Care Home: The Pleasance

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: The Pleasance Edlington Lane Edlington Doncaster South Yorkshire DN12 1PL One star adequate The quality rating for this care home is: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Christine Rolt Date: 2 9 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Internet address www.csci.org.uk Information about the care home Name of care home: Address: The Pleasance Edlington Lane Edlington Doncaster South Yorkshire DN12 1PL 01709866303 01709860646 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Cristal Care Limited Name of registered manager (if applicable) Ms Dawn Marie Barraclough Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 3 0 care home 3 learning disability Additional conditions: The registered person may provide the following category of service only: Care home only - Code PC, to service users of the following gender: Either, within the following categories: Learning disability - Code LD The maximum number of service users who can be accommodated is: 3 The maximum number of service users who can be accommodated is: 3 Date of last inspection Brief Description The Pleasance is one of several newly built detached properties within a gated area on the outskirts of Old Edlington. There are three en-suite bedrooms and the main office on the first floor, which is accessed by stairs. There is a large lounge, dining room and kitchen on the ground floor. There are patio doors leading to an enclosed garden. Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: One star adequate Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home How we did our inspection: The quality rating for this service is 1 star. This means that the people who use this service experience adequate quality outcomes. This is a newly registered home and at the time of this inspection there were no people living in the home, therefore the highest rating that this home could achieve is 1 star. This is a newly registered home and has no previous requirements. However, the following paragraph is for general information. 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 a key inspection and comprised information already received from or about the home and a site visit. The site visit was from 9.45 am to 2:15 pm. The registered manager completed an Annual Quality Assurance Assessment but this was not received before the site visit. This document gave the manager the opportunity to say what the home did well, and what they were working on to improve. Various aspects of the service were checked during the site visit but because there were no people living in the home and no staff, this was restricted to checking documentation, an inspection of the building and discussing service provision with the registered manager. The inspector wishes to thank the registered manager for her assistance and cooperation. What the care home does well What has got better from the last inspection What the care home could do better: Information of fees needs to be included in the statement of terms and conditions. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People will only move into the home after their needs have been assessed and been assured that the home can meet their needs. Evidence: The service had a Statement of Purpose that had been amended to take account of people moving into the home who were under 18 years of age. The homes had a Service User Guide with pictures to make it more appealing to young people. The Guide did not provide details of fees or information of what was not included in the fees. This was discussed with the manager during the site visit. The home was in the process of assessing a person to determine whether the home could meet their needs. The assessment form was seen. This contained a good range of information covering needs, wishes, preferences and daily routines. Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Peoples assessed and changing needs and their methods of communication will be reflected in their care plans to ensure that their needs and wishes will be met. Evidence: Information in the assessment showed that the persons wishes had been taken into consideration. The manager said that the person had been consulted about their goals for the future and the promotion of life skills within a risk management framework. The home had a range of risk assessment forms. One of the risk assessment forms was designed for consultation with the person to determine their understanding of risk in any given situation. Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People will be able to participate in activities and leisure activities both inside and outside the home. Their rights will be respected and choices will be offered. Evidence: Information in the assessment and discussion with the manager showed that this home intends to encourage people to lead full and active lives through person centred care. Life skills were to be promoted under the guidance of staff. People would take responsibility, as far as they were able, for meal planning, shopping, preparing and cooking meals, cleaning and personal laundry. They would be encouraged to participate in leisure activities both inside and outside the home and helped to pursue their hobbies. Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People will receive the personal support they prefer and their physical, emotional and heath needs will be met. People will retain, administer and control their own medication if this is appropriate and within a risk management framework. Evidence: There were no people living at the home during this site visit, therefore care plans could not be checked. The manager said that each persons medication would be kept in a locked cupboard in each persons bedroom but these had not yet been fitted. There was lockable storage within the office if this was required. The manager said that staff would undertake Boots accredited medication training before they dealt with any medication. The home had policy and procedures and some guidelines on medication procedures and the manager was advised to obtain a copy of the Royal Pharmaceutical Societys guide The Handling of Medicines in Social Care as extra guidance. Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The homes complaint procedure ensures that people and their representatives have the means to complain. Adult safeguarding policies and procedures and proposed staff training will ensure that staff have the means to understand and report allegations of abuse. Evidence: The home had a complaints procedure and the information was also included in the Service User Guide. The homes adult safeguarding procedures were checked. The home also had a copy of the South Yorkshire Adult Safeguarding Policy and Procedures and the Whistleblowing procedure. All new staff were to undertake a basic introduction to adult protection as part of their basic induction. The format for this was seen during the site visit. The manager said that more detailed training would be provided as part of each persons training. Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home was clean, comfortable and safe but would benefit from minor repairs and adjustments. Evidence: The home is a new build and from the outside looks like any large domestic property. All rooms are large and airy. Bedrooms were on the first floor and were accessed by a flight of stairs. The staircase had one handrail and would benefit from a handrail being fitted on the other side. Bedrooms were spacious and had en-suite lavatories but there were no mirrors or shelves for toiletries. Only one bedroom was partially furnished. The manager said that this was deliberate as they wanted people to choose the furniture and furnishings to personalise their rooms. Bedroom doors could be locked from the inside only. This meant that people would not be able to lock their bedrooms to maintain their privacy when they went out. The overhead lights in the lounge were not domestic in character and one light was flickering. This can cause problems for some people who have epileptic seizures. Throughout the site visit there was a constant tapping, which was irritating. This was traced to the outside vent from an extractor fan and needs to be fixed. All of the above were discussed with the manager. Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Recruitment procedures will be robust and staff will undertake training and be competent to provide the relevant support. Evidence: The manager said that no staff had yet been employed. The documentation to be used when staff applied for posts was seen. This included application forms, reference requests, interview procedures, staff contract and other relevant information. The manager was aware that no person must be employed without receipt of a CRB disclosure, identification documents and references. The manager said that for the immediate future, the plans were that newly recruited staff would work on a one to one basis with people who moved into the home . All staff were to undertake a basic induction course of their duties, skills training and basic information of mandatory health and safety training to familiarise them with the home. This would be followed by a more in depth induction training that complied with Skills for Care. The manager said that staff would undertake mandatory health and safety training including moving and handling, infection control, fire awareness, adult safeguarding, basic food hygiene, medication training and first aid. Staff would also be encouraged to undertake National Vocational Training in Care. The manager said that staff would also be receive formal supervision. Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The homes quality assurance will ensure that peoples views are sought and that the home is run in their best interests. Systems checks and staff training will ensure that the home protects peoples health and safety. Evidence: The registered manager is a qualified nurse and also a qualified social worker and is registered with the NMC (Nursing and Midwifery Council) and the GSCC (General Social Care Council). Discussions with her during the site visit showed that she promoted person centred planning and the rights of the individual. The homes quality assurance programme includes plans for individual and group discussions of what people want for their home. Also included were health and safety checks of the environment. Advice was given on how this monitoring system could be expanded to include other checks of the environment and audits of systems and procedures used within the home. A sample of servicing and maintenance certificates were checked and these were within date. The manager said that staff would undertake mandatory health and safety training. See previous section for further information. Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action 1 1 5 The service user guide must 24/11/2008 contain information of fees charged, what they cover and how they are to be paid. Details of what is not included in the fees must also be provided. This ensures that people have a clear understanding of the what they can expect for the fees. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 20 The Royal Pharmaceutical Societys guide The Handling of Medicines in Social Care would remind staff of the correct procedures for dealing with medication. The registered person should ensure that the environment meets the needs and wishes of the people who will be living in the home i.e. locks to bedroom doors, domestic type lighting, repair of extractor fan outlet. 2 24 3 39 The quality assurance monitoring system would benefit from inclusion of audits of systems and procedures used throughout the home and environmental checks. These would enhance the system to ensure that the home was run in the best interests of people living in the home. Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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