Care Home: Putney House

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What the care home does well The service provides a good service to people living at the home. People living at the home told us that they were happy there. They commented "It`s alright here". A comment from a social care professional said "Putney House provide a quality service for people with Prada Willi Syndrome and appear to have the skills to manage this very difficult condition." A relative commented that the home has "very good care and good staff". What has improved since the last inspection? Information for people living in the service and for anyone wishing to move into Putney House are now given information setting out what is available to them and some of the home`s policies. Some of this information, such as howto make a complaint, has been presented in a pictorial format making it easier for people to read, understand and use. The last key inspection highlighted that review documentation was not available on care records. This was available at this visit. A manager Mrs. Michelle Grimson has now been registered for the home. She has experience of working at the home and knows the people who live there and their needs. Mrs. Grimson is in the process of making improvements to the service, and several of these were identified during the visits. These improvements were based on ensuring that people living at Putney House remained safe and will ensure they will become more involved in the decisions made about their lives and their service. What the care home could do better: We have made a recommendation to organise care records so that they are easier for care staff to use. CARE HOME ADULTS 18-65 Putney House 47 Scarborough Road Bridington East Yorkshire YO16 7PE Lead Inspector Gill Sample Key Unannounced Inspection 15th January 2008 10:30 Putney House DS0000044926.V357516.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 Putney House DS0000044926.V357516.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. Putney House DS0000044926.V357516.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Putney House Address 47 Scarborough Road Bridington East Yorkshire YO16 7PE 01262 674818 F/T 01262 674818 putney@learningdisabilitiesprovider.co.uk 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) Putney House Limited Mrs Michelle Patricia Grimson Care Home 18 Category(ies) of Learning disability (18) registration, with number of places Putney House DS0000044926.V357516.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th January 2007 Brief Description of the Service: Putney House occupies two premises on the one site and is situated on the outskirts of Bridlington, with local amenities that are accessed readily by service users. Accommodation is provided over two floors, with wheelchair access at the rear of the building. There is no passenger lift. The home has a private garden for service users and there are car-parking facilities. A mini-bus is provided for service users who contribute towards the cost of this facility. Putney House Limited owns the home. The fees for the home range from £847.00 to £2442 per week, with additional charges for example, for toiletries. Putney House DS0000044926.V357516.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 the people who use this service experience good quality outcomes. The key inspection has used information from different sources to provide evidence for this report. These sources include: ● ● ● ● ● ● ● Reviewing information which has been received about the home since it became registered Information provided by the registered manager prior to the inspection Comment cards returned from people living at the home Written surveys from the relatives, carers and advocates of people living at the home. Written surveys from health and social care professionals with experience of the service. Written surveys from staff working at the home. Visits to the home on 15th and 17th January 2008. The visits to Putney House lasted seven hours. The inspector spoke to people living at the home, care workers, the registered manager and the operations manager from the organisation which operates the home. Records relating to people receiving the service, staff records and the management activities of the home were inspected. The day to day operation of the home was seen. This helped the inspector gain an insight into what it is like to live at Putney House. The registered manager and senior staff helped the inspector and the manager was given verbal feedback at the end of the inspection. What the service does well: What has improved since the last inspection? Information for people living in the service and for anyone wishing to move into Putney House are now given information setting out what is available to them and some of the home’s policies. Some of this information, such as how Putney House DS0000044926.V357516.R01.S.doc Version 5.2 Page 6 to make a complaint, has been presented in a pictorial format making it easier for people to read, understand and use. The last key inspection highlighted that review documentation was not available on care records. This was available at this visit. A manager Mrs. Michelle Grimson has now been registered for the home. She has experience of working at the home and knows the people who live there and their needs. Mrs. Grimson is in the process of making improvements to the service, and several of these were identified during the visits. These improvements were based on ensuring that people living at Putney House remained safe and will ensure they will become more involved in the decisions made about their lives and their service. 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. Putney House DS0000044926.V357516.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 Putney House DS0000044926.V357516.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. They will be given the opportunity of visiting the home prior to moving in and will have their needs properly assessed so that their needs will be met. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: Care records showed that an assessment of the needs of each person had been made. These were comprehensive in scope, included all aspects of the person’s needs and identified objectives in each area assessed. Records reflected the specialised nature of service users’ needs in relation to Prada Willi Syndrome, for example, the monitoring of diet and weight. Care records showed that each person had been given a copy of the home’s Service User Guide and the Statement of Purpose for the service. The registered manager said that the intention was to make these documents available in a format which would be suitable for people who live or may wish to move into the home. Putney House DS0000044926.V357516.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. They can make choices about how they live their lives and are protected from risk. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: Care plans were in place for each person living at the home. These covered a very comprehensive range of needs broken down into individual objectives. Any risks associated with people’s condition, providing care or activities of daily life had been assessed. For instance, one person who would be vulnerable when outside the home had assistance from two staff to prevent them being at risk from traffic or getting into uncontrolled social situations. All care records seen showed that the care planning process was reviewed on a weekly basis by care staff identified as key workers. This is an improvement since the last key inspection. Reviews also take place on an annual basis with the purchasing authority and other interested parties. A social care professional commented “I was very impressed at the quality of care given to one of my service users at the recent review.” It was noted that each care record was large and unwieldy and we discussed separating the working care plan and weekly Putney House DS0000044926.V357516.R01.S.doc Version 5.2 Page 10 reviews from active supporting records. This would enable staff to involve people in their own care. People who live at the home said they were happy with their lives there. One commented “It’s alright here”. They said that they took part in activities outside the home, attending clubs etc. in the local area. A relative commented that the service provided “very good care and good staff”. Putney House DS0000044926.V357516.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, 14, 15, 16 and 17 People who use the service experience good quality outcomes in this area. They have the opportunity to spend time as they wish and retain contacts with family. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: Care records showed that people can spend time as they wish. Organised activities are available so people have the opportunity to take part in classes and local events. A weekly programme is posted so that people know what things they can do. People were seen knitting, drawing, doing puzzles and playing computer games. People said that they were happy with the activities on offer, though one written survey said that “activities want sorting out.” Care records also showed the contact people had with their families either by telephone or by visiting their family home. People said that they sometimes had visits from their families at Putney House. Some residents live in accommodation adjacent to the main home, and are encouraged and supported by staff to live a more independent lifestyle. Putney House DS0000044926.V357516.R01.S.doc Version 5.2 Page 12 People were seen doing as they wished on the visits to the home. They have free access to all general areas of the home, with the exception of the kitchen. People’s bedrooms were full of items which reflected their favourite pastimes, such as music systems and televisions along with CDs, videos and DVDs. The majority of people living at the home have Prada Willi Syndrome which affects their ability to control appetite. The service prepares meals with the intent of ensuring that people have a reasonable diet restricted to reach or maintain a healthy body weight. Care records showed the close monitoring of body weight as part of the overall aim of achieving this. People said they enjoyed the food provided at the home. People are excluded from the kitchen so that there is no access to food which is not planned as part of their diet. Putney House DS0000044926.V357516.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. They can be assured that their health and personal care needs will be recognised and met. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: Care records showed that they enjoyed the company of staff and told us who they liked. The staff rota is posted so that people know which staff will be on duty. Staff were seen dealing sensitively with people and supporting them to express themselves, giving people time to answer in their own words. Care records showed the health and personal care needs of individual people living at the home. These also reflected the specific needs of people with Prada Willi Syndrome. All care records seen had been reviewed on a weekly basis so that records showed progress made toward achieving personal objectives. Both the registered manager and senior staff spoken with were keen to include people in maintaining their own care records with support from care staff and this was discussed on the visits. The health care needs of people were also set out in a separate document intended to go with a person should they be admitted to hospital so that nursing and medical staff know and understand their specific needs. Putney House DS0000044926.V357516.R01.S.doc Version 5.2 Page 14 Medication was seen being administered. No person deals with their own medication. The ordering, storage, administration, recording and disposal of medication was good. The current location of medication in a cupboard on a first floor landing is not ideal, and the registered manager plans to create a new storage cupboard on the ground floor which will give more space to store and organise medication. The first stage of ordering a lockable medication cupboard designed for the purpose has been done, and following minor building work medication storage should be relocated over the next few months. Putney House DS0000044926.V357516.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. They have information presented in a pictorial format so that they have the means to complain and are protected from abuse by the awareness of staff. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: One complaint has been referred to the Commission since the last key inspection but was unfounded. No complaints have been made direct to the service since the last visit. The service has improved the way that information about making a complaint is presented to people who live at the home, and a pictorial complaints procedure was seen in people’s rooms so that they could make a complaint independently of staff if they wished. The registered manager has taken proper action to make sure that people are protected from suspected or alleged abuse. Care records showed any action taken by the manager in relation to this. A copy of the local authority’s policy on the protection of vulnerable adults is available and staff told us that they had been on protection of vulnerable adults training. The way in which people’s money is dealt with was seen in operation. This requires any money taken out to be receipted for instance, when staff are out with people and is also recorded on return. People’s money is held separately and recorded so that people are protected by good and up to date record keeping. Putney House DS0000044926.V357516.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People who use the service experience good quality outcomes in this area. People live in a clean and homely place which is maintained to a good level of comfort and safety. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: All general areas of the home were seen, one bed-sit room in an adjacent building, and some bedrooms and bathrooms in the main house. The home was warm and comfortable in all areas and was decorated in keeping with the overall style of the building and suitable for the age group of the people who live there. All areas seen were clean and hygienic, and staff were working on general cleaning and maintenance during the visits. The layout of the home ensures that people can spend time with others living or working at the home or in their own rooms. There are systems in place for the maintenance of health and safety at the home and a maintenance worker is employed to make health and safety checks to ensure that people living in a safe environment. Putney House DS0000044926.V357516.R01.S.doc Version 5.2 Page 17 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 the service experience good quality outcomes in this area. They are supported by well trained and supervised staff team who have been properly checked prior to being appointed. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: Staff records showed that staff had been recruited and selected properly. The last key inspection found that in one instance a staff member had started work at the home without being checked against the list of people unsuitable to work with vulnerable adults or criminal records. There has been an improvement since the last key inspection. All records seen showed that people had made written application, two written references had been obtained, face to face interviews had been conducted and a criminal record check had been made prior to staff starting work at the home. The registered manager said that the process of recruitment included candidates spending time with people living at the home so that they could meet the candidates and contribute their views to the process of selecting staff. Staff files showed records of supervision with the registered manager and staff confirmed they had had regular supervision. Staff are trained to provide care for people living at the home and in addition to training in health and safety topics, had trained in topics specific to their needs, including training in Putney House DS0000044926.V357516.R01.S.doc Version 5.2 Page 18 diabetes and Prada Willi Syndrome. Staff undertake LDAF (Learning Disability Award Framework) training at induction and foundation level. Seventy five per cent of care staff have achieved the NVQ level 2 in care and the remainder are working towards the award. The needs of people at the home are met by a one to one staffing ratio, so they can be properly supported. Care staff demonstrated their skill in relating to people living at the home, and showed sensitivity while doing so, and staff were seen supporting people to communicate and behave in a socially appropriate way. A relative commented that the home had “very good staff.” Putney House DS0000044926.V357516.R01.S.doc Version 5.2 Page 19 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. The service is managed well, improvements have been identified and systems are in place to ensure that the building remains a safe place to live. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: A manager Mrs. Michelle Grimson has recently been registered for the home. She has experience of working at the home and knows the people who live there and their needs. She is qualified to Level 4 in care and management. Mrs. Grimson is supported by an Operations Manager who was present at the second visit to the service. Improvements have been made so that the home continues to maintain good levels of hygiene. This includes refurbishing the laundry, replacing laundry equipment and redecoration of the kitchen which has been completed since the last key inspection. Putney House DS0000044926.V357516.R01.S.doc Version 5.2 Page 20 Written information provided by the registered manager confirmed that health and safety checks are in place. The maintenance person presented records of checks made to ensure that the building’s fire safety and water supply is maintained properly. The service is monitored by monthly visits from a representative from the organisation. Putney House DS0000044926.V357516.R01.S.doc Version 5.2 Page 21 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 X 3 X LIFESTYLES Standard No Score 11 X 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 X 3 X X 3 X Putney House DS0000044926.V357516.R01.S.doc Version 5.2 Page 22 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 YA6 Good Practice Recommendations Consideration should be given to separating the working care plan so that care staff can more easily involve people in what is written about them in their care plan. Putney House DS0000044926.V357516.R01.S.doc Version 5.2 Page 23 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 Putney House DS0000044926.V357516.R01.S.doc Version 5.2 Page 24 - 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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