Care Home: Shieling The - Coach House The

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What the care home does well The information kept about people is good and is the right kind of information needed; this helps staff support people properly all of the time. People are involved in what is recorded about them and this is done with pictures, diagrams and photographs. This helps make sure people understand what is recorded about them and gives them some control and choice about this. The training staff do is good, it includes training about people with learning disabilities and how to make sure people who have learning disabilities can have more choice and control in their lives. This means staff know how to support people to be as independent as possible, treated kindly and with respect. There are good relationships between people who live at the home and staff, staff showed kindness and respect towards people. One person said, " The staff here are really good, they help you do things you want to" People have the chance to say what they think about The Shieling and how it could be better. Craegmoor, who run The Shieling, send surveys to people who live at The Shieling with pictures to make it easier to understand and they organise meetings where people can get together and talk about what it is like getting support from Craegmoor and how it could be better. This is called "Your Voice" The home has a stable and settled staff team so that people at the home receive a good consistent standard of care from people who know them well. The manager and staff team work hard to improve the quality of lives of people living at the home. What has improved since the last inspection? There is a new way for keeping information about people to help staff provide the best support. This information gathering includes the person and their point of view it includes picture prompts for people who find written language difficult. This gives people more say about how their support is given. The way complaints are recorded has improved this makes sure that people`s concerns are properly acted upon. What the care home could do better: Staff and managers do everything they need to run the home properly and they should continue to look at ways to improve the way they do things. CARE HOME ADULTS 18-65 Shieling The - Coach House The 58 Harlow Moor Drive Harrogate North Yorkshire HG2 0LE Lead Inspector Chris Taylor Key Unannounced Inspection 2nd July 2008 09:30 Shieling The - Coach House The DS0000007909.V367617.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 Shieling The - Coach House The DS0000007909.V367617.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. Shieling The - Coach House The DS0000007909.V367617.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Shieling The - Coach House The Address 58 Harlow Moor Drive Harrogate North Yorkshire HG2 0LE 01423 508948 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.craegmoor. Co.uk Parkcare Homes Ltd Miss Joanne Metcalfe Care Home 13 Category(ies) of Learning disability (13) registration, with number of places Shieling The - Coach House The DS0000007909.V367617.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th July 2007 Brief Description of the Service: The Shieling provides residential personal and social care for 11 adults aged between 18 and 65 years old who have learning disabilities and may present other complex needs. The home is a large semi detached property situated close to Harrogate town centre and with good access to its services and amenities. The registered provider is Parkcare Homes Ltd a subsidiary of Craegmoor Healthcare UK Ltd. The registered manager is Miss Joanne Metcalfe. The current fees for the home at the time of the site visit range from £450 to £1550 per week and do not include costs for chiropody, hairdressing and toiletries. Current information about services provided at The Shieling is available in the form of a statement of purpose and service user guide that explains the care and services on offer at the home. Shieling The - Coach House The DS0000007909.V367617.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. This is what was used to write this report. • • • Information about the home kept by the Commission for Social Care Inspection. Information asked for before the inspection, this is called an Annual Quality Assurance Assessment (AQAA). An unannounced visit to the home. This lasted five hours and included talking to support staff about their jobs and the training they have completed. And checking some of the records polices and procedures the agency has to keep. Information from surveys. Six surveys were received from people who live at the home. Time was spent with people who live at The Shieling. • • What the service does well: The information kept about people is good and is the right kind of information needed; this helps staff support people properly all of the time. People are involved in what is recorded about them and this is done with pictures, diagrams and photographs. This helps make sure people understand what is recorded about them and gives them some control and choice about this. The training staff do is good, it includes training about people with learning disabilities and how to make sure people who have learning disabilities can have more choice and control in their lives. This means staff know how to support people to be as independent as possible, treated kindly and with respect. There are good relationships between people who live at the home and staff, staff showed kindness and respect towards people. One person said, “ The staff here are really good, they help you do things you want to” People have the chance to say what they think about The Shieling and how it could be better. Craegmoor, who run The Shieling, send surveys to people who Shieling The - Coach House The DS0000007909.V367617.R01.S.doc Version 5.2 Page 6 live at The Shieling with pictures to make it easier to understand and they organise meetings where people can get together and talk about what it is like getting support from Craegmoor and how it could be better. This is called “Your Voice” The home has a stable and settled staff team so that people at the home receive a good consistent standard of care from people who know them well. The manager and staff team work hard to improve the quality of lives of people living at the home. 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. Shieling The - Coach House The DS0000007909.V367617.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 Shieling The - Coach House The DS0000007909.V367617.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): Standard 2. People who use this service experience good quality outcomes in this area. Peoples’ needs are properly assessed prior to admission this helps make sure that staff know they will be able to meet all of the persons needs when they move into the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff confirmed that people are admitted following a local authority care management assessment and the home’s pre admission assessment. This assessment includes information from the person, their family and other professionals and is particularly useful for those people who have complex needs and /or difficulties with communication. This document supports staff in making the admission for the person as smooth and as comfortable as possible. If at this stage the home believes they could offer a service then introductory visits commence and these are taken at a pace set by the person. New placements are under review and further assessments are completed. Usually after a settling in period a review is held to confirm that the person and other people in the house are happy with the arrangements. People are provided with and assisted in understanding the service user guide which is produced pictorially. Shieling The - Coach House The DS0000007909.V367617.R01.S.doc Version 5.2 Page 9 One person had been admitted to the home since the last inspection. Despite this admission taking place in an emergency the local authority provided their assessment and the home’s assessment was completed fully. A further three care files were looked at and all contained preadmission assessments. Shieling The - Coach House The DS0000007909.V367617.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): Standards 6, 7 and 9. People who use this service experience good quality outcomes in this area. Peoples’ needs are assessed and are met promoting independence, choice and respect for individuals. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Whilst staff were supporting people during the morning it was clear that they understood individual’s needs. They supported people sensitively and supported people to make choices. Support was given to help people prepare packed lunches, attend medical appointments and in completing household tasks. A new care planning format has been introduced. It is a pre printed document with sections to cover every aspect of the person’s life. It is also supported with pictorial prompts and diagrams. Four people’s care plans were looked at; they were all dated and signed by the author and the person’s whose care plan Shieling The - Coach House The DS0000007909.V367617.R01.S.doc Version 5.2 Page 11 it belonged to. One person identified the care plan as her own and was able to talk about the contents and that she had been involved in putting it together. Care plans are written in the first person and each section has an area to complete which identifies what the individual’s needs are and what action is needed to meet them. This is documented step by step to make sure the support is provide exactly how the person wants and needs. The care plans looked at were completed fully and included information about religious beliefs and how the individual should be supported in making choices and decisions. Support plans are reviewed regularly and are completed with the person. Also present were risk assessments with the purpose of supporting people to live as independently as possible with safeguards in place, these were also reviewed regularly. Risk assessments also covered instances any restrictions choice because the risk to the person is too great, going out unaccompanied for instance. Creagmoor provide a good induction and ongoing training for staff which makes sure people are treated with respect, dignity and are supported to make choices in their lives. This was reflected in the observations of staff working with people throughout the visit. From the surveys returned all except one person said that they were able to make decisions about their lives. Shieling The - Coach House The DS0000007909.V367617.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): Standards 12, 13, 15, 16 and 17. People who use this service experience good quality outcomes in this area. People are supported by the staff to make choices about their lifestyle, in developing new skills and to participate in activities. This supports them to lead full and active lives. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each person has a weekly timetable of activities which is put together in consultation with the person. Activities relate directly to what people are interested in and supports people to develop skills. Activities include specialist day centres or college and days at home to participate in personal shopping, laundry and household tasks. During the visit a number of people were out at a Vocational Skills Centre, a gardening project and a project called The Gift People. Shieling The - Coach House The DS0000007909.V367617.R01.S.doc Version 5.2 Page 13 There was written information in peoples’ care plans about how people spend their days. Details about family, friends and significant events are recorded in plans. Examples of how people are supported to maintain relationships with family and friends were given. All surveys received said that people could do what they wanted at the weekend and activities included going to the cinema, shopping and going to the pub. The previous day some people had been to Scarborough for the day and everyone except one person, whose preference was to stay at home, has a holiday planned for later in the year. People’s religious and cultural needs are recorded and people are supported to attend the church of their choice. Additional staffing is provided to ensure people have the opportunity to participate in activities of their choice on a one to one. Daily records provided a good picture of how people spend their day and would provide essential information to track any changes people may experience, with ill health or involvement in social activities. One person said that they discuss menus in house meetings and take it in turns to help with the supermarket shopping. There is a weekly menu but people choose what they want to eat particularly at breakfast and lunch. The menus indicated that a healthy choice is available. Staff support these meal choices discreetly to make sure people are choosing a healthy diet. Shieling The - Coach House The DS0000007909.V367617.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): Standards 18, 19 and 20. People who use this service experience good quality outcomes in this area. People’s personal and healthcare is provided appropriately and sensitively according to individual needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All the case records looked at included a Health Action Plan, which included assessment and aims for holistic health needs and more specific health needs. For instance a record was made about whether a person wanted to attend well men and women clinics. Information included medical logs, referrals for medical interventions and any further requirements and medication. Health Action Plans were signed by the person. People can access psychology, physiotherapy, and art therapy, speech therapy and specialist community nursing from the local learning disability team. Staff said they have a good working relationship with this team and evidence was seen in case records of specialist assessments and guidance for staff. A monitored dosage system is in use with proper procedures in place for the receipt, storage, administration, recording and return of medicines. Staff Shieling The - Coach House The DS0000007909.V367617.R01.S.doc Version 5.2 Page 15 receive accredited medication training and are not permitted to administer medication until their competence is assessed. An annual competence test is carried out. Those people who require PRN (as required) medication have a risk assessment and procedure for staff to follow. This includes permission to administer the medication from the senior member of staff on duty or on call. Shieling The - Coach House The DS0000007909.V367617.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): Standards 22 and 23. People who use this service experience good quality outcomes in this area. People can be confident that concerns are listened to and appropriate action is taken. There are sufficient effective systems in place to safeguard people from harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People are provided with a complaints procedure which is produced pictorially. All surveys received indicated that people were aware of who they could talk to if they had any concerns or complaints. Advocates are available to provide an independent voice for people. The process for recording information has been altered since the last inspection and this now meets with data protection guidance. No formal complaints have been made directly to the Commission for Social Care Inspection or to the home. There is a comprehensive policy and procedure with regard to safeguarding adults and the procedure to take if there is a suspicion of abuse. Staff demonstrated a good awareness of this. Staff receive training in adult protection and safeguarding issues during induction and foundation training and as part of NVQ level 2 and 3. Shieling The - Coach House The DS0000007909.V367617.R01.S.doc Version 5.2 Page 17 Some people take care of their own spending money and others need staff to do this on their behalf. Money is locked away and there is a recording sheet to record when money is spent and this is receipted. These records are audited by Craegmoor externally and are checked as part of shift change routine. Shieling The - Coach House The DS0000007909.V367617.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): Standards 24 and 30. People who use this service experience good outcomes in this area. People live in a clean, comfortable and safe home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has four floors that can only be accessed by stairs so it is not suitable for people with mobility problems. Each person has their own bedroom that is personalised to suit their individual tastes. Only one bedroom has ensuite facilities but toilets and bathrooms are accessible to all the people at the home. The home has a garden and paved patio area to the rear of the building where people can sit and smoke if they choose to do so. There is a dining room where some people like to sit and a separate lounge area with a television. There has been an extensive refurbishment programme over the past few years and the only remaining area to be redecorated is the hall, stairs and landings. The manager explained that she has had great difficulty in securing a contractor to do the work because to the height of the walls and ceilings. Shieling The - Coach House The DS0000007909.V367617.R01.S.doc Version 5.2 Page 19 However a contractor has been secured and the work is due to be carried out in the near future. There are separate laundry facilities where people’s personal clothing and bedding are attended to and procedures are followed to prevent the risk of infection. Shieling The - Coach House The DS0000007909.V367617.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, 34 and 35. People who use this service experience good quality outcomes in this area. Staff are properly vetted and trained to ensure people receive the care and support they need. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All recruitment is managed by the oraginisation centrally by a human resources department. They ensure that references and appropriate police and POVA (protection of vulnerable adults) first checks are completed before contacting the person to agree a start date. Three staff files were checked and this process had been followed. Prospective staff attend for interview and complete a literacy test. A second interview is carried out where people have the opportunity to meet service users. Feedback on this interview is obtained from service users. The manager is hoping to expand this to include people more formally in staff recruitment processes. Shieling The - Coach House The DS0000007909.V367617.R01.S.doc Version 5.2 Page 21 Training profiles were available and demonstrated that staff had completed a range of training which included statutory health and safety training as well as training specific to the needs of people with learning disabilities. Staff spoken to thought that the training provided is good and that the staff team is very supportive. There are usually three or four members of staff on duty with additionally funded hours for specific people to attend specific activities. There are two members of staff on duty at night one awake and one asleep. There is also an on call system for emergencies. The organisation has a policy and procedure with regard to supervision and appraisal called Personal Performance Agreement. The manager, who has had specific training in providing supervision, carries this out with staff every four to six weeks, each session has an agenda and is recorded and signed by both parties. Staff confirmed this. Staff meetings are held regularly. Shieling The - Coach House The DS0000007909.V367617.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 and 42. People who use this service experience good quality outcomes in this area. The home is managed in such a way that promotes the best interests of the people who live at the home. Staff take proper precautions to ensure the health and safety of people living at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has extensive experience in the field of learning disabilities, she places the service users’ needs as her first priority and she demonstrates enthusiasm and imagination in ensuring the best for people. She is well organised and delegates responsibilities appropriately to all staff team Shieling The - Coach House The DS0000007909.V367617.R01.S.doc Version 5.2 Page 23 members. She has just completed the Registered Manager’s Award. People living in the home and staff said that she is “supportive and approachable”. There is a formal quality assurance system. This process includes collating surveys form service users, their families and friends and other professionals and staff. A development plan is formulated from the outcome of surveys and is monitored to ensure achievement. Surveys are provided in pictorial format for those who need it. Additionally, monthly audits are completed by a manager from another service, this includes talking to people about their experiences of living in the home. Records were seen which confirmed that equipment is maintained and serviced appropriately. Fire detection and fire fighting equipment is tested and maintained regularly. Staff receive training with regard to all health and safety matters and there is an effective system to ensure updates are completed. Shieling The - Coach House The DS0000007909.V367617.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 3 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 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 x 3 x 3 3 x Shieling The - Coach House The DS0000007909.V367617.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Yes 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 YA24 Good Practice Recommendations In order to improve the standard of the living environment for people living at the home arrangements should be made to: Update the décor on all the landings in the home and to the ceiling areas above these landings. Shieling The - Coach House The DS0000007909.V367617.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 Shieling The - Coach House The DS0000007909.V367617.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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