Care Home: Village The (8)

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What the care home does well Staff have good relationships with people who live at The Village, staff showed kindness and respect towards people. One survey said, "Staff treat those in their care with dignity and kindness" 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. 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. And are treated kindly and with respect. People are able to access the primary health care team and other professionals ensuring that their health care needs are met. A good choice of well prepared food, and drinks are available. This ensures that people receive a varied and nutritious diet. What has improved since the last inspection? The home has now employed a manager; this will help ensure that there is some consistent leadership for the home. Staff have completed training which will help them understand people`s communication, particularly when it is non-verbal. This will help people express their views and participate in making decisions about what happens in their lives. What the care home could do better: The service needs to make sure that when a person has restrictions placed upon them, this decision is made in conjunction with the person`s representatives and considers the person`s human rights. Parts of the home need urgent redecoration to ensure that people live in a comfortable, well maintained home. CARE HOME ADULTS 18-65 Village The (8) 8 The Village Haxby York YO32 3HT Lead Inspector Chris Taylor Unannounced Inspection 16th January 2008 09:30 Village The (8) DS0000015840.V352994.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 Village The (8) DS0000015840.V352994.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. Village The (8) DS0000015840.V352994.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Village The (8) Address 8 The Village Haxby York YO32 3HT 01904 750308 F/P01904 750308 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) None United Response vacant post Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Village The (8) DS0000015840.V352994.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registration is for a maximum of 8 persons with learning disabilities 6 of whom may also have a physical disability 31/01/07 Date of last inspection Brief Description of the Service: 8, The Village is registered to provide residential, social, and personal care for eight people, with learning disabilities, under 65 years of age. The home consists of two properties, The Mews which has two service users who live semi independently with 24 hour support, and the main house which has four service users. The home is situated close to the centre of Haxby and provides good access to the local services and amenities. The service is part of the United Response organisation. Information provided by the registered manager on 8th January 2008 indicated that the current weekly fees for the home are £1441.04. The inspection report is available on request. Village The (8) DS0000015840.V352994.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 agency kept by the Commission for Social Care Inspection. Information asked for from 8 The Village before the inspection, this is called an Annual Quality Assurance Assessment. Information from surveys received. Four surveys were received from relatives. An unannounced visit to the home. This lasted four and half hours and included talking to support staff and the manager about their jobs and the training they have completed. A tour of the premises was made. Some of the records, policies and procedures the home has to keep were checked and time was spent observing people who live at the home and how they spent their day. • What the service does well: Staff have good relationships with people who live at The Village, staff showed kindness and respect towards people. One survey said, “Staff treat those in their care with dignity and kindness” 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. 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. And are treated kindly and with respect. People are able to access the primary health care team and other professionals ensuring that their health care needs are met. A good choice of well prepared food, and drinks are available. This ensures that people receive a varied and nutritious diet. Village The (8) DS0000015840.V352994.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Village The (8) DS0000015840.V352994.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 Village The (8) DS0000015840.V352994.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 excellent 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 met the person’s needs when the person moves in. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has had one new admission since the last inspection. An assessment by the home had been undertaken as well as an assessment by the local authority care manager. This assessment includes information from the person, family and other professionals and is particularly useful for those people who have complex needs and /or difficulties with communication. This document also 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. Compatibility between people is given considerable thought and views of those people already living in the home would be included in this. New placements are kept under review and further assessments are completed. Village The (8) DS0000015840.V352994.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): Standards 6, 7 and 9. People who use this service experience good quality outcomes in this area. People’s care needs are assessed and met and their privacy and dignity is respected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two people’s case records were looked at. The format for care plans includes different sections for every aspect of the service user’s life. 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. Some documents, however, where not dated or signed by the author. This could mean that staff are not confident about what is the most up to date information. Also present Village The (8) DS0000015840.V352994.R01.S.doc Version 5.2 Page 10 were risk assessments with the purpose of supporting people to live as independently as possible. These were also reviewed regularly. One of the care plans included restrictions to the service user. It wasn’t clear how or who had made this decision. Although the restrictions in place are in the best interest of the person they do infringe upon his human rights. He doesn’t have the capacity to understand why these restrictions are in place. It is important that the person is represented in this decision-making and evidence of how and why restrictions are in place have been agreed. Staff are provided with a good induction and ongoing training which makes sure people are treated with respect, dignity and are supported to make choices in their lives. Staff were observed supporting people in a respectful manner and encouraging them to be independent. One survey said: - “ staff treat those in their care with dignity and kindness” Village The (8) DS0000015840.V352994.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): 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: People have the opportunity to attend specialist day centres or college and have days at home to participate in personal shopping, laundry and household tasks. There are also opportunities go to the pub, cinema, and church, into town to shop or have a meal or coffee. The recent re configuration of day services provided by the council has had an impact on people’s daytime occupation and usual routines. Staff are in the process of negotiating different daytime activity giving due consideration to people’s needs and wishes. Some additional staffing has been secured to ensure people have the opportunity to participate in activities of their choice on a one to one. Village The (8) DS0000015840.V352994.R01.S.doc Version 5.2 Page 12 During the visit people were out at specialist day centres. Three people were at home carrying out activities of their choice which included a baking session. People’s religious and cultural needs are recorded. Two people living at The Village are supported to attend the church of their choice. There was written information in people’s support plans about how people spend their days and these arrangements are discussed with people’s representatives and staff. Details about family, friends and significant events are recorded in people’s plans. Examples of how people are supported to maintain relationships with family and friends were given. Daily records provided a good picture of how people spend their day. They provide essential information to track any changes people may experience, with ill health or involvement in social activities. Comments from surveys included: “ The home is caring and providing good stimulation for people” “ They take her on mini holidays, also shopping and taking her out to dinner” Wherever possible people are included in menu and meal preparation. Two people particularly enjoy doing the weekly shop for the house. Specialist advice from the dietician was recorded for specific people. Village The (8) DS0000015840.V352994.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): Standard 18, 19 and 20. People who use this service experience excellent 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: A whole section on each support plan related to health care needs. Included was information on health action plans, medical logs, referrals for medical interventions and any further requirements and medication. Some of these plans included pictorial prompts. People can access psychology, physiotherapy, and art therapy, and specialist community nursing from the local learning disability team. There was evidence that people have the choice to attend well women and well men clinics. 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. Comments from surveys included: “ In relation to medical problems they have been very good”. Village The (8) DS0000015840.V352994.R01.S.doc Version 5.2 Page 14 Medication administration was observed. A monitored dosage system was in use with proper procedures in place for the receipt, storage, administration, recording and return of medicines. Staff receive accredited medication training provided by United Response and are not permitted to administer medication until their competence it assessed. Village The (8) DS0000015840.V352994.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): 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. Because of the complexity of people’s needs and difficulties with communication it is unlikely that an individual would make a complaint in the usual manner. Staff, therefore, need to have the skills to interpret people’s behaviours to identify whether they are unhappy about something. Advocates are used to provide an independent voice for people. The home has had one complaint since 2006. The records were seen which confirmed that the complaints procedure had been followed appropriately. No formal complaints have been made directly to the Commission for Social Care Inspection. Village The (8) DS0000015840.V352994.R01.S.doc Version 5.2 Page 16 There is a comprehensive policy and procedure with regard to safeguarding adults and the procedure to take if there is a suspicion of abuse and 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 National Vocational Qualifications (NVQ) level 2 and 3. Village The (8) DS0000015840.V352994.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): Standards 24 and 30. People who use this service experience adequate outcomes in this area. Parts of the home are in need of re decoration in order that people live in a clean comfortable home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is a converted coach house and stable. Each is known as the village and the mews respectively. People have their own bedrooms which are personalised. There are sufficient bathrooms and costings are being sought to convert one bathroom into a wet room. One of the additional lounge areas is going to be converted into a relaxation/sensory room. Parts of the home are in need of repair. The main lounge in The Village has damaged flooring and chipped paintwork. The kitchen is in need of refurbishment. Tiles are damaged and grouting looks dirty. The manager confirmed that these areas of decoration form part of the home’s development plan. Village The (8) DS0000015840.V352994.R01.S.doc Version 5.2 Page 18 The laundry is fitted with an appropriate washing machine which has a sluice cycle. There is a clinic waste contract. Staff have received training in infection control and there were ample supplies of gloves, aprons and handwash evident around the home. Village The (8) DS0000015840.V352994.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): Standards 32, 34 and 35. People who use this service experience excellent quality outcomes in this area. People receive support from staff that are properly recruited and vetted. And who are appropriately trained and supervised. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff recruitment procedures make sure that staff are vetted and checked to a very safe standard. Prospective staff complete an application form and attend formal interviews. Written references and POVA (Protection of Vulnerable adults) first checks are made and staff are not permitted to work in the home until they have a CRB (Criminal Records Bureau) check. Staff training records examined showed a comprehensive training programme. All staff complete a home specific induction programme followed by Common Induction Standards accredited induction. There is an expectation that staff complete National Vocation Qualifications in Care (NVQ) level 2 or 3. A range of other training including health and safety training is provided. Specialist training has been completed to ensure the specific needs of service Village The (8) DS0000015840.V352994.R01.S.doc Version 5.2 Page 20 users are met. This provides staff with the knowledge and skills to perform their duties in a competent manner. Comments from surveys include: “ Excellent skilled staff” Staff spoken to thought that the training provided is good and that the staff team was 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 manager carries out individual staff supervision every four to six weeks, each session has an agenda and is recorded and signed by both parties. An annual appraisal is also completed. Staff meetings are held regularly. Village The (8) DS0000015840.V352994.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): Standards 37, 39, 41 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 people. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Village has experience some difficulties in retaining a manager over the last few years. This has been a result of circumstance and has not unduly affected the outcomes for service users. There is a new manager and she has been in post for three weeks. The manager has experience in the field of learning disabilities and has acted as registered manager for other registered services. She has spent the first few weeks getting to know service users and Village The (8) DS0000015840.V352994.R01.S.doc Version 5.2 Page 22 staff by working alongside them; she has ideas to share with staff about how to improve the service but has a sensitive approach in implementing change. There is a formal quality assurance system called Annual Service Planning. 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. Village The (8) DS0000015840.V352994.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 x 2 4 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 4 23 4 ENVIRONMENT Standard No Score 24 2 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 4 33 x 34 4 35 4 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 x 3 x LIFESTYLES Standard No Score 11 x 12 4 13 4 14 x 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 4 x 3 x 3 x 3 3 x Village The (8) DS0000015840.V352994.R01.S.doc Version 5.2 Page 24 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. 1 Standard YA24 Regulation 23 (2) (b) Requirement Plans with timescales for completion must be submitted to the CSCI with regard to updating and refurbishing the kitchen and lounge areas. Timescale for action 01/06/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2. Refer to Standard YA7 Good Practice Recommendations Consideration needs to be given about how and who makes decisions which place restrictions upon service users and have the potential to infringe human rights. There should be more consistency in dating and signing documents so that staff know which is the most up to date information. YA41 Village The (8) DS0000015840.V352994.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 Village The (8) DS0000015840.V352994.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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