re[porting to the responsible individual. Colne House DS0000062797.V370493.R01.S.doc Version 5.2 Page 23 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 N/A 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 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 2 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X 2 3 X 3 X X 3 X Colne House DS0000062797.V370493.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? NO 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. Standard YA20 Regulation 13 (2) Requirement A suitable storage system must be obtained for the safe storage of controlled drugs. Timescale for action 30/09/08 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 YA7 Good Practice Recommendations The staff should consider more meaningful ways of ascertaining people’s views in advance of their planning meetings so that they have the space to do this at their own pace and with the right support. People’s sexual behaviour should be supported sensitively so that they may enjoy their rights as sexual beings while others are protected from any inappropriate behaviour. The Trust should consider adopting a simpler picture format for raising awareness about how to complain among the people they support. It would be good practice to monitor the use of transport for those people who are reluctant to go out to make sure they receive value for money from their contributions. 2. 3. 4 YA15 YA22 YA23 Colne House DS0000062797.V370493.R01.S.doc Version 5.2 Page 25 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. 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