Inspection on 05/05/05 for 1 Greville Road

This inspection was carried out on 5th May 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

1 Greville Road 18/12/08

1 Greville Road 23/05/07

1 Greville Road 17/01/06

1 Greville Road 16/12/04

1 Greville Road 24/06/04

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Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 1 Greville Road Shirley Southampton Address 3 SO15 5AW Lead Inspector Chris Hemmens Unannounced 5 May 2005 10:00 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 Greville Road H55-H03 S12088 1 Greville Road V218847 050505.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 1 Greville Road Address Shirley, Southampton SO15 5AW 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) 023 8039 3403 Royal Mencap Society Care Home 7 Category(ies) of Learning disability (7), Learning disability over registration, with number 65 years of age (7) of places 1 Greville Road H55-H03 S12088 1 Greville Road V218847 050505.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Service users must be at least 55 years of age. Date of last inspection 16/12/04 Brief Description of the Service: 1 Greville Road is a residential home providing care and support to 7 older service users with learning disabilities. The home has a condition on its registration that it is unable to admit service users under the age of 55. However the homes standards are measured using the Care Homes for Adults (18-65) because of the complex needs of the service users living within the home. The home is a large domestic style house providing a homely and comfortable appearance inside and out, blending well with other homes in the local area. Each service user has a room of their own that has been decorated and adapted to meet their individual needs and characters. The home is situated in Shirley, a residential area of Southampton. It is close to Southampton City Centre, Shirley High Street and a local amenities store with in easy walking distance. The home is local to Southampton Common and Southampton Sports centre where yearly attractions and community events are held. The home is owned by Hyde Housing and is leased to Mencap, a national organisation providing care and support to service users with learning Disabilities. 1 Greville Road H55-H03 S12088 1 Greville Road V218847 050505.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection of 1 Greville Road was the first inspection to be undertaken this year. Three residents, two staff and the manager assisted the inspector with the inspection. The three requirements made at the previous visit were reviewed, one requirement was met and two were extended. The inspector would like to thank the residents for their hospitality and especially the resident who made a very nice cup of tea and the resident who produced some wonderful artwork depicting their life at 1 Greville Road. Permission has been given by the resident to display the pictures in the area office. What the service does well: What has improved since the last inspection? The home continues to encourage and support the residents to play an active role in making decisions about their daily lives and provide them with opportunities to explore and experience new activities. The inspector has observed over the last three visits a more relaxed and inclusive environment for the residents to live in. 1 Greville Road H55-H03 S12088 1 Greville Road V218847 050505.doc Version 1.30 Page 6 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 Greville Road H55-H03 S12088 1 Greville Road V218847 050505.doc Version 1.30 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 Greville Road H55-H03 S12088 1 Greville Road V218847 050505.doc Version 1.30 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) 2 The manager demonstrates good practice in ensuring a thorough assessment process is undertaken prior to a new resident moving and to advocate that current residents needs are reassessed, however the manager must continue to pursue to have the existing residents’ needs reassessed by Social Services. EVIDENCE: The home currently has a vacancy. The manager has received a number of referrals and with the support of a key member of staff is undertaking an assessment on a potential resident. The manager talked the inspector through the process of the assessment, which includes taking into the account the needs of the new resident, the needs of residents currently living in the home, the environment and the skills of the staff. The manager verbally demonstrated good values by ensuring that the views and wishes of the current residents will be taken into account and that the assessment and trial placement will be taken at the pace and need of the new resident. The manager is fully aware of her responsibilities to ensure new residents can be fully and appropriately supported and are compatible with other residents living in the home. The current residents living in the home have lived in the home for many years and for some their needs have significantly changed, requiring additional support and supervision for them to continue to maintain their health and welfare and where possible their independence. The manager has previously been advised to request social services to undertake a review of the residents 1 Greville Road H55-H03 S12088 1 Greville Road V218847 050505.doc Version 1.30 Page 9 needs. The manager informed the inspector that steps have been taken by the organisation to involve social services however they have been very slow to respond to the request. 1 Greville Road H55-H03 S12088 1 Greville Road V218847 050505.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 9 The home provides a continuity of care and ensures residents’ needs, identified risks, wishes and choices are appropriately met and respected. However the home must ensure where possible residents are fully involved and empowered in their care and life planning process. EVIDENCE: The home has adopted a person centred approach in developing personal plans for the residents, these include their personal details, identify their strengths and support needs, associated risks to their health and wellbeing, their daily routines, and likes, dislikes, hobbies and interests. The care plans gives specific detail and informs the carer “how” to support the resident. This approach provides a consistency of care and supports new or relief staff to quickly get to know the residents and their needs. However to ensure the home is fully adopting a person centred approach the residents must be involved in the review of their plans and where possible to sign and be empowered to take ownership of their plans. Discussion took place with the manager on how this could be achieved. One resident with whom the inspector spoke with said he knew he had a file with information on him and that he meets with his keyworker to look at it. However he did not appear to know what was in his plans. 1 Greville Road H55-H03 S12088 1 Greville Road V218847 050505.doc Version 1.30 Page 11 The inspector saw evidence of residents being actively supported and encouraged to make decisions about how they would like to spend their day, what they would like to eat, what activities they wish to be involved in and where they would like to go for a holiday. The personal plans support this and there is evidence documented in monthly reviews that the residents’ wishes are being respected. The inspector observed from staff respect and positive approach to supporting the residents. A member of staff with whom the inspector spoke with demonstrated good values and a clear understanding of her role to ensure that the residents receive the correct support to be a valued member of society. Individual risk assessments provide specific information on how to minimise specific identified risks to the residents. 1 Greville Road H55-H03 S12088 1 Greville Road V218847 050505.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15,and 16. The home provides a stimulating environment where residents are supported to live ordinary and meaningful lives appropriate to their individual needs, desires and wishes. EVIDENCE: The inspector met with three residents during the visit and established from them that they are involved in a number of activities that enable them to maintain or personally develop independent living skills, undertake leisure and social activities and have a presence within their community. Residents were observed making their own drinks and snacks and informed the inspector that they are involved in cleaning their rooms, doing their own laundry, collecting their benefits and shopping. One resident was very excited about attending a 60’s and 70’s concert and the inspector heard discussion regarding how the resident was attending independently and the arrangements put in place to ensure his safety. Another resident with limited verbal communication presented the inspector with a number of beautifully drawn pictures. Staff confirmed that the pictures reflected the resident’s routine, places he likes to 1 Greville Road H55-H03 S12088 1 Greville Road V218847 050505.doc Version 1.30 Page 13 go to, his preferred form of transport and the important people in his life. A frail elderly resident stated he was happy living at 1 Greville Road because the staff were very kind and helped him to do the things he wanted to do and support him to do the things he really enjoys. The manager informed the inspector that individual holidays were being planned with the residents. Individual activity plans indicate that the residents are regularly taking part in valuing and personally rewarding activity. Residents are supported to develop and maintain relationships with family and friends. The manager demonstrated a very good understanding of her role to ensure the rights and wishes of the residents with regards to forming and maintaining relationships is respected. 1 Greville Road H55-H03 S12088 1 Greville Road V218847 050505.doc Version 1.30 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 and 19 The home provides very good support in ensuring the health care needs of the residents are appropriately met. EVIDENCE: The residents with whom the inspector met with said staff offered support and advice with regards to their personal care and wellbeing. This was observed at the time of the inspection when a resident was offered assistance to tidy his appearance. In each residents individual personal plan the inspector saw a description of the residents’ daily routine, from the time they get up to the time they go to bed and the assistance they require to undertake a particular activity such as cleaning teeth. There are no restrictions placed on what time residents go to bed, however if a resident is engaged in a particular activity and the time it takes for them to get ready will determine the time in which they are prompted to get up in the mornings. There is evidence that residents’ health care needs are fully supported, one resident informed the inspector that he will visit the GP when required, and see the dentist, the chiropodist and optician on a regular basis. The home is very well supported by specialist health care teams such as district and community nurses, speech and language therapists and dieticians who provide support, information and training for staff. Outcomes of visit made to or by health care professionals are recorded in the residents’ notes and each resident has a 1 Greville Road H55-H03 S12088 1 Greville Road V218847 050505.doc Version 1.30 Page 15 handling profile on them. The manager informed the inspector that she has recently had authority to replace the bathroom hoist and provide a walk in shower room to meet the changing physical needs of some of the residents. Each resident has had a handling risk assessment undertaken with them. The staff with whom the inspector spoke with were able to clarify the information in the residents notes and were aware of current treatment for the residents. This demonstrates that the staff are kept informed and are involved in the support and review of the residents health care needs. 1 Greville Road H55-H03 S12088 1 Greville Road V218847 050505.doc Version 1.30 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 The home takes seriously complaints and concerns and the vulnerability of the residents its supports, however the home must produce an accessible complaints procedure to meet the individual needs of the residents. EVIDENCE: The residents with whom the inspector spoke with said they were very happy living at 1 Greville Road, that staff are very kind, helpful and listened to them. The residents informed the inspector if they were unhappy they would speak to the manager. The manager is advised to devise a complaints procedure that is individually accessible for all residents, especially for those people with limited understanding and communication skills. Staff demonstrated an understanding of their responsibilities to take seriously, listen carefully and report any concerns raised by the resident or anyone on their behalf. A member of staff spoken with confirmed that she had received training on abuse and provided detail on what she considered constituted abuse and how she would deal with an allegation. This demonstrates that the home takes seriously the vulnerability of the residents they support and has in place measures to minimise the risk of potential harm. 1 Greville Road H55-H03 S12088 1 Greville Road V218847 050505.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 27 and 30 The home provides a comfortable, welcoming and accessible home for the residents to live in. However unsightly damage must be repaired promptly. EVIDENCE: The residents living at 1 Greville Road are provided with a large spacious, clean, airy and tastefully decorated home. The rooms are domestic in style, comfortably furnished and fitted with the “mod cons” of daily living, such as wide screen TV’s, computers and a dishwasher. The kitchen is the centre of the home where residents share quality time talking with staff and where they are involved in the day to day running of the home. The home has an enclosed garden with added features that attract small wildlife and ensure comfort and stimulus. At the time of the inspection a resident was enjoying the use of the garden. Staff undertake the responsibility of the upkeep of the garden. However at the time of the visit the grass was very long and in need of cutting. 1 Greville Road H55-H03 S12088 1 Greville Road V218847 050505.doc Version 1.30 Page 18 The damage to the ceiling caused by a leaking bath noted at the previous visit in December 2004 has not yet been repaired. The home is owned by Hyde Housing Association who are responsible for repairs, the manager stated she had had difficulty getting them to do the work but understood that they were coming the week of the visit to start work on the bathroom and repair the ceiling. The work will be monitored during the next visit. The home has adequate numbers of bathing and toilet facilities, the inspector was informed that the home has recently had their proposal to upgrade the bathing facilities in the home accepted, this will mean the changing physical and health care needs of the aging residents will be appropriately accommodated and met. This will include a downstairs walk-in shower room, an appropriate hoist on the upstairs bath and a further upstairs walk-in shower room. This demonstrates the home has taken into account the changing physical needs of the elderly residents it supports. The home is very clean and residents are supported to do their laundry and undertake daily cleaning chores. Staff receive training in food hygiene and infection control and are provided with information from alternative sources such as the Internet to support their understanding of communicable diseases such as MRSA. 1 Greville Road H55-H03 S12088 1 Greville Road V218847 050505.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 and 35 The home ensures residents are supported by an efficient, skilled and competent staff team. EVIDENCE: Standard 33 was not fully reviewed on this occasion, however the manager stated she ensures as far as feasibly possible that she has adequate numbers of staff on duty to meet the personal, physical and welfare needs of the residents, this sometimes means calling upon relief staff to fill absences. The manager informed the inspector that she is in the process of readvertising for staff, as staff will be leaving in the very near future. The manager has carefully selected her staff team and has established a balance of age, gender, and experience. All staff with whom the inspector met were observed to be approachable, relaxed, and respectful. A respectful camaraderie was observed between staff peers and residents providing a relaxed and comfortable environment to live in. Staffing levels will be monitored at the next visit. The inspector met with a member of staff who demonstrated confidence and a clear understanding of her roles and responsibilities. The member of staff demonstrated very good values and an empathy towards the residents. The member of staff confirmed that she has received various training including an induction and foundation course, NVQ and courses related to the needs of the residents such as diabetes and abuse. However the home is advised to introduce the staff team to person centred planning. 1 Greville Road H55-H03 S12088 1 Greville Road V218847 050505.doc Version 1.30 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 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 and 42 The home provides an environment where the health, safety and welfare of the residents and staff are promoted and as far as feasibly possible protected. However the home must consider the views of the residents, relatives, visiting professionals and others, to further improve the quality of care provided in the home. EVIDENCE: The home actively involves the residents individually to make decisions and choices about their health and welfare, this is seen as very good practice, however the previously made requirement to produce an accessible tool to seek the views of the residents and others who are involved in their care and support has not yet been carried out. The manager informed the inspector that she and some of her peers were working on an appropriate questionnaire. Therefore in order for the home to ensure they are providing a quality service the home must where possible seek the residents views’ The home receives monthly visits fro the area manager who will audit the home to ensure it is 1 Greville Road H55-H03 S12088 1 Greville Road V218847 050505.doc Version 1.30 Page 21 providing a quality service. Reports are sent to the Commission for Social Care Inspection a required Standard 42 was not fully reviewed during this visit, however fire records held in the home provided evidence that the home regularly undertakes fire drills, training that includes residents and staff, and equipment, which is regularly tested and serviced. 1 Greville Road H55-H03 S12088 1 Greville Road V218847 050505.doc Version 1.30 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 2 x x x Standard No 22 23 ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x 3 x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 x Standard No 31 32 33 34 35 36 Score x x 3 x 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 1 Greville Road Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x 2 x x 3 x H55-H03 S12088 1 Greville Road V218847 050505.doc Version 1.30 Page 23 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA22 Regulation 22 Requirement The manager must produce the complaints procedure in an accessible format for the residents. The manager must develop a system for seeking the views of the residents, family representatives, visiting professionals and staff. This requirement has been repeated. A further failure to comply may result in further action being taken. The manager must supply the Commission for Social Care Inspection with a copy of the report referred to in requirement 2. This requirement has been repeated a further failure to comply may result in further action being taken. The manager must ensure the ceiling in the hallway is repaired without delay. Timescale for action 31/08/05 2. YA39 24 (1)(a)(b) 24(3) 21(1)(2) 31/07/05 3. YA39 24(2) 08/08/05 4. 5. YA24 23(2)(c) 10/06/05 1 Greville Road H55-H03 S12088 1 Greville Road V218847 050505.doc Version 1.30 Page 24 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. Refer to Standard YA35 Good Practice Recommendations The manager is advised to introduce person centred training for staff. 1 Greville Road H55-H03 S12088 1 Greville Road V218847 050505.doc Version 1.30 Page 25 Commission for Social Care Inspection 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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. 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