Inspection on 13/10/05 for 1 Church Road

This inspection was carried out on 13th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

1 Church Road 21/01/10

1 Church Road 10/11/09

1 Church Road 02/04/09

1 Church Road 21/11/08

1 Church Road 23/11/06

1 Church Road 15/02/06

1 Church Road 18/03/05

1 Church Road 24/11/04

1 Church Road 27/02/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 1 Church Road Wembdon Bridgwater Somerset TA6 7RQ Lead Inspector Ms Sue Hale Unannounced Inspection 13th October 2005 09:00 1 Church Road DS0000039968.V250979.R01.S.doc Version 5.0 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 1 Church Road DS0000039968.V250979.R01.S.doc Version 5.0 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. 1 Church Road DS0000039968.V250979.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 1 Church Road Address Wembdon Bridgwater Somerset TA6 7RQ 01278 453635 01278 456656 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) Home First & Foremost Ltd Mr James Reginald Marchant Care Home 13 Category(ies) of Learning disability (0), Physical disability (0) registration, with number of places 1 Church Road DS0000039968.V250979.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th March 2005 Brief Description of the Service: No 1 Church Road is a large extended house providing a high standard of accommodation. The home is situated in a quiet residential area on the outskirts of Bridgwater. The property is surrounded by landscaped gardens. The home can accommodate up to thirteen people with a learning disability and additional physical impairments. All residents have their own bedrooms with en-suite facilities. The home is sufficiently spacious to allow the people who live here to be alone or mix with others according to their needs. Support is provided by the manager, James Marchant, and a small staff team throughout the 24 hr period. The people living here are supported to access a wide range of recreational activities within the home and the wider community. Contact with friends and families is promoted and supported according to individual needs and wishes. 1 Church Road DS0000039968.V250979.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over the course of one day in October 2005. The inspector met several of the residents and sat and had lunch with a number of residents and staff. The inspector viewed all parts of the home, checked all records relating to three individual residents including care and support plans and the accident book. Selected staff files were examined. The inspector met several residents and spoke to the manager and some staff on duty. Voyage had notified all parents/relatives, care managers and placing authorities that an inspection was expected and invited comments that would then be forwarded to the inspector. The inspector received eleven comments from parents and three comments from social workers/care managers. Two comment cards were received from healthcare professionals. The overwhelmingly majority of comments received were very complimentary of the services that are provided at the home. As a result of this inspection one requirement and two recommendations were made. What the service does well: What has improved since the last inspection? 1 Church Road DS0000039968.V250979.R01.S.doc Version 5.0 Page 6 A recommendation that residents’ money was kept separately was made at the last inspection. This had been addressed by the home and all monies were now kept individually and checked regularly by the manager. 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. 1 Church Road DS0000039968.V250979.R01.S.doc Version 5.0 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 1 Church Road DS0000039968.V250979.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed, as there have been no new admissions to the home since the last inspection. EVIDENCE: 1 Church Road DS0000039968.V250979.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9. Residents are encouraged to make decisions about their life and are supported to be involved in the day-to-day routine as far as they are able. The home uses alternative methods of communication to offer choice and aid decisionmaking. The staff team and culture within the home supports residents to take risks while promoting an independent lifestyle. Risk assessments are conducted and reviewed when needed. The care and support plans are individual, well organised and regularly reviewed and updated. The home kept good records in relation to the management of service users’ finances. EVIDENCE: The inspector viewed three care and support plans, all of which were detailed and comprehensive and gave clear information to staff. Each resident has a nominated key worker. Relatives and other people important to residents had 1 Church Road DS0000039968.V250979.R01.S.doc Version 5.0 Page 10 been involved in the residents’ plan of care and consulted on a regular basis. A relative commented that, ‘Communication between staff and relatives has always been good’. Risk assessments were in place, detailed and up-to-date and were reviewed as necessary to ensure the safety of residents. Residents were supported by staff to access all necessary medical and health care and copies of medical and health care assessments were on file. Residents have the opportunity to attend a church of their choosing if they wanted to meet their spiritual needs. Staff spoken to said that residents were made welcome at the local church and had been included in the recent harvest festival celebrations. At the time of the inspection it was noted that residents were being offered choices in many aspects of daily living. Staff use Total Communication for some service users. Signs and Symbols are also used where needed. The inspector spoke to some staff at the time of the inspection who were able to demonstrate how residents are offered choices in all aspects of daily living. Residents spoken to told the inspector that they were able to make their own choices about their rooms, daily activities and have as much control as possible over their own lives. The inspector viewed and discussed the arrangements for the management of service users’ finances. The relatives of three residents manage their finances. The relatives provide monies and the home keeps well-documented records relating to these finances. The inspector viewed the documentation of two resident’s finances. Daily records are kept of all transactions with receipts kept. The manager audits these records regularly as part of the homes procedure to safeguard residents’ monies. 1 Church Road DS0000039968.V250979.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16, 17. The home has a planned menu that is healthy and with choices available. The home encourages and supports residents to access the local community and partake in a variety of leisure, recreational and social activities. The home encourages family and friends to visit the home and residents rights are respected and promoted. EVIDENCE: A relative commented that they, ‘Were very impressed by the friendliness of neighbours’ and that it was, ‘Comforting to know that the home is part of the local community’. The home encourages residents’ contact with family members and friends. The manager keeps records of such contact. It was evident at the time of the inspection that residents are offered choices in leisure, social and recreational activities. At the time of the inspection one 1 Church Road DS0000039968.V250979.R01.S.doc Version 5.0 Page 12 resident was at college and a resident was supported to go shopping with a member of staff. Activities are based on individual choice and need and records are kept of all activities that are undertaken. Activities available included hydrotherapy, aromatherapy, music therapy and trips to the local pub. One relative expressed concerns that the frequency of activities had been affected by staffing difficulties but that this had begun to improve as new staff had recently been appointed. The home pays for each resident to have a holiday with individuals making a small contribution towards the cost. A resident spoken to said that they enjoyed regular aromatherapy sessions at the home. Some residents have access to only the ground floor of the home due to access difficulties. The majority of the bedrooms have a keypad to promote privacy. The ground floor of the home is accessible to all residents including those who use a wheelchair. The home operates a six-week menu. Wherever possible service users are involved in menu planning and can request an alternative meal if so wished. The mealtime on the day of the inspection was relaxed and unhurried, with staff assisting residents, if necessary, appropriately. Staff were familiar with individual resident’s likes and dislikes and special dietary information was available on one personal file checked. Appropriate eating aids were available as required by individual residents. All residents had a special cake and tea on their birthday to celebrate the occasion. The home also had an allocated budget to purchase a birthday present for each resident. Two dining areas were available and residents could chose to eat alone or with other residents and staff. 1 Church Road DS0000039968.V250979.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19. The home provides technical aids and equipment to promote independence. The home ensures that residents have access to all appropriate health care professionals. Residents would benefit from a higher male gender balance in the staff team. EVIDENCE: The majority of the current residents are male. The staff team of twenty three, including the manager, includes three men. To allow the residents a choice of a member of staff of the same gender for personal care and leisure activities consideration should be given to this when recruiting staff. The care and support plans viewed contained records of visits made to health care professionals. These included visits to the GP, dentist, chiropodist, optician and to speech and language therapists. Several relatives commented that residents were always well cared for and well dressed. 1 Church Road DS0000039968.V250979.R01.S.doc Version 5.0 Page 14 The inspector noted that the home has aids and equipment to promote independence. All staff had received training in moving and handling and residents’ individual needs are identified in their care plans. The inspector viewed risk assessments in relation to moving and handling. These had been reviewed and up dated as necessary to give clear information to staff. The inspector observed that residents were supported by staff to choose their own daily routines as far as practicable. One resident spoken to confirmed that they chose when they rose and retired. 1 Church Road DS0000039968.V250979.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. The home has a detailed complaints procedure that is available in appropriate formats for residents. Robust systems are in place to protect residents from abuse. EVIDENCE: The home has a clear complaints policy and procedure, which is also available in an accessible format. No complaints have been received by the home or the Commission for Social Care Inspection since the last inspection. Staff spoken to were clear about the procedure to follow if a complaint was received. A relative commented that they felt, ‘Able to contact the staff at any time for any queries’. Residents spoken to were clear about whom they would speak to if they had any problems or wanted to complain. All prospective staff has a POVA check and an enhanced CRB clearance before being employed to work at the home. The home has a detailed Adult Protection and Whistle blowing policy and procedure and staff spoken to were familiar with the policies and what to do if an allegation of abuse was made. 1 Church Road DS0000039968.V250979.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29. The interior and exterior of the home is accessible and designed to meet the needs of the residents living at the home. The home offers a very high standard of furnishings, fittings and decoration. The shared space is well maintained and the ground floor area fully accessible to all residents. The home has specialised equipment to maximise independence for residents. On the day of the inspection the home was very clean and tidy. Staff facilities would benefit from maintenance and redecoration. EVIDENCE: 1 Church Road does not have a passenger lift to the upper floors. However, there are bedrooms on the ground floor accessible to those residents who use a wheelchair. All ground floor areas of the home are wheelchair accessible, including accessible pathways around the exterior of the home in the garden. There are aids and adaptations available to suit individual residents assessed needs. 1 Church Road DS0000039968.V250979.R01.S.doc Version 5.0 Page 17 All bedrooms are of single occupancy and offer en suite facilities for residents’ comfort and privacy. They are well decorated and furnished and contain personal possessions including family photographs, pictures, ornaments, television, hi-fi and DVD players. Two residents spoken to said that they were able to choose how their room was decorated and personalised. On the day of the inspection all areas of the home were clean, hygienic and tidy but still retained a very homely atmosphere. A variety of shared space is available throughout the home to ensure privacy for residents if they wished to spend time alone or with visitors in private. Relatives described the home as having, ‘Quality décor’, ‘Well decorated and clean’, with residents’ bedrooms, ‘Individualised’ and ‘Very suitable’ to individuals needs. Staff facilities include a sleep over room and en suite toilet/shower room. The toilet/shower facilities were poorly decorated and maintained and smelt of damp. 1 Church Road DS0000039968.V250979.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35. On the day of the inspection the home appeared appropriately staffed to meet the needs of the residents. Voyage has a commitment to provide staff with the knowledge and skills to promote and maintain a well-trained workforce. Voyage has a robust recruitment process that protects residents from the risk of abuse and harm. EVIDENCE: The inspector viewed the recruitment files of two recently appointed staff members. The files contained the required documentation. Voyage has a dedicated training department and the manager is notified of forthcoming courses and able to nominate staff as required for their professional development. All staff had completed basic training such as first aid, moving and handling, food hygiene and fire safety. Newly appointed staff undertake the Learning Disability Award Framework training. Five staff are qualified to NVQ level 2 or above with a further seven staff registered on NVQ level 2 training courses. The percentage of qualified staff has fallen to 23 as several senior staff have recently left the home. The 1 Church Road DS0000039968.V250979.R01.S.doc Version 5.0 Page 19 manager and staff spoken to said that Voyage has a commitment to providing staff training and that courses including those to do with developing communication skills are readily available. The manager told the inspector that funding had been agreed for three new full time posts that would be advertised in the near future to increase the numbers of the staff team. It is recommended that the gender make up of the team is considered during this recruitment drive to ensure that residents are able to choose to have a choice of the gender of the member of staff available for personal and social care. Staff spoken to felt very supported by the manager, they were paid to attend regular staff meetings and felt that they were able to contribute to the meetings and that their professional opinions were valued. Comments received from relatives all indicated that the residents were very well supported by the staff team. Comments included that staff were, ‘Sympathetic, understanding, kind and knowledgeable’ and that the professional relationship between staff and residents was a ‘Joy to observe’. 1 Church Road DS0000039968.V250979.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 40, 41, 43. The manager is qualified, competent and experienced to run the home and shows direction and leadership. Residents’ benefit from living in a well run home. Voyage has a clear management structure and comprehensive policies and procedures. All policies and procedures are available in the home. EVIDENCE: The manager is James Marchant who has several years experience of working with and managing a home for residents with a learning disability. Mr Marchant achieved the Registered Managers Award in 2002 and has also achieved D32 / 33 NVQ Assessors Award qualification he is committed to his own continuing professional development. The inspector spoke in private to some care staff who all commented that Mr Marchant is approachable, a good listener and supportive. 1 Church Road DS0000039968.V250979.R01.S.doc Version 5.0 Page 21 All records sampled were well presented and maintained and held in a secure and confidential manner. Voyage has comprehensive policies and procedures that have been recently reviewed to give up to date guidance and advice for the manager and staff. Monies held on behalf of residents were kept individually and securely with adequate systems set up to ensure that residents’ funds were safeguarded. The home’s insurance and registration certificate were displayed for all to see. Staff spoken to described the manager as supportive and always available to offer advice and guidance. Comments received from relatives were very positive and stated that the manager was always, ‘Very helpful and understanding’. 1 Church Road DS0000039968.V250979.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 4 4 4 4 2 4 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 4 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 2 2 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 1 Church Road Score 2 3 X X Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 3 X 3 DS0000039968.V250979.R01.S.doc Version 5.0 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. 1. Standard YA28 Regulation 23(3) Requirement The registered person must ensure that the staff facilities are adequately maintained and decorated. Timescale for action 28/02/05 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 YA33, YA18 YA32 Good Practice Recommendations It is recommended that consideration be given to increasing the number of male members of the staff team. The registered person should ensure that at least 50 of staff are qualified to NVQ level 2 or above by 31/12/05. 1 Church Road DS0000039968.V250979.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: 0845 015 0120 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 1 Church Road DS0000039968.V250979.R01.S.doc Version 5.0 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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