Care Home: Town View

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What the care home does well People are supported to make choices in their everyday lives and live their lives as they choose. They can continue with their usual daytime activities whilst staying in the service and the staff team support people well with this. There are a variety of activities available to people, both within the service and when going out in the local community. The service has access to good transport facilities to be able to support people to participate in activities of their choice. People are supported during their stay to maintain contact with their home and family as much as they wish to. People can use the telephone and relatives and friends may visit the home.As the home is newly built it offers clean and modern accommodation to people. Bedrooms have en-suite facilities, which offer privacy, and people are happy with the new facilities. People are supported by staff that have been recruited following systems that check that they are suitable to work with vulnerable people. The staff team are experienced and are trained to help to make sure that they can meet the different needs of the people who access the service. What has improved since the last inspection? This is not applicable as this is the first inspection of this home. CARE HOME ADULTS 18-65 Town View Mill Lane Beverley East Yorkshire HU17 9DH Lead Inspector Sarah Rodmell Key Unannounced Inspection 6th June 2008 09:00 Town View DS0000071363.V365704.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 Town View DS0000071363.V365704.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. Town View DS0000071363.V365704.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Town View Address Mill Lane Beverley East Yorkshire HU17 9DH 01482 869935 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) diane.golding@eastriding.gov.uk East Riding of Yorkshire Council Manager post vacant Care Home 14 Category(ies) of Learning disability (14) registration, with number of places Town View DS0000071363.V365704.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD. The maximum number of service users who can be accommodated is: 14 Not applicable. 2. Date of last inspection Brief Description of the Service: Town View is situated in the town of Beverley, close to the main shopping areas. The home provides accommodation and care for up to 14 people who have a learning disability. Support is provided on a respite/short term basis. People may visit more than once a year. Emergency health access is provided by the local GP and the district nursing services. There are three floors that can be accessed by either a passenger lift or stairs. In addition to the individual bedrooms there are two lounge areas and a dining room. There is also a small courtyard area and roof garden. All of the bedrooms are single and all have en-suite facilities. The home has two bathrooms with bath hoists and overhead tracking. The home has toilets throughout, in particular near the lounge and dining areas. There is a small car park at the front of the building. The environment is modern, homely, clean and well presented. Information about the home and its service can be found in the statement of purpose and service user guide. Both these documents are available from the manager of the home. The manager told us on the 6th June 2008 that the weekly fees range from £45- £112 per week depending upon individual assessment by the Local Authority. There are additional charges for toiletries, and the hairdresser. Town View DS0000071363.V365704.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 stars. This means that the people who use this service experience Good quality outcomes. This inspection report is based on information received by the Commission for Social Care Inspection (CSCI) since the last visit to the home, including information gathered during a visit to the home. Since the registration of the home, the CSCI has not received any information about the home from the registered provider; there have been no letters or complaints to us from other people. The site visit took place on 6th June 2008, beginning at 9.00 am and ending at 4.00 pm. The provider was not told in advance of the date or time we planned to visit. The manager was available for this visit and during the time we spent at the home. We also spoke to the staff on duty, and some of the people living in the home that were able to participate. We looked around the home including in people’s rooms and the shared areas of the home, and we inspected records of people’s care, staff files, and health and safety documents. There were no relatives available at the time of the visit; consequently we did not hand out any relative’s questionnaires. We received the Annual Quality Assurance Assessment (AQAA) from the home. The AQAA is an audit tool, which provides us with information on the home, how it has developed over the last year and how it plans to develop in the coming year. What the service does well: People are supported to make choices in their everyday lives and live their lives as they choose. They can continue with their usual daytime activities whilst staying in the service and the staff team support people well with this. There are a variety of activities available to people, both within the service and when going out in the local community. The service has access to good transport facilities to be able to support people to participate in activities of their choice. People are supported during their stay to maintain contact with their home and family as much as they wish to. People can use the telephone and relatives and friends may visit the home. Town View DS0000071363.V365704.R01.S.doc Version 5.2 Page 6 As the home is newly built it offers clean and modern accommodation to people. Bedrooms have en-suite facilities, which offer privacy, and people are happy with the new facilities. People are supported by staff that have been recruited following systems that check that they are suitable to work with vulnerable people. The staff team are experienced and are trained to help to make sure that they can meet the different needs of the people who access the service. 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. Town View DS0000071363.V365704.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 Town View DS0000071363.V365704.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): 1, 2 & 5 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 are assessed and provided with information before they access the service. This helps to make sure that both them and the service provider are confident that their needs can be met. EVIDENCE: There is a statement of purpose and service user guide available to people, that provides them with information regarding the home to help them to understand the facilties and services available within the home. The service user guide also includes pictures to help to make is an easier to read document. We looked at the files for three of the people who were staying in the home. All three of the files included details of assessments of need and care plans that had been undertaken by the Local Authority repersentative. The care plans describe peoples’ needs and how these are to be met. The assessments and care plans covered a variety of areas including: personal care, health care, likes and dislikes of the individual and their religious needs. Town View DS0000071363.V365704.R01.S.doc Version 5.2 Page 9 Of the three files we looked at they all included a copy of the person’s contract/ terms and conditions for living in the home. The contract stated that this was a short break service and when possible this had been signed by the person using the service to show their agreement. Town View DS0000071363.V365704.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 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 are supported through a care planning process to live their lives as they choose. EVIDENCE: People’s individual files included copies of their plan of care that detailed their individual needs and wishes. In addition some of the files included ‘About Me’ books that include more detail about peoples’ individual wishes. When we spoke to staff they knew where to gain information to keep up to date on the individual needs of people, this included looking at care plans and risk assessments. Daily diary notes described what people did each day both in and out of the home, this included making their own breakfast, choosing not to join in with the residents meeting and reading their newspaper. During our visit staff offered people support in choosing what to do and where to go, asking if they Town View DS0000071363.V365704.R01.S.doc Version 5.2 Page 11 had decided what they wanted to do or what they were going to do. People were seen to be able to get up at different times of the day, dependent upon their individual preference or activities. People told us that they are happy in the home and when asked said ‘yes’, that they can do what they want, that the staff listen to them and that they felt their needs were being met. Staff told us that people have choices throughout their day this includes, whether to have a bath or shower, what activities to participate in and what to do for the day. Were necessary peoples’ files included risk assessments to help people to live their lives with minimal risks whilst at the service. These assessments included; the washing of clothes, the use of the lift, the moving and handling of people and the use of the kitchen. Town View DS0000071363.V365704.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 & 17 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 are supported to continue the lifestyle of their choice. EVIDENCE: The senior person on duty told us that whilst staying at the service, people continue to access services that they would normally access from their own home. We observed one person being supported to use public transport to attend an activity and other people being given a lift to their work placement. Some of the people who access the service attend the adjacent Millers day care facility. People’s diary notes included that people attended a variety of activities both in the service and in the local community these included; ‘ out to brothers’, ‘to the social club’, ‘out to the pub and ride out’ and ‘ out with mum and Town View DS0000071363.V365704.R01.S.doc Version 5.2 Page 13 friend’. Staff told us that available activities included, going into the local town, painting, and jigsaws, going for a coffee, going to the pub and bowling. The service is designed to allow respite for the carers of individuals, and also allows people to maintain contact with their family and friends supporting these important relationships. People told us that they can telephone their relatives and that their relatives can ring them at the service. People’s notes also included that people go out with their relatives whilst staying at the service. We observed that staff support people to maintain their independence as far as possible and to choose their daily lives. People told us ‘ I read a book and watch TV, I can do what I want’ and ‘ Yes the staff are nice’ and confirmed that staff knock on people’s doors before entering their room. Staff told us that they respect peoples’ privacy by making sure that doors are closed, not letting them people be embarked and making sure that people have time alone if that is what they want. Meals are provided from The Millers adult education service adjacent to the service. This is shared with the adjacent service ‘New house’. People choose what meals they would like. There are menus in place based on a 4-week cycle and this offers people a choice at mealtimes. However as the meals are provided on a ‘first come first served’ basis with lunchtime being busy there can be limits to the amounts of choice people have; the cook and staff team are working on solutions to this. People were offered support to choose and eat meals by the staff team and the mealtime seemed relaxed and pleasant. One person told us that they require a specific diet to manage their health condition and that they are happy that the service provides this. Town View DS0000071363.V365704.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, & 20 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 and medication needs are met. EVIDENCE: People’s individual files included key details regarding their health and any specific needs. Staff told us that they support people to meet their health needs, that they observe people for any changes and that they make sure peoples’ dietary and medication needs are observed in the service. Although people tend to undertake specialist appointments when in their own home, for example, the dentist, the service does support people to attend these appointments should this be necessary. Due to the people attending the service for short periods of time only, there is a comprehensive policy in place to help to make sure that medication risks are reduced. There is an individual stock sheet for each person that is double signed by staff members to confirm entries and the medicine stock balance is checked at each time of receipt, administration and discharge. The manager Town View DS0000071363.V365704.R01.S.doc Version 5.2 Page 15 confirmed that all of the care officers and senior care officers have completed medication training that meets the National Minimum Standards. Town View DS0000071363.V365704.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 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 are supported by policies and procedures to raise concerns and to be protected. EVIDENCE: There is a complaints file held within the service that includes the details of any complaints made to the service. The manager confirmed in their AQAA that there had been no complaints made. When we spoke to staff they were confident in the procedure that they would use if a complaint was made to the service, including that they would make clear records of the initial complaint. There is a copy of the procedure ‘ The Protection of Vulnerable Adults’ held in the service. When we spoke to the staff they were clear in their role of protecting people and how to handle any allegations of harm. The manager told us that there has been one referral made to the safeguarding team and that this is being monitored by a representative from the Local Authority. This referral was not notified to the CSCI and the manager must make sure that the CSCI is informed of any future allegations. Town View DS0000071363.V365704.R01.S.doc Version 5.2 Page 17 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 People live in a clean and modern home that they are happy with. EVIDENCE: Town view is a new building that was built to replace a previously existing Local Authority service. The service is close to the town centre and to public transport. The manager told us that due to the new location people are now more able to use public transport to maintain their daily activities whilst they stay at the service. The service is bright, clean and modern with individual rooms that offer ensuite facilities and privacy. Each room has a rise/fall bed, television and DVD player. There are also lockable cupboards for people to be able to store personal items. Town View DS0000071363.V365704.R01.S.doc Version 5.2 Page 18 There are two lounge areas with the main one being on the ground floor. This is also the dining area. There is a courtyard that people use to relax in and a roof garden area. People told us that they like their rooms and that they like the new service. There is a fire risk assessment in place and a code of practice. The manager confirmed to us that emergency lighting tests have been completed. Town View DS0000071363.V365704.R01.S.doc Version 5.2 Page 19 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 A well recruited and trained staff team supports people. EVIDENCE: When we spoke to the staff they told us that as part of their recruitment process they had needed to provide a Criminal Records Bureau (CRB) Check and two written references. People’s files also included the details that these checks had been completed. These help to show that the person does not hold a criminal conviction that would prevent them from working with vulnerable people and that they are suitable for this role. Additionally people told us about the training that they had undertaken over the last year, this included, epilepsy, care of dying people, Control of Substances Hazardous to Health COSHH and Food Hygiene. People’s personnel files included the details of some of the training that people had undertaken. The manager included in the AQAA that staff had undertaken training in equality and diversity. They also confirmed to us that 50 of the staff team Town View DS0000071363.V365704.R01.S.doc Version 5.2 Page 20 have achieved a national vocational qualification (NVQ) at level 2 or equivalent. Town View DS0000071363.V365704.R01.S.doc Version 5.2 Page 21 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 People are supported by an experienced manager, who includes them in the decisions made in the service. EVIDENCE: The manager is not yet registered with the CSCI and should make an application to be registered. She confirmed that she has several years experience working with people who have a learning disability and also has management experience. She is currently undertaking a National Vocational Qualification (NVQ) at Level 4 in management and care. There are polices and procedures in place to support people in the service. These include a handbook that addresses culture, spiritual and religious needs Town View DS0000071363.V365704.R01.S.doc Version 5.2 Page 22 and the disability equality scheme 2006-2008. There are regular staff and residents meetings, with visits by a representative of the management completing quality monitoring visits as per the requirements of regulation 26. The quality assurance report was last completed in December 2007 and included the results of surveys, conclusions and recommendations. This was also available in makaton. There are risk assessments in place to help to make sure that any risk of harm is reduced. This includes risks associated with the use of the kitchen. Records are kept of any accidents in the service include if these involve any violence or aggression. As this is a new service the facilities and products are also new and as such have not required annual maintenance checks. Town View DS0000071363.V365704.R01.S.doc Version 5.2 Page 23 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 3 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 3 x 3 X 3 X X 3 x Town View DS0000071363.V365704.R01.S.doc Version 5.2 Page 24 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 YA37 Regulation Care Standards Act Section 11. 37 Requirement The manager must undertake an application for registration with the CSCI. The registered person must make sure that the CSCI is notified of incidents in the home, including safeguarding referrals. Timescale for action 04/08/08 2 YA23 06/08/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Town View DS0000071363.V365704.R01.S.doc Version 5.2 Page 25 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 Town View DS0000071363.V365704.R01.S.doc Version 5.2 Page 26 - 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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