Care Home: New House

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What the care home does well People receive a full assessment before they are admitted to the home to make sure that the staff in the home are fully aware of their needs before they move in. Following this people are offered individual levels of support to help them with the move into the home. Choices are seen as part of everyday life for people and are supported by the staff team. People go out and about in the local community and relax in their home as they wish to. Individual medication cabinets in peoples` own room allows for privacy with the administration of medicines at the persons own pace. In addition peoples rooms are a good size and offer space to relax, watch TV, make a snack or take a shower. People are supported by a staff team who are in turn well supported by their manager in carrying out their roles. The manager is experienced, they know the staff team and the majority of the people in the home well and have continued to develop their professional knowledge to assist people in their daily lives. What has improved since the last inspection? This section is not applicable as this is a newly registered service. What the care home could do better: A list of the signatures for the staff that administer medication is recommended. This would assist in the auditing of medications, making it easier to understand who was responsible for administration at specific dates and times. Door wedges are in use in the communal areas, including the kitchen area of the home. It is recommended that clarification should be sought from the local fire officer to make sure that this does not compromise people`s safety if a fire should occur. CARE HOME ADULTS 18-65 New House New House 94 Mill Lane Beverley East Yorkshire HU17 9DH Lead Inspector Sarah Rodmell Key Unannounced Inspection 2nd June 2008 09:00 New House DS0000071361.V365675.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 New House DS0000071361.V365675.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. New House DS0000071361.V365675.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service New House Address New House 94 Mill Lane Beverley East Yorkshire HU17 9DH 01482 887700 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) rose.parvin@eastriding.gov.uk East Riding of Yorkshire Council Ms Rosemary Parvin Care Home 8 Category(ies) of Learning disability (8) registration, with number of places New House DS0000071361.V365675.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. The maximum number of service users who can be accommodated is: 8 None 2. Date of last inspection Brief Description of the Service: New House is situated in the town of Beverley and it is a short walk to the main shopping areas. The home provides accommodation and care for up to eight people who may have a learning disability. GP and district nursing services are accessed via the local GP practice. There are three floors with one passenger lift that is accessed through the adjacent adult education centre and stair access. There are two lounge areas and a dining room. There is a small courtyard on the ground floor and a roof garden for people to be able to access. All of the rooms are large singles that have en-suite facilities and provide small kitchen areas. The home has two bathrooms with bath hoists and overhead tracking. The home has single toilets throughout, including and near the lounge and dining areas. There is a small car park at the rear of the building. The environment is modern, homely, clean and well presented. Information about the home and its service can be found in the statement of purpose and service user guide. Both these documents are available from the manager of the home. The registered manager told us on the 2nd June 2008 that the weekly fees are £784 per week, with additional charges for toiletries. New House DS0000071361.V365675.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 two star. This means the people who use this service experience good quality outcomes. This inspection report is based on information received by the Commission for Social Care Inspection (CSCI) since the last visit to the home, including information gathered during a visit to the home. Since the registration of the home, the CSCI has not received any information about the home from the registered provider; there have been no letters or complaints to us from other people. The site visit took place on 2nd June 2008, beginning at 9.00 am and ending at 4.00 pm. The provider was not told in advance of the date or time we planned to visit. The manager was available for this visit and during the time we spent at the home we also spoke to the staff on duty, and some of the people living in the home that were able to participate. We looked around the home including people’s rooms and the shared areas of the home, and we inspected records of people’s care, staff files, and health and safety documents. There were no relatives available at the time of the visit; consequently we did not hand out any relative’s questionnaires. We did not have any written surveys to use as part of this inspection report and we did not have an Annual Quality Assurance Assessment (AQAA) from the home. As the home has replaced a previous facility run by the same manager, within the same organisation and with the majority of the same people living there we discussed the previous AQAA with the manager and the changes to the service as a result of moving different premises. The AQAA is an audit tool, which provides us with information on the home, how it has developed over the last year and how it plans to develop in the coming year. New House DS0000071361.V365675.R01.S.doc Version 5.2 Page 6 What the service does well: 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. New House DS0000071361.V365675.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 New House DS0000071361.V365675.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 provided with good information and contracts for living in the home to support them in decision making. People are assessed before they move into the home to make sure that the home can meet their needs. EVIDENCE: There is a statement of purpose and service user guide available to people who may wish to live in the home. This provides them with information about the terms and conditions for living in the home, what services they may expect , the accomodation and the standards within the home. Both of these documents are written in plain English and include some pictures and larger print to make the documents easier to read. We looked at the files for three of the people who live in the home. Two of these people had recently moved into the home. All three files included details of assessments of need that had been developed into individual plans of care, describing peoples needs and how these are to be met. The assessments covered a variety of areas including personal care, health care, likes and dislikes of the individual and their religious needs. New House DS0000071361.V365675.R01.S.doc Version 5.2 Page 9 New house was built to replace another Local Authority home and the majority of people here had lived in the previous home. The manager told us how people had coped with the move to the new home and how this has been a positive experience for people. We also discussed the moves for the two new people. One person already knew the service quite well and had visited the home several times. The other person was new to the area but, due to other issues had needed to move into the home very quickly. The staff team had worked with this person when they first moved in, giving them additional support to help them to settle. Detailed notes had been gathered regarding the person and their life to help to make sure that the staff team were aware of their needs and were able to support them as fully as possible. Of the three files we looked at all included a copy of the person’s contract/ terms and conditions for living in the home. These detailed which room the person would have and included details of the rules for living in the home. Wherever possible people had signed to confirm their agreement to the contract. New House DS0000071361.V365675.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 & 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are supported to live their lives through a care planning and risk assessment process. EVIDENCE: Each of the files we looked at included a copy of a plan of care that describes the support that each person requires for their needs to be met. The care plans covered a variety of areas, from people’s personal care and how this was to be met to people’s social needs and preferences. The home has a key worker system and the care plan is reviewed regularly to make sure that the information is correct and up to date. Copies of the minutes of reviews with the placing authority were available on file. These included that the individual had been involved in their care review and that their needs were currently being met. New House DS0000071361.V365675.R01.S.doc Version 5.2 Page 11 Throughout our visit we heard and observed people being given choices and how they were able to make decisions. One person chose to divide their time between New house and The Millers adult education facility, and another went out for a walk. People were asked what they would like to do and what they would like to eat. People are supported to take risks in their daily lives and these are documented in the person’s individual file. The risks included the managing of peoples mental health needs and the risks they may present to the individual and to other people that they live with. New House DS0000071361.V365675.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): 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’s leisure, relationship and dietary needs are met in the home. EVIDENCE: The registered manager told us that one of the people living in the home was at work at the time of our visit. This was something that they undertook before they moved into the home and had been supported to continue with since the move. Other people continued to attend their adult education placement. At the time of the visit one person was being assisted to go out in the local community to take photographs. People’s daily notes included details of the activities they undertake including that they go out into the local community to access shops and to go for a walk or ride out. People also attend local social clubs, swimming and bowling sessions. New House DS0000071361.V365675.R01.S.doc Version 5.2 Page 13 One person told us that their relative continues to visit them in their new home and that their relative likes the new building. They also told us that they can visit at anytime that they wish to. There is a telephone in a quiet lounge for people to be able to make telephone calls to friends and relatives if they wish to and one person’s diary notes included that this is something that they do. One person also regularly leaves the home and visits relatives, staying overnight. It was clear on the day of the visit that people are able to access different areas of their home as they wish to. Some people enjoy a fixed routine and others prefer the flexibility of being able to get up and have breakfast at different times. The registered manager told us that the new larger bedrooms have increased each person’s privacy. This was in part due to the fact that bedrooms were all en-suite so people could bathe as and when they wished to without others knowing what they were doing. Also, because peoples medication cabinets were situated in their own room, others people in the home did not know if people took medication. We observed that the people in the home and the staff team seemed to have good relationships and talked easily with each other. People’s nutritional needs are assessed as part of the care planning process. The meals are provided from The Millers adult education service adjacent to the home. People choose whether to stay in their own home and have meals brought in or to go next door for a meal. There are menus in place based on a 4-week cycle and this offers people a choice at mealtimes. However as the meals are provided on a ‘first come first served’ basis with lunchtime being busy there can be limits to the amounts of choice people have; the cook and staff team are working on solutions to this. People were offered support to choose and eat meals by the staff team and the mealtime seemed relaxed and pleasant. New House DS0000071361.V365675.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 & 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Peoples personal, health care and medication needs are met in the home. EVIDENCE: Details of the individual support required by people in the meeting of their personal care needs was included in their care plans. There are additional About Me documents that are more detailed and specify how people like to be supported. People’s appearances reflected their individual personalities. File notes also included the details of peoples health needs and any ongoing health issues. When necessary people were assisted to attend hospital and specialist appointments and other professionals, for example, physiotherapists or an epilepsy specialist nurse would visit the home to help people to meet their needs. Records are kept of health appointments which include optician and dental check ups. New House DS0000071361.V365675.R01.S.doc Version 5.2 Page 15 There are new systems in place to support people with the meeting of their medication needs. Each person has an idividual locked medication cabinet in their own room which provides more privacy. There are records for the administration and disposal of medicines and the registered manager told us that the medication is checked in upon receipt each Sunday. Although on the record we examined the senior person had not signed to confirm this on the previous Sunday. There are detailed records of each person and what medication they are currently prescribed and, in addition details of the medication, its uses and side effects. There are policies in place for the handling of medication and staff files held details confirming that staff had undertaken training on the handling of medication. There is no list of peoples’ sample signatures and initials to assit with any audit of the medication records and the registered manager told us that people’s practice regarding medication is not observed after they have comlpeted training, to make sure that they are competent. New House DS0000071361.V365675.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 & 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are protected from harm and are supoprted to raise any concerns. EVIDENCE: The home has a complaints procedure that is available to the people living and working in the home. The procedure includes details of how to handle a complaint and the timescales within which responses will be completed. It includes the contact details of the CSCI but this is of the old office address and needs altering to the new contact point. When we spoke to staff they were confident in how they would handle a complaint and felt that any complaint would be dealt with appropriately within the home. There has been one complaint made direct to the home and records of this, the actions taken and the outcome are clearly recorded. There are procedures in place for the safeguarding of vulnerable people and the registered manager has attended safeguarding adults training. When we spoke to staff they were confident about how they would handle any situations or allegations of harm although they have not attended Safeguarding training; the registered manager told us that this training is planned for later in the year. People are supported to handle their own finance as far as is possible and one person has clear guidelines within their plan of care for this. There are records New House DS0000071361.V365675.R01.S.doc Version 5.2 Page 17 kept of each person’s monies including any bank accounts and the records held in the home were found to be correct. New House DS0000071361.V365675.R01.S.doc Version 5.2 Page 18 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. People live in a clean, comfortable and modern home. EVIDENCE: New House has been built recently and provides modern accomodation for the people who live there. It is close to the centre of the town, providing good access to local shops and facilities. The registered manager told us that this has helped people increase the amount of trips out into the local community. It offers large private en-suite bedrooms with good communal space. When necessary additional aids have been included, for example, overhead tracking that assists people with specialist mobility needs. There is a lift available to gain access to the second floor. However, this is only accessible by entering the adjacent Millers facility. The registered manager told us that people are tending to use the downstiars lounge as a communal meeting area, leaving the upstairs lounge as a quiet New House DS0000071361.V365675.R01.S.doc Version 5.2 Page 19 area and meeting room. The staff told us that people now watch the television more and this seems to be due to the fact that it is a large wide screen television and people can see it more clearly and appear to enjoy it. People have been able to personalise own rooms choosing the colour schemes and have added their own personal items. As this is a new build all of the fire equipment has been newly installed. Staff make regular recorded checks of the fire equipment and undertake regular fire drills. There is a fire risk assessment in place. To make doors stay open door wedges are used in the communal areas of the home, including the kitchen and the registered manager was advised that they must seek clarification with the local fire officer regarding the risks involved with this practice. New House DS0000071361.V365675.R01.S.doc Version 5.2 Page 20 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, 33, 34 & 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are supported by correctly recruited and adequately trained staff. EVIDENCE: The staff duty rotas have been re-designed to meet people’s needs now they have moved into the new home. There is usually a senior and two carers on duty throughout the day and one carer at night. In addition, there is a senior carer who shares their time between this home and the adjacent Town View, a service that is also a Local Authority provision. We looked at the staff files for 3 of the staff team. There have not been any new staff commencing work in the home and of the files we looked at all had worked in the home for some time. People’s files recorded that two written references and a Criminal Records Bureau (CRB) check were completed prior to their commencement of employment. These checks help to show that people are suitable to work with vulnerable people and that they do not hold a criminal conviction which may prevent them from working in a care setting. New House DS0000071361.V365675.R01.S.doc Version 5.2 Page 21 People’s files included details of their regular supervision sessions with a line manager. People told us that they felt well supported and that they could approach managers with any queries. The registered manager told us that people were due to have an annual development review and that this would highlight peoples’ training needs. People’s files also included details of the training that they have completed and this varies from person to person. The registered manager and staff told us that, now the house move has been completed, there are more opportunities for training and that this will also improve once the home is fully staffed. However, the staff files did reflect that the staff team do hold a variety of qualifications, both general and specific to the needs of the people in the home. These include Food Hygiene, Fire Safety, Medication training, Epilepsy training and Behaviour Management. The registered manager told us that there is not yet 50 of the staff team have not yet achieved a National Vocational Level (NVQ) 2, but that this will be met when one more staff member has undertaken the course. The registered manager also told us that there are plans to introduce Learning Disability Award Framework (LDAF) training when the staff vacancies have been filled. New House DS0000071361.V365675.R01.S.doc Version 5.2 Page 22 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. People are supported by good management systems to be able to live their lives. EVIDENCE: The registered manager has supported the people in the home with the move from the previous home, where she was the manager for some time. She has continued to develop her professional knowledge by undertaking courses, including Safeguarding Adults. There is a quality assurance system in place that takes into account the views of the people who live in the home and other stakeholders. Due to the house move this has not yet been completed this year, but plans are in place to New House DS0000071361.V365675.R01.S.doc Version 5.2 Page 23 undertake it later in the summer. There are records in place for the maintenance of the home, including fire safety . As the home is new, the fixtures and fittings are also new and maintenance checks have not yet been completed. New House DS0000071361.V365675.R01.S.doc Version 5.2 Page 24 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 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 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 3 x New House DS0000071361.V365675.R01.S.doc Version 5.2 Page 25 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 YA20 Good Practice Recommendations To assist in the safeguarding and audit processes, the registered person should make sure that there is an up to date and accurate record of all staff signatures for those who administer medication. The registered person should liaise with the local fire officer and confirm that the use of door wedges in communal and kitchen areas does not compromise the safety of the people who live in the home. The registered person should make sure that 50 of the staff team are qualified to a National Vocational Qualification (NVQ) level 2 or equivalent. 2 YA29 3 YA35 New House DS0000071361.V365675.R01.S.doc Version 5.2 Page 26 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 New House DS0000071361.V365675.R01.S.doc Version 5.2 Page 27 - 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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