Care Home: Progress House (Kilnhurst)

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What the care home does well The home provides good quality care for the service users with the needs of service users met. Activities provided were good including group and individual activities. The people also had a good selection of holidays. The environmental standards were good with a programme of routine maintenance carried out to ensure the home is maintained to a high standard. The training provided for staff was very good all new starters completed induction training and were then enrolled on NVQ training to level 2. The acting manager ran the home well and created an open, positive and inclusive atmosphere, which benefited the people who lived there. What has improved since the last inspection? All rooms at progress house had been redecorated and new furniture was on order. New floor coverings were also to be laid to ensure the home is maintained to a high standard for the people who lived there. Additional staff had been put on nights to ensure people`s needs were met. Activities were being organised from the home, which is improving this service for the people ensuring their needs were met. What the care home could do better: There was insufficient staff employed to cover shifts, the acting manager and staff from other homes were ensuring adequate staff were on duty to meet peoples needs. This was due to changes within the company. The activities were now being organised from the home and the number of staff on nights had been increased. The acting manager was currently recruiting. People`s needs may not always be met as care plans were not always reviewed when changes occurred. CARE HOME ADULTS 18-65 Progress House (Kilnhurst) 17 Rix Road Kilnhurst Rotherham South Yorkshire S64 5TZ Lead Inspector Sarah Powell Key Unannounced Inspection 10 & 22 September 2008 15:00 th nd Progress House (Kilnhurst) DS0000003137.V371815.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 Progress House (Kilnhurst) DS0000003137.V371815.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. Progress House (Kilnhurst) DS0000003137.V371815.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Progress House (Kilnhurst) Address 17 Rix Road Kilnhurst Rotherham South Yorkshire S64 5TZ 01709 589385 F/P 01709 589385 progress.house@craegmoor.co.uk www.craegmoor.co.uk Sapphire Care Services Limited 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) Manager post vacant Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Progress House (Kilnhurst) DS0000003137.V371815.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th September 2006 Brief Description of the Service: Progress House is a detached property in a residential area of Kilnhurst near Rotherham. It provides care for 4 service users with learning disabilities ages 18 to 65. There is parking to the front of the property and an enclosed garden at the rear with a patio. Progress House (Kilnhurst) DS0000003137.V371815.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 star. This means that the people who use this service experience good quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. This was an unannounced key inspection and took place on 10th and 22nd September 2008. The first day we visited only the decorator was in the home. The people that lived at progress house were out, therefore a second visit was arranged for 22nd, which started at 9.50 and finished at 12.30. The visit included talking with the acting manager and peoples relatives. A walk around the building to gain an overview of the facilities and we checked a number of records. At the time of the visit an annual quality assurance assessment (AQAA) had not been returned, however the acting manager told us she had returned this. What the service does well: The home provides good quality care for the service users with the needs of service users met. Activities provided were good including group and individual activities. The people also had a good selection of holidays. The environmental standards were good with a programme of routine maintenance carried out to ensure the home is maintained to a high standard. The training provided for staff was very good all new starters completed induction training and were then enrolled on NVQ training to level 2. The acting manager ran the home well and created an open, positive and inclusive atmosphere, which benefited the people who lived there. Progress House (Kilnhurst) DS0000003137.V371815.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Progress House (Kilnhurst) DS0000003137.V371815.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 Progress House (Kilnhurst) DS0000003137.V371815.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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The assessments clearly identified people’s needs to be able to determine if they could be met. EVIDENCE: Staff carried out assessments on people who wanted to move into the home. The assessments were very detailed with all peoples needs identified, ensuring that the home could meet their needs before a place was offered to them. Progress House (Kilnhurst) DS0000003137.V371815.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Each person in the home had a plan of care with clearly identified needs, these were met, and people were treated with respect, were able to make decisions about their lives and take risks as part of an independent lifestyle. EVIDENCE: The care plans were very detailed and comprehensive and clearly identified peoples needs and how to meet those needs. The people had all completed a person cantered plan and health action plans, these ensured their choices and needs were identified and could be met. However it was not clear form the plans of care that they were regularly reviewed. Information was out of date regarding activities, changes had Progress House (Kilnhurst) DS0000003137.V371815.R01.S.doc Version 5.2 Page 10 occurred in June 2008 due to the day centre closure and these were not reflected in the plans. It was evident from talking to the acting manager that people were able to make decisions were given choices and were able to take reasonable risk as part of an independent lifestyle. Progress House (Kilnhurst) DS0000003137.V371815.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People exercised choice and control over their daily lives and activities ensuring their needs were met. EVIDENCE: The activity programme had changed in June 2008, the day centre had closed and activities had to be provided by staff at the home. In consultation with the people and their relatives the manger and staff had developed a new programme for each person to ensure their needs were met. However the change in activities had not been updated in peoples plans of care. Additional staff were being recruited to provide the activities and the acting manager told us that it had been difficult to start with changing peoples Progress House (Kilnhurst) DS0000003137.V371815.R01.S.doc Version 5.2 Page 12 routines, but it was working much better and people seemed much happier with the new arrangements. While staff were being recruited staff from other homes were covering shifts to ensure peoples needs were met. The activity programme showed there was choice and flexibility. That people participated in the local community as much as they were able and were well supported by staff. People were able to see family and friends when they wished and a number of the people regularly visited families. Staff were aware of peoples rights regarding intimate relationships and have obtained professional help for people who lived at Progress House, to ensure peoples needs were met. Meals and mealtimes are very flexible all people were able to choose what they wanted to and a healthy diet was promoted. People cook their own meals with support from staff and people also went shopping for the food with a member of staff if they wished, which ensured their choices were considered and needs met. Progress House (Kilnhurst) DS0000003137.V371815.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People’s health care needs were met and they were supported in the way they preferred. Medication procedures protected people. EVIDENCE: The acting manager told us people were able to maintain their own personal care with some support from the staff this was also seen documented in the plans of care. Health care needs of people were maintained; all people were registered with a GP, access local dentists, chiropodists and opticians. They also receive an annual health check from their GP’s. This was will documented in the care plans ensuring their needs were met. The medication policy and procedure was good medication was stored correctly and good records kept to ensure people were protected. Progress House (Kilnhurst) DS0000003137.V371815.R01.S.doc Version 5.2 Page 14 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 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has a good complaints procedure. Procedures to protect service users from abuse could be more robust. EVIDENCE: There was a clear and effective complaints procedure, which included set timescales. The complaints procedure also states that the CSCI can be contacted at any time. The home had received no complaints since our last visit. The home had a good adult safeguarding policy, which clearly defined different types of abuse, and staff were well aware of the different types, they were also aware of the importance of whistle blowing. However one safeguarding referral had been made since the last visit and staff did not follow the correct procedure. The Area manager had addressed this and all staff had completed safeguarding training. This was to ensure it did not occur again and people were protected. Progress House (Kilnhurst) DS0000003137.V371815.R01.S.doc Version 5.2 Page 15 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. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home is well maintained and clean. EVIDENCE: The standard of cleanliness throughout the home was good and all routine maintenance was carried out. Which ensured a homely, comfortable and safe environment was provided, for the people who lived at Progress House. Since the last inspection most rooms had been redecorated and new furniture was ordered for the lounge. The acting manager told us that a new floor covering was to be laid throughout the downstairs of the property. The people had been consulted on this to ensure their choices and views were listened to and taken into account. Progress House (Kilnhurst) DS0000003137.V371815.R01.S.doc Version 5.2 Page 16 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. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Recruitment procedures protected people, staff supported people and understand their needs. EVIDENCE: We looked at a selection of staff personnel files these contained all the required information, completed application form, two written references, CRB checks and all other relevant information to protect people. Staff training for all mandatory training was up to date and two new starters were completing their induction. This ensured staff were able to meet peoples needs. The acting manager told us she needed to recruit further staff, this was due to the day centre closing and the activities now being organised from the home. The staffing numbers on nights had also increased to ensure peoples needs were met therefore additional staff were also required for nights. Progress House (Kilnhurst) DS0000003137.V371815.R01.S.doc Version 5.2 Page 17 The acting manager told us, “I am recruiting additional staff and am interviewing this afternoon. In the meantime I am covering a number of shifts and I am also using staff from other homes to maintain the correct staffing levels”. Progress House (Kilnhurst) DS0000003137.V371815.R01.S.doc Version 5.2 Page 18 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. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Management and administration safeguards people, good health and safety policies and procedures were in place ensuring the safety of people in the home. EVIDENCE: Good quality monitoring systems based on seeking views of people were in place and Regulation 26 visits are carried out to ensure peoples views underpin development in the home. Progress House (Kilnhurst) DS0000003137.V371815.R01.S.doc Version 5.2 Page 19 There was a comprehensive health and safety policy and the acting manager told the inspector that all staff receive health and safety training. The acting manager also told the inspector that all safety certificates are kept at the home and all checks are up to date. We saw these and were all up to date, which ensured people were safeguarded. The acting manager has been in post at Progress house since February 2006 but has not yet registered with CSCI. The acting manager had completed her registered mangers award but had decided not to register with the Commission for Social Care Inspection. The providers were looking to recruit a new permanent manager, which would ensure stability and a good ethos within the home. Progress House (Kilnhurst) DS0000003137.V371815.R01.S.doc Version 5.2 Page 20 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 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 4 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X 3 X 4 X X 3 X Progress House (Kilnhurst) DS0000003137.V371815.R01.S.doc Version 5.2 Page 21 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. 1 Standard YA6 Regulation 15 Requirement Peoples plans of care must be reviewed to show changes to care to ensure needs are met. Timescale for action 01/11/08 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 2 Refer to Standard YA34 YA23 Good Practice Recommendations Continue to recruit additional staff to be able to maintain staffing levels to meet people’s needs. Continue to keep staff updated on adult safeguarding to ensure incidents are properly reported. Progress House (Kilnhurst) DS0000003137.V371815.R01.S.doc Version 5.2 Page 22 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 Progress House (Kilnhurst) DS0000003137.V371815.R01.S.doc Version 5.2 Page 23 - 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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