Care Home: David Lewis Centre - Bryce House

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What the care home does well In summary the expert by experience said, "It is a nicely decorated place. As soon as I walked in I got a good feeling about it. Everybody seemed happy and friendly and willing to chat to us, which made me think things were ok and there aren`t any big problems. Staff were happy to leave people to chat to me in private, and left us alone and didn`t try to interfere. The people were smartly, casually dressed which makes me think they are being well supported. People said they were happy and seemed to be happy." Assessment documents and trial visits are available so that everyone concerned can be sure that the person`s needs can be met at the home. People living in the home have access to a range of healthcare facilities including valuable specialist support at the David Lewis Centre.Staff are managing risks relating to people dealing with their own medicines in an appropriate manner to ensure safety and to develop confidence, so that people can achieve more independence. Regular meetings are held to discuss the running of the home; the expert by experience said people seemed very involved in this in the house. Menus are planned around individual likes and offer a healthy balanced diet. The expert, who ate with people living in the home said, "The choice of food was good"; "It was good food as well, not cheap and nasty stuff." There is continuous training for staff so that they follow correct adult protection procedures and so people living in the home are safeguarded from abuse. There is a comprehensive staff training schedule available at regular intervals which ensures that staff maintain their skills and provide support in line with current good practice. What has improved since the last inspection? A problem of mould in one person`s bedroom has been dealt with so the person`s living space is free from health hazards. The fire officers` requirements and the requirements made by the David Lewis Centre`s health and safety officer have been completed so that people live in safe surroundings. The kitchen has been replaced so that hygiene standards can be maintained in the home. What the care home could do better: The organisation should look at the way in which the large centre meetings are held so that all stakeholders can be involved, one person said they didn`t understand what was talked about at these meetings, and they were boring. The manager should continue to look for opportunities for work and college so that people`s independence is further promoted. A record should be maintained in the home for inspection of the action taken and the outcome of any adult protection referrals made to the social work team at the centre. CARE HOME ADULTS 18-65 David Lewis Centre - Bryce House 2,3/4 Consort Close Bollington Macclesfield Cheshire SK10 5FB Lead Inspector Ms Julie Porter Key Unannounced Inspection 28 August 2008 15:30 David Lewis Centre - Bryce House DS0000006673.V364987.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 David Lewis Centre - Bryce House DS0000006673.V364987.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. David Lewis Centre - Bryce House DS0000006673.V364987.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service David Lewis Centre - Bryce House Address 2,3/4 Consort Close Bollington Macclesfield Cheshire SK10 5FB 01625 576768 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) www.davidlewis.org.uk David Lewis Centre Mrs Rachel Elizabeth Clare Care Home 12 Category(ies) of Physical disability (12) registration, with number of places David Lewis Centre - Bryce House DS0000006673.V364987.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18 December 2007 Brief Description of the Service: Bryce House is a community-based care home run by the David Lewis Centre. The people who live in the home are aged over 18 and need support because they have epilepsy, neurological problems, learning disabilities and other associated difficulties. The home is in the village of Bollington, approximately two miles from Macclesfield, within easy reach of local facilities such as shops, churches and pubs. Bryce House is made up of two interlinked bungalows owned by a housing association and a semi-detached property within walking distance. There are 12 single bedrooms. Spaces that are shared by the people who live there include two lounges and two kitchen/dining rooms. There is a utility room with a washing machine and tumble drier, and there are enough bathrooms and toilets for the number of people who live in the home. The house is registered for one person to live in semi independently. Outside, there is car parking space and a garden with walkways and sitting areas. Information about The David Lewis Centre’s Bryce House including fees and charges and copies of the most recent inspection report can be acquired by contacting the centre’s administrative staff on 01565 640000 or the registered manager. David Lewis Centre - Bryce House DS0000006673.V364987.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The overall quality rating for this service is 2 stars. This means that the people who use the service experience good quality outcomes. This visit took place on 28 August 2008 and took five and a half hours. It was carried out by an inspector of the Commission. An expert by experience also visited the home as part of the key inspection. An expert by experience is a person who, because of their shared experience of using services and/or ways of communicating visits a service with an inspector to help get a picture of what it is like to live in or use the service. The expert by experience who came on this visit has been appointed by the Quality Company, under the direction of the Commission for Social Care Inspection, to take part in the inspection of services for people with a learning disability. During the visit we spoke with people living in the home, the manager and staff. We looked around the premises, joined the people living there for a meal and the inspector looked at various records held by the home. The visit was just one part of the inspection. Before the visit the home manager was asked to complete a questionnaire to provide up to date information about the home. CSCI questionnaires were made available to people living in the home and staff so they could tell us what they think of the home. There were ten people living in the home on the day of the visit. What the service does well: In summary the expert by experience said, “It is a nicely decorated place. As soon as I walked in I got a good feeling about it. Everybody seemed happy and friendly and willing to chat to us, which made me think things were ok and there aren’t any big problems. Staff were happy to leave people to chat to me in private, and left us alone and didn’t try to interfere. The people were smartly, casually dressed which makes me think they are being well supported. People said they were happy and seemed to be happy.” Assessment documents and trial visits are available so that everyone concerned can be sure that the person’s needs can be met at the home. People living in the home have access to a range of healthcare facilities including valuable specialist support at the David Lewis Centre. David Lewis Centre - Bryce House DS0000006673.V364987.R01.S.doc Version 5.2 Page 6 Staff are managing risks relating to people dealing with their own medicines in an appropriate manner to ensure safety and to develop confidence, so that people can achieve more independence. Regular meetings are held to discuss the running of the home; the expert by experience said people seemed very involved in this in the house. Menus are planned around individual likes and offer a healthy balanced diet. The expert, who ate with people living in the home said, “The choice of food was good”; “It was good food as well, not cheap and nasty stuff.” There is continuous training for staff so that they follow correct adult protection procedures and so people living in the home are safeguarded from abuse. There is a comprehensive staff training schedule available at regular intervals which ensures that staff maintain their skills and provide support in line with current good practice. What has improved since the last inspection? What they could do better: The organisation should look at the way in which the large centre meetings are held so that all stakeholders can be involved, one person said they didn’t understand what was talked about at these meetings, and they were boring. The manager should continue to look for opportunities for work and college so that people’s independence is further promoted. A record should be maintained in the home for inspection of the action taken and the outcome of any adult protection referrals made to the social work team at the centre. David Lewis Centre - Bryce House DS0000006673.V364987.R01.S.doc Version 5.2 Page 7 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. David Lewis Centre - Bryce House DS0000006673.V364987.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 David Lewis Centre - Bryce House DS0000006673.V364987.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): 2 People who use services experience good care in this outcome area. We have made this judgement using available evidence, including a visit to the service. People moving to the service have their needs assessed before they move in so that they know that their needs can be met and staff know what support they need as soon as they move in. EVIDENCE: Since the last visit nobody new has come to live at the home. The David Lewis Centre has comprehensive assessment documents to use when new referrals are made. In recent times Bryce house has admitted people to the home from the main site of the David Lewis Centre situated at Warford. The manager confirmed that all relevant information is collected regarding the individual’s needs and the process of moving in would include visits to the home and over night stays so people are sure they want to move there. David Lewis Centre - Bryce House DS0000006673.V364987.R01.S.doc Version 5.2 Page 10 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, 8 and 9 People who use services experience good care in this outcome area. We have made this judgement using available evidence, including a visit to the service. Care plans accurately reflect the person’s needs so that staff can give them appropriate support to help them towards independence. EVIDENCE: One care plan was inspected and showed that a person centred plan had been completed in June 2008 and reviewed in August 2008. The plan included what the person could do independently and where support was needed. Information was available to show that the person’s health was being monitored by staff, other health care professionals in the community and medical staff at the main David Lewis Centre. Risks associated with daily living and the activities that the person is involved with had been assessed. A risk management programme was being followed so that he could administer his own medication in the future. The expert by experience was asked to discuss with people living in the home how they were involved in the running of the home. He found, “residents said David Lewis Centre - Bryce House DS0000006673.V364987.R01.S.doc Version 5.2 Page 11 there are meetings in the house to sort out food shopping and menus on Tuesdays and Wednesdays. There are also meetings on Sundays about what goes on in the house, how to make things better, different activities. But a couple of people said they didn’t want to go to the big meetings at the David Lewis Centre – one person said they didn’t understand what was talked about at these meetings, and they were boring”. David Lewis Centre - Bryce House DS0000006673.V364987.R01.S.doc Version 5.2 Page 12 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 and 17 People who use services experience good care in this outcome area. We have made this judgement using available evidence, including a visit to the service. People living at the home are given support and encouragement so they can lead full active lives and gain skills to fulfil their potential. EVIDENCE: Information was available in the home that showed people had various activities they attend either throughout the day or for pleasure. One person we spoke with enjoyed having people from the church visit him at home. The expert by experience was able to spend time talking with people in the home about their lives and felt that; “everyone had lots of things to do during the day, mainly to do with the David Lewis Centre. Some people had been doing the same things for a long time. Some people are trying to move out to get their own place, and to find new things to do. Maybe people need more opportunities to try different things and to be introduced to change – things seemed a bit stale. David Lewis Centre - Bryce House DS0000006673.V364987.R01.S.doc Version 5.2 Page 13 People went on lots of trips out and holidays, they had lots of things to do. People seemed to take turns with the housework and cooking, but some people enjoyed cooking more than others – people seemed very involved in this in the house. Someone was thinking about going to work, coming off benefits and being worse off.” Surveys returned from people living in the home confirmed that most of the time they could choose what they wanted to do each day. The expert by experience also commented “the fact that we were offered a meal on an unplanned inspection was great, it was very genuine. The choice of food was good and someone said she had much more choice of food at Bryce House than where she used to live. It was good food as well, not cheap and nasty stuff.” Menus were checked and appeared to offer a good selection and provide a balanced diet. David Lewis Centre - Bryce House DS0000006673.V364987.R01.S.doc Version 5.2 Page 14 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 services experience good care in this outcome area. We have made this judgement using available evidence, including a visit to the service. The health of people living in the home is monitored so that they get the support/care they need. EVIDENCE: People living in the home confirmed that they get up and go to bed when they want and that they have a named key worker who supports them with completing plans and the more complex issues around daily living. The expert was given the impression that people living in the home do not generally have a choice of key worker. People living in the home are fully mobile and therefore no adaptations or equipment is needed. Staff monitor the healthcare needs of people living in the home; each person is registered with the local doctor, opticians and the dentist. Specialist advice in relation to people’s epilepsy is from the David Lewis Centre medical team. The David Lewis Centre has medication policies and procedures so that people living in the home receive their medicine as prescribed. People living in the David Lewis Centre - Bryce House DS0000006673.V364987.R01.S.doc Version 5.2 Page 15 home can manage some or all of their medicine subject to a risk assessment. Staff receive training at the David Lewis Training Centre so that they administer medication correctly. Medication records were seen and were being completed appropriately. David Lewis Centre - Bryce House DS0000006673.V364987.R01.S.doc Version 5.2 Page 16 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 services experience good care in this outcome area. We have made this judgement using available evidence, including a visit to the service. There is a complaints procedure that people living in the home are aware of and staff get training in adult protection so that people are protected from harm. EVIDENCE: The David Lewis Centre has a complaints procedure and staff spoken with said that they would always support people with their literacy and completing forms where needed or if they were asked. People living in the home have completed questionnaires and confirmed that they knew who to complain to if they were unhappy with any aspect of the service. We spoke with some people who said that they found it easy to tell staff when they were unhappy. All staff have received training relating to vulnerable adults and when we asked they were knowledgeable about the course of action they would take should they suspect abuse. The manager confirmed that one referral had been made to the social work team based at the main site relating to adult protection in accordance with David Lewis Centre’s procedures. Records were not available in the home for inspection regarding the outcome. David Lewis Centre - Bryce House DS0000006673.V364987.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 services experience good care in this outcome area. We have made this judgement using available evidence, including a visit to the service. The improvements made and the ongoing monitoring of maintenance issues ensure that the people living in the home live in safe, comfortable surroundings. EVIDENCE: The landlord of the property is Northern Counties Housing Association and the people living there have license agreements to stay. The landlord is responsible for the maintenance of the property and the manager could provide evidence when staff and the people living there make requests for repairs. We had a tour of the building and some people who lived there invited the expert by experience to view their rooms. Since the last inspection the problem of mould in one person’s room appears to have been dealt with and the room has been decorated. The kitchen worktops and units have been replaced and the manager confirmed that requirements David Lewis Centre - Bryce House DS0000006673.V364987.R01.S.doc Version 5.2 Page 18 made by the fire officer and the David Lewis Centre’s health and safety officer have been met. The additional property recently registered was clean, bright and modern. However the radiators in the property do not have covers and could pose a risk to safety. We spoke with the person living there who had obviously settled well and was very pleased with their home. People’s bedrooms are nicely furnished and reflect their interests. The home was fresh and clean throughout. David Lewis Centre - Bryce House DS0000006673.V364987.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 and 35 People who use services experience good care in this outcome area. We have made this judgement using available evidence, including a visit to the service. Thorough recruitment processes are in place and training is given to staff so that staff are suitable to work in care and people living in the home are protected from harm and poor practice. EVIDENCE: The Davis Lewis Centre has a full induction programme for new staff and training is offered each Monday and Tuesday in respect of updating mandatory training. The manager monitors staff attendance to ensure that they maintain competency. All staff at the home have either achieved or are working towards a National Vocational Qualification (NVQ) in care at level 2 or above. No new staff have been employed since the last visit and therefore no staff records were checked. Past inspections have indicated that the David Lewis Centre has a thorough recruitment process and this is managed well by the human resources department at the main site. David Lewis Centre - Bryce House DS0000006673.V364987.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, 38, 39 and 42 People who use services experience good care in this outcome area. We have made this judgement using available evidence, including a visit to the service. The manager is aware of her responsibilities and the home is well managed so it is run in the best interests of the people living there. EVIDENCE: The manager is registered with the Commission for Social Care Inspection and has the relevant qualifications for the position. The expert by experience felt that home had a nice atmosphere and “staff were happy to leave people to chat to me in private, and left us alone and didn’t try to interfere. Staff seemed to let residents get on with it and didn’t seem bossy or too motherly”. David Lewis Centre - Bryce House DS0000006673.V364987.R01.S.doc Version 5.2 Page 21 We found that there are a number of ways that people can comment on the quality of the service, the complaints procedure is accessible and used by people living in the home. A number of meetings take place in the home regarding the running of the home. An annual questionnaire is sent to all the people living at the home to find out what they think of the service. Regular meetings are held at the main David Lewis site although these are not popular with the group living at Bryce House. The fire test log book and accident record were inspected and showed that alarms are tested weekly, two evacuations had happened involving the people living in the home and fire equipment had been serviced in July 2008. Twenty-six accidents had been recorded since the last visit all were recorded appropriately and mainly related to bumps and falls due to seizures. David Lewis Centre - Bryce House DS0000006673.V364987.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 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 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 X X 3 X David Lewis Centre - Bryce House DS0000006673.V364987.R01.S.doc Version 5.2 Page 23 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. 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 YA8 Good Practice Recommendations The organisation should continue to explore ways to involve people living at Bryce House with the meeting held at the main site regarding development of the service so they can contribute to this aspect of the organisation. The manager should continue to explore opportunities for work and education in line with people’s aspirations. A record should be maintained in the home of all allegations of abuse the action taken and the outcome to show that allegations have been properly investigated and dealt with. Radiators should be covered depending on the assessed risk to the individual living in the home to make sure they do not present a risk to people living there. 2 3 YA12 YA23 4 YA24 David Lewis Centre - Bryce House DS0000006673.V364987.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North West Region Unit 1, Level 3 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. 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