Inspection on 14/09/05 for 1 Empire Road

This inspection was carried out on 14th September 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

1 Empire Road 15/12/08

1 Empire Road 25/01/07

1 Empire Road 26/01/06

1 Empire Road 12/01/05

1 Empire Road 07/07/04

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 Empire Road Torquay Devon TQ1 4LA Lead Inspector Sam Sly Announced 14 September 2005 th 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 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 Stationary 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 Empire Road D54-D07 S18408 1 Empire Road V243488 140905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 1 Empire Road Address Torquay, Devon, TQ1 4LA Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01803 326215 01803 326215 www.parkviewsociety.org.uk Parkview Society Limited Mr WayneOsbond Care Home 1 Category(ies) of Learning disability (1) registration, with number of places 1 Empire Road D54-D07 S18408 1 Empire Road V243488 140905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 12th January 2005 Brief Description of the Service: 1 Empire Road was initially registered, and continues to provide care for one resident with a learning disability. The service is tailored to meet the specific needs of this resident and there is no further admissions planned. The home is situated in a residential area of Torquay, within walking distance of some shops, and within driving distance of the town centre. There is a double bedroom, a staff office/sleep-in room, a shower room, bathroom, lounge, quiet lounge, and kitchen. Outside is a small garden to the rear. The Owners are a local registered charity the Parkview Society that runs several care homes in the Devon area. 1 Empire Road D54-D07 S18408 1 Empire Road V243488 140905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Inspection was announced and took place on a weekday in September between 10am – 1pm. The registered manager Wayne Osbond and deputy manager Pauline Dorrins were at 1 Empire Road throughout the visit. The resident who lives at 1 Empire Road was also present and contributed to the visit. Evidence was collected by examining care records, staff files and health and safety records, talking to the registered manager and deputy manager, talking to the resident and observing interaction with staff. A tour of the premises was also made. A comment card was received from the resident’s relatives. What the service does well: What has improved since the last inspection? What they could do better: 1 Empire Road D54-D07 S18408 1 Empire Road V243488 140905 Stage 4.doc Version 1.40 Page 6 Medication management training is required for all staff to ensure the resident is protected from the risk of error, and the resident would benefit if staff accessed a wider range of specialist training. A comprehensive quality assurance system would enable the Owners to demonstrate to the resident and the Commission that the quality of services is continually monitored and improved at 1 Empire Road. 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 Empire Road D54-D07 S18408 1 Empire Road V243488 140905 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection 1 Empire Road D54-D07 S18408 1 Empire Road V243488 140905 Stage 4.doc Version 1.40 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 standard(s) 1 &2 The resident can be confident that he has the information required about his rights and responsibilities, and that his needs are reviewed regularly and well understood by the staff. EVIDENCE: There has only ever been one resident at 1 Empire Road for over ten years. Therefore the Owners should be commended on the fact that the whole service has developed to meet his changing needs. These needs are well understood and reviewed regularly within his care plan. The Statement of Purpose and Service User Guide now better reflect the services provided, and inform the resident of their rights and responsibilities. It is recommended however that the contract is filled in and signed and copies of the Statement of Purpose and Service User Guide are sent to the Commission. 1 Empire Road D54-D07 S18408 1 Empire Road V243488 140905 Stage 4.doc Version 1.40 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 standard(s) 6 &7 The resident’s care plan reflects his needs, goals and aspirations however should be in a more accessible format. The resident is supported to make decisions about his life therefore promoting his independence. . EVIDENCE: The care plan was detailed, included goals, and was reviewed regularly. Separate reviews were carried out every six weeks with his day activity provider. Discussion took place about developing the current written format into a more user friendly one including digital photos so that the resident could be genuinely involved in the process. It was also recommended that the staff found out more about Person Centred planning, developed their total communication skills and explored the purchase of a computer to help this process. Due to there only being one resident, and 1:1 staff support being available at all times, the resident was able to make decisions about every aspect of his life. The deputy manager said the home had photos of activities that helped the resident make choices about going out. The resident is unable to manage his own finances, so the deputy manager does this with appropriate records kept. 1 Empire Road D54-D07 S18408 1 Empire Road V243488 140905 Stage 4.doc Version 1.40 Page 10 1 Empire Road D54-D07 S18408 1 Empire Road V243488 140905 Stage 4.doc Version 1.40 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 standard(s) 12, 13, 14, 15, 16 & 17 The resident leads an active, stimulating, interesting life, which includes regular family contact. EVIDENCE: The resident attends a day service provided locally four days a week, and has one day at home. It was his day off on the day of the Inspection and after a short ‘lie-in’, and involvement in the Inspection he was off out for a walk and lunch. Records showed the resident went out regularly to a range of activities; walking, trips out, a holiday with his day service, watching Torquay United play, bike shows, evening clubs, to the pub, and shopping. He also regularly visits his family for the day and staff support him to keep in touch by phone throughout the week. A comment card was received from the family, which showed they were satisfied with the care he received. 1 Empire Road is a normal house that blends well into the local community, of which the resident is part of; using the local shops and amenities. The deputy 1 Empire Road D54-D07 S18408 1 Empire Road V243488 140905 Stage 4.doc Version 1.40 Page 12 manager said staff keep up to date with what is available for the resident to do in the community, and use photos and pictures to help him make choices about where to go. Due to the 1:1 staffing levels the resident can go out at anytime. The home has a car for the resident’s use, which at present the registered manager said the resident does not contribute towards. In previous years the deputy manager said the resident has been on holiday, but due to staff shortages this year he has gone on day trips instead. The daily routines of the home revolve around the resident, and promote choice and independent. The home has space for him to be with staff or chose to be alone. Staff were seen to interact with the resident at all times, and he has access to all parts of the home. Some of the goals set in the residents care plan seek to encourage him to become more involved in the household chores. Meals are based solely on what is good for the resident and what he likes. He is involved as much as possible in shopping and preparing the meals, but sometimes opts out, as these are not his favourite pastimes. 1 Empire Road D54-D07 S18408 1 Empire Road V243488 140905 Stage 4.doc Version 1.40 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 standard(s) 18, 19 & 20 The resident receives really good support with his personal and care support in the ways he prefers and requires. Without appropriate training, staff administering medication could potentially put the resident at risk. EVIDENCE: It should be commended that with 1:1 staff support at all times the resident’s personal preferences can be met. Meals, getting up and going to bed and other activities are carried out as and when he requires. Key staff have worked with the resident for many years and know him very well. There is a predominantly male staff team, which reflect his needs, and all the whole team take on the key worker roles, under the direction of the deputy manager. The resident has regular health checks including visiting the dentist, and having hearing and optician tests. There are also regular GP visits required and the staff can contact the local learning disability team if necessary. The staff team manages the storage, administration, and disposal of the resident’s medicines, and the process was being adhered to. However, due to staff changes none of the present staff team had attended a medication management course, and this could potentially put the resident at risk. The 1 Empire Road D54-D07 S18408 1 Empire Road V243488 140905 Stage 4.doc Version 1.40 Page 14 Pharmacist visited regularly and was happy with the way medication was dealt with. 1 Empire Road D54-D07 S18408 1 Empire Road V243488 140905 Stage 4.doc Version 1.40 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 standard(s) 22 & 23 The resident can be confident that his views will be listened to and acted on, and that staff will be able to take the necessary steps to protect him from abuse. EVIDENCE: There was a complaints procedure within the Statement of Purpose and Service User Guide. Neither the Owners, nor the Commission had received any complaints about the home since the last Inspection. A comment card received from the resident’s family stated that there had never been a need to make a complaint. There was a copy of the Local Authority Alerter’s Guidance available, key staff had attended the Adult Protection training, and all staff were taken through the procedure at Induction. Three staff had not attended a training course, and their names were on a waiting list. It was recommended that if the timescale for this training was lengthy then other training providers should be investigated so that the whole team received training. 1 Empire Road D54-D07 S18408 1 Empire Road V243488 140905 Stage 4.doc Version 1.40 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 standard(s) 24 & 30 The resident’s house is clean, comfortable, safe, homely and set out specifically for him. It is truly his home. EVIDENCE: 1 Empire Road was registered for one person, and that resident still lives there. The home has been developed to meet his particular needs and is clean, well maintained and decorated with space for the resident to be alone or with staff. There is a bathroom and shower room, lounge and quiet room, a bedroom for the resident and another for a staff member and a kitchen. The laundry facilities are in the kitchen, which has been agreed with the Commission due to the nature of the home, and needs of the resident. Outside is a small, well-kept garden with sitting area. The home is situated is a residential area of Torquay near local shops, bus routes and amenities, and blends in well into the community. There has been no Environmental health visit for several years as the home has been given a low risk priority. Staff and an external provider carry out regular fire checks, as well as ensuring through training that the house is clean and hygienic. 1 Empire Road D54-D07 S18408 1 Empire Road V243488 140905 Stage 4.doc Version 1.40 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 34, 35 & 36 The resident benefits from services provided by a fit, competent, wellsupported staff team, however training could be better targeted to his needs, and better planned. EVIDENCE: The staff team is small, with a new member just about to join. Over the past year there has been recruitment problems and specific Agency staff have been used at times. The registered manager, deputy manager and one staff member were present on the day of Inspection and the resident was very comfortable with all of them. They were knowledgeable about the residents needs, approachable, interested and committed. Only the deputy manager was working towards any national vocational qualification (the registered manager award), and she said it was difficult to motivate the team members to do this type of training although they were keen to do short courses. It was hoped that the new member of staff would do an NVQ. 1 Empire Road D54-D07 S18408 1 Empire Road V243488 140905 Stage 4.doc Version 1.40 Page 18 The staffing levels were 1:1 support for the resident at all times, with emergency backup, and support from the registered manager throughout the week. Staff had hand over sessions and discussed issues on a daily basis. Staff records were kept at the home and the recruitment process was discussed, and relevant fitness checks and documents seen. The home did not routinely record staff interviews. Supervision sessions were being held, but the deputy manager admitted these were not as regularly as required. The registered manager said appraisals took place, although there was no paperwork in staff files. The Owners reviewed and highlighted mandatory training needs for staff, and the deputy manager gave staff information on other more specialist courses available, however it did not appear that the present staff team had attended much specialist training including Total Communication training. The registered manager said staff were given time to attend training. However, there was no training and development plan showing what training staff had done, and what was needed with relation to the resident’s needs. 1 Empire Road D54-D07 S18408 1 Empire Road V243488 140905 Stage 4.doc Version 1.40 Page 19 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 & 42 The resident’s health and welfare is protected through safe working practices, however there is no quality assurance system to prove to the Commission, and the resident that 1 Empire Road is continually monitoring and improving the services it provides. EVIDENCE: The registered manager said the Owners were still deciding on what format their quality assurance system would take. There were checks and monitoring through maintenance checks, visits by the Owners, and health and safety checks that could feed into an overall quality assurance system. The Owners monitor all the mandatory health and safety training for staff. Staff attended First Aid, Manual handling, food hygiene and fire safety training. The fire book and fire checks were up to date. Accidents were recorded appropriately, and records were kept of electrical, gas and other health and 1 Empire Road D54-D07 S18408 1 Empire Road V243488 140905 Stage 4.doc Version 1.40 Page 20 safety checks. Water temperatures were restricted and checks carried out to control the risk of Legionella. 1 Empire Road D54-D07 S18408 1 Empire Road V243488 140905 Stage 4.doc Version 1.40 Page 21 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 3 4 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 4 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 1 Empire Road Score 4 3 2 x Standard No 37 38 39 40 41 42 43 Score x x 2 x x 3 x D54-D07 S18408 1 Empire Road V243488 140905 Stage 4.doc Version 1.40 Page 22 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. 2. Standard 20 39 Regulation 13 (2) 24 Requirement All staff must attend an appropriate medication management course. The Home must have a quality assurance system that is underpinned by the views of the resident, his representatives, and stakeholders. A report should be developed annually that is available for CSCI and other interested people that shows how the home has developed, and what still needs to be done to improve the quality of care. Timescale for action 15th November 2005 15th March 2006. 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 1 6 Good Practice Recommendations The residents contract should be completed and signed, and copies of the revised Statement of Purpose and Service User Guide sent to the Commission. The use of multi-media formats (digital photos, symbols, line drawings) should be investigated to communicate his care plan and other currently written information to the D54-D07 S18408 1 Empire Road V243488 140905 Stage 4.doc Version 1.40 Page 23 1 Empire Road resident and would increase decision making and choice. Staff should find out more about Person Centred planning, receive training in Total Communication and consider purchasing a computer.. If the timescale for staff attending the Local Authority adult protection training is over six months other training providers should be investigated. 50 of staff should have at least NVQ 2 by 31st December 2005. There should be a format for recording staff interviews and decision making about employment. There should be a training and development plan for the staff team which includes specialist as well as mandatory training. Regular supervision should take place. 3. 4. 5. 6. 7. 23 32 34 35 36 1 Empire Road D54-D07 S18408 1 Empire Road V243488 140905 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton Devon, TQ13 7UP 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 Empire Road D54-D07 S18408 1 Empire Road V243488 140905 Stage 4.doc Version 1.40 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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