Inspection on 11/09/08 for Russell Street 40- 44

This is the latest available inspection report for this service, carried out on 11th September 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Russell Street 40- 44 13/12/05

Russell Street 40- 44 20/06/05

Russell Street 40- 44 05/01/05

Russell Street 40- 44 18/11/04

Russell Street 40- 44 04/02/04

Similar services:

Coopers Mill Ltd

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Paradise Lodge

Grangewood

Upaya Ananda

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Kings Lane (32)

Pemdale

Extracts from inspection reports are licensed from CQC, this page was updated on 13/11/2008.

CARE HOME ADULTS 18-65 Russell Street 40- 44 Cambridge CB2 1HT Lead Inspector Andy Green Key Unannounced Inspection 11th September 2008 10:00 Russell Street 40- 44 DS0000033505.V371311.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 Russell Street 40- 44 DS0000033505.V371311.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. Russell Street 40- 44 DS0000033505.V371311.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Russell Street 40- 44 Address Cambridge CB2 1HT 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) 01223 712261 01223 714297 www.cambridgeshire.gov.uk Cambridgeshire County Council Mrs Wendy Mary Bullivant Care Home 8 Category(ies) of Learning disability (8), Learning disability over registration, with number 65 years of age (2) of places Russell Street 40- 44 DS0000033505.V371311.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th March 2007 Brief Description of the Service: 40-44 Russell Street is a purpose built home for residents with learning and physical disabilities; the home is owned and managed by Cambridgeshire County Council. The home consists of two houses, number 40 being a permanent home for four residents with learning disabilities, and number 44 providing short term respite accommodation for up to four residents with learning disabilities. Both houses have their own kitchen, dining area and lounge, four single bedrooms and toilet and bathing facilities. All residents accommodation is on the ground floor. The two houses are linked by an internal corridor and share an enclosed patio garden. The home is within a short walk of a range of local shops, pubs, restaurants, and a leisure complex. The centre of Cambridge is also a short bus ride or drive away. Cambridge railway station is close by, giving easy access to London and other major towns and cities. Russell Street 40- 44 DS0000033505.V371311.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 the people who use this service experience good quality outcomes. CSCI undertook an unannounced inspection on 11th September 2008. We inspected a number of records including care plans, training records and staff files. We met a number of service users to gain their view regarding the care and support that is provided. Three members of the care staff were also spoken with. The Annual Quality Assurance Assessment (AQAA) was completed by the agency. This a self assessment process that focuses on how outcomes are being met for people who use the service. Comment cards were also received from residents and staff. What the service does well: What has improved since the last inspection? What they could do better: The carpets and furnishings need to be replaced in a number of areas of the home. Decoration in corridors need attention. (See details in the ‘Environment’ section of this report) Russell Street 40- 44 DS0000033505.V371311.R01.S.doc Version 5.2 Page 6 The recording of reviews, medical/healthcare appointments and daily notes in care plans would benefit from review to aid easier access to information. (See ‘Individual Needs and Choices’ section of this report) The manager has delegated management tasks to the team leader and senior care staff. The current computer system in the home’s office would benefit from a broadband upgrade to improve the management and communication tasks. 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. Russell Street 40- 44 DS0000033505.V371311.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 Russell Street 40- 44 DS0000033505.V371311.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. Prospective residents have their needs assessed to ensure they receive appropriate care and support. EVIDENCE: Prospective residents usually make an informal visit and have a meal and meet other service users. Families can be involved in the assessment process wherever possible. Information is available to staff members to inform them of the individuals’ needs and preferences for care and support. The assessment process can be extended to meet individual residents needs. There have been no further changes to the assessment procedure since the last inspection. Russell Street 40- 44 DS0000033505.V371311.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. Care plans give clear guidance to ensure that resident’s needs are being appropriately met. EVIDENCE: A person centred planning process is used by the home care plans were inspected and they contained a variety of clear and concise information regarding the care and support that is required and preferred by residents. Examples included preferences regarding bathing, nutrition advice, weight charts and a list of property. There was evidence that 6-monthly reviews are undertaken. In addition to the resident files, person centred profiles are in place with the creative use of photographs to evidence preferences and activities. This process clearly involves the individual resident in a positive way. Russell Street 40- 44 DS0000033505.V371311.R01.S.doc Version 5.2 Page 10 Since the last inspection each resident file now includes a ‘goals and aspirations’ sheet clearly identifying each residents interests and future developments A thorough risk assessment process is in place to ensure that residents are protected from harm both in the home and when accessing the community. Examples included use of bedrails and mobility/wheelchair requirements. There was evidence of ongoing healthcare monitoring and appointments with healthcare professionals including GPs, opticians, dentists etc. are recorded as part of the daily notes process. There is a confidentiality policy in place to ensure that staff are clear about their responsibilities. However, the recording systems used in the home needs to be amended in the following areas; • • Reviews in care plans need to be more detailed as current review notes are very brief and not sufficient. The recording of medical/healthcare appointments would benefit from being amended with individual sheets kept in care plans for easier access rather than having to look back through previous daily notes. The ‘daily notes’ process need to be reviewed as the current form used is overly complicated. Staff spoken also confirmed that they would prefer to have a simpler form in place. • Russell Street 40- 44 DS0000033505.V371311.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported to lead full and active lives. EVIDENCE: Residents are involved in a wide range of activities and leisure pursuits, both within and outside the home. Several people attend organised day services in Cambridge at Horizons and Next Steps. During the inspection a number of residents were out at various activities and three residents had decided to spend the day at home. It was clear from observations that residents receive a friendly and supportive service from the care staff during the day. Residents continue to be encouraged and supported to maintain contact with family and friends. For example, one person visits family every week, and another’s relatives visit the home every week. Russell Street 40- 44 DS0000033505.V371311.R01.S.doc Version 5.2 Page 12 Regular shopping and daytrips are organised throughout the year. There have been recent holidays organised for a number of residents including Norfolk, Centre Parcs and Bruges. One service commented “Staff discuss with me what I want to do” The residents are encouraged to participate in the choices of menus during the week and a cooked meal is prepared in the evenings as most of the residents are out during the day. There is a meeting each week where residents can decide what should be on the menu for the following week, but this can change if they prefer something different to the planned meal. A varied menu is provided, with choices, to meet individual dietary needs and preferences. The home has access to a nutritionist for specific advice regarding individual residents. Residents are encouraged to participate in the daily running of the home as much as possible including cleaning their bedroom and preparing drinks/ snacks. Russell Street 40- 44 DS0000033505.V371311.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ personal and healthcare needs are appropriately met. EVIDENCE: Individual care plans, and daily records continue to show that residents receive support in the way they prefer. One resident commented “You treat me well and so do the other staff”. Regular health checks are undertaken for all residents when needed. The home has good links with the local surgery and care staff sensitively provide residents with assistance for appointments with health care professionals. This has included looking at pictures, discussion and visiting the local surgery. Residents using the respite service are also assisted to keep healthcare appointments if these fall during their stay. Improvements to the recording of temperatures in the medication room have been made and daily checks are recorded. Temperature records were accurate and up to date. Russell Street 40- 44 DS0000033505.V371311.R01.S.doc Version 5.2 Page 14 The records of administration and storage of medication in the home were accurate . The manager carries out regular spot checks to ensure a consistent approach is being maintained. Russell Street 40- 44 DS0000033505.V371311.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints process to ensure that concerns are dealt with appropriately. EVIDENCE: The home ensures that all concerns are fully investigated and dealt with appropriately. There has been one complaint since the last inspection, which is being appropriately dealt with via Safeguarding Adults procedures. A record is kept of all concerns raised by service users, and the way in which these have been dealt with. CSCI has not received any complaints since the last inspection. The home has a copy of the Cambridgeshire County Council’s procedure and protocol for safeguarding adults from abuse. Staff spoken to clearly understood their responsibilities and would have no hesitation in reporting any incident or allegation of abuse. Records of training show that care staff have undertaken safeguarding training. Russell Street 40- 44 DS0000033505.V371311.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The environment generally meets the needs of residents but some improvements need to be made. EVIDENCE: Russell Street 40- 44 DS0000033505.V371311.R01.S.doc Version 5.2 Page 17 The premises are generally well maintained and suitable for the needs of the residents. Bedrooms are decorated to meet the individual preferences of each resident and this was clearly evidenced during the inspection. However a number of improvements need to be made as follows; • • • The carpets need to be replaced in 40 in the corridor, lounge and bedrooms as they are badly stained and deteriorating. The lounge carpet in number 44 is also stained and needs to be replaced. Decoration needs to be undertaken to paintwork in hallways where there is consistent damage from wheelchairs. It is recommended that ways be researched to protect areas of walls and doorways where there is ‘traffic’ and continuous damage. The settees in both lounges need to be replaced as they are old and deteriorating. • There are a variety of communal areas in the home to provide sitting and dining space for residents and a conservatory adjoining one of the lounges. There is an attractive and well-maintained garden/ patio area with a variety of seating and a creative art installation. The garden is shared by number 40 and 44 and barbecues are organised during the warmer months of the year . The home was generally clean and tidy and free from odours. Russell Street 40- 44 DS0000033505.V371311.R01.S.doc Version 5.2 Page 18 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): 32,34,35,36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. The home’s recruitment and training processes ensure that residents are safe and protected from harm.. EVIDENCE: Training is well co-ordinated and staff spoken to confirmed that they had received a number of sessions and updates including; safeguarding adults, moving & handling, food hygiene, fire safety, first aid, brain injury, challenging behaviour strategies, fire safety, Learning Disability Qualifications (LDQ) and National Vocational Qualification (NVQ) courses at level 2 & 3. Staff supervision has improved and evidence of regular sessions was seen. The manager has now delegated a number of supervisions to senior members of staff to provide greater frequency. Staff spoken to confirmed that they had received regular supervision sessions and an appraisal either with their manager, deputy managers. Three staff files were inspected and they contained relevant recruitment information. There was evidence of two references, an application form and satisfactory Criminal Records Bureau checks (CRB), which ensures that Russell Street 40- 44 DS0000033505.V371311.R01.S.doc Version 5.2 Page 19 residents are protected from harm. There have not been any changes to the recruitment procedure since the last inspection of the home. There continues to be a minimum of three (and mostly four) staff on duty each day and two staff at night to support residents. The duty rota showed these staffing levels to be maintained and there was sufficient staff on duty to provide appropriate care and support for residents at home. However the staff in the home stated that the current arrangements, via the local authority, for accessing agency staff is a cumbersome process and needs to be streamlined for greater efficiency, The manger is in discussion with her line manager regarding this issue. Residents continue to have access to advocates and Community Nurses. Russell Street 40- 44 DS0000033505.V371311.R01.S.doc Version 5.2 Page 20 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. The home is well managed and the manager provides supportive leadership and guidance to staff to ensure that residents receive good quality care. EVIDENCE: The manager has relevant skills and experience and she undertakes regular training to update her own knowledge and skills. Staff stated that the manager is very approachable and professional and encourages participation in the running and development of the service. There are regular staff meetings where care practices are discussed and staff are able to raise concerns. There is a cheerful and supportive atmosphere in the home and staff clearly displayed that they enjoyed their work with residents. Staff comments included; “We are, from the manager on down , focused on providing an individual and high quality service” Russell Street 40- 44 DS0000033505.V371311.R01.S.doc Version 5.2 Page 21 The home continues to ensure a quality service is offered. Resident questionnaires are sent out annually and residents are involved in reviews carried out by the local authority at which they are encouraged to give their views about the service. Weekly alarm and monthly emergency light testing records were inspected and they are recorded accurately. Hot water testing records are also accurately maintained. It was noted that the current computer system in the home’s office is inefficient and would benefit from a broadband upgrade to improve the management and communication tasks. Russell Street 40- 44 DS0000033505.V371311.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 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 3 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 X 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 Russell Street 40- 44 DS0000033505.V371311.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action 31/12/08 1 YA24 23(2)(b) Carpets and furnishings need to be replaced as detailed in this report to improve the environment for residents 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 Russell Street 40- 44 DS0000033505.V371311.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Russell Street 40- 44 DS0000033505.V371311.R01.S.doc Version 5.2 Page 25 - 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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