CARE HOME ADULTS 18-65
Warwick Road, 2 2 Warwick Road Wallsend Tyne And Wear NE28 6RT Lead Inspector
Deborah Haugh Announced Inspection 3rd November 2005 10:00 Warwick Road, 2 DS0000000353.V249529.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 Warwick Road, 2 DS0000000353.V249529.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. Warwick Road, 2 DS0000000353.V249529.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Warwick Road, 2 Address 2 Warwick Road Wallsend Tyne And Wear NE28 6RT 0191 234 3933 0191 234 3933 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) Northern Life Care Limited T/A U.B.U. Emma S Adamson Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Warwick Road, 2 DS0000000353.V249529.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The number of persons for whom residential accommodation with board and care is provided at any one time shall not exceed 4 men or women 19th August 2002 Date of last inspection Brief Description of the Service: The home is privately owned by Northern Life Care and is registered to provide care for four adults with learning disabilities who may also have physical disabilities. The home does not provide nursing care. It was purpose built in recent years and provides homely ground floor accommodation and each service user has a single bedroom. It is situated in the centre of Wallsend and close to all local amenities. It is immediately adjacent to No 4 Warwick Road, which provides a similar service. Warwick Road, 2 DS0000000353.V249529.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The announced inspection took place on 3/11/05 from 10.00 until 1pm. The Registered Manager, Emma Adamson was on duty during the visit. Time was spent looking around the home to check the cleanliness, maintenance and decoration during the visit. Prior to the inspection questionnaires were provided to service users and relatives. A service user completed a questionnaire with assistance. Time was also spent observing the contact between the service users and staff. One questionnaire was completed by Relatives /Visitors. At the time of the inspection an advocate of one of the service users visited. Two plans of care were examined. Health and safety arrangements and arrangements for the administration and management of medication were checked. What the service does well:
No 2 Warwick Rd has a homely atmosphere. The communal living areas help provide a personalised approach and service users bedrooms are individualised. The Manager is planning new decoration and refurbishment for the bedrooms. The service users showed their enjoyment of the activities, which they are supported to access by staff and advocates. The relatives and visitor comments were very positive and included; - ‘They are so much happier and do much more with their day than they ever did.’ Plans of care are detailed and cover a range of developmental and support needs. There is a good multi-disciplinary approach to care. Service users have complex communications but staff demonstrated their knowledge and understanding of these needs. The manager and her team are responsive to change and want to develop and improve the service. The staff team is now stable and have good relationships with the service users. All but 2 staff have completed or nearly NVQ Level 2 & 3. Staffing levels were appropriate to meet the needs of the service users. The Registered Manager has nearly completed her Registered Managers Award and NVQ 4 in Care.
Warwick Road, 2 DS0000000353.V249529.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Warwick Road, 2 DS0000000353.V249529.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 Warwick Road, 2 DS0000000353.V249529.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): NMS 2 was assessed and met at last inspection July 2005. EVIDENCE: Warwick Road, 2 DS0000000353.V249529.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 & 9 were assessed at this inspection. 7 was met at the last inspection. Care plans are detailed and identify the needs of the service users and actions to meet them therefore service users receive the care they need. Risk assessments provide guidance to staff and protect service users. EVIDENCE: Two care plans were examined, staff discussed their approaches to caring for the service users and interactions between service users and staff were observed. Warwick Road, 2 DS0000000353.V249529.R01.S.doc Version 5.0 Page 10 Care plans are very comprehensive and look at a full range of needs of the service users. They include information on the support package from the organisation and other agencies. Staff now record that they have read and understood the care plan interventions. Communication with the service users is complex and the various methods developed by the staff are clearly identified. Targeted ambitions are identified each year so that new activities and experiences are introduced. The care plans are evaluated on a regular basis and reviews are carried out on a six monthly basis. Limitations of choice to safeguard the service users are fully recorded. Risk assessments covering all aspects of the service users’ lives are recorded. Risk assessments are in place for dealing with service users behaviours that challenge the home. Steps to address behaviours are recorded. The Manager and her team continue to work very hard to develop the care plans, health care and risk assessments. Warwick Road, 2 DS0000000353.V249529.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): 15 & 16 were assessed. 12,13 & 17 were met at the last inspection July 2005. Service users maintain relationships with family and friends. Service users rights are respected. EVIDENCE: Visitors are welcome in the home at any time and visitors themselves confirmed this. Evidence in care plans shows that relationships are supported. Routines in the home are centred around the preferences and needs of the service users. Evidence is found in the care plans and from speaking to visitors and staff. Warwick Road, 2 DS0000000353.V249529.R01.S.doc Version 5.0 Page 12 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): NMS 18,19 & 29 were assessed at this inspection. Care plans record the approach to be taken to care so service users receive personal care in a way that respects their dignity and privacy. The health needs of service users well met with multi disciplinary working taking place on a regular basis. The medication at this home is being managed so service users receive the care they require. EVIDENCE: The staff continue to monitor service users health needs, which are recorded in the care plans. Care plans record the preferences and routines and staff demonstrated these. Routine health checks are carried out and service users attend appointments with relevant health care professionals with staff. Advice is sought from professionals and care plans reflect this. Medication arrangements have improved and the new monitored dosage system is effective. The Manager undertakes her own audits each month. Staff are trained. Warwick Road, 2 DS0000000353.V249529.R01.S.doc Version 5.0 Page 13 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): NMS 22 & 23 were assessed and met at last inspection July 2005. EVIDENCE: Warwick Road, 2 DS0000000353.V249529.R01.S.doc Version 5.0 Page 14 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): NMS 24 & 30 were assessed at this inspection Service users live in a well maintained, clean and decorated home. EVIDENCE: Since the last inspection one of the bedrooms and the bathrooms have been re-decorated and repairs made to a damp patch on the corridor ceiling, to damage to the plasterwork near the window in a service user’s bedroom and the bathroom. A new bath has been fitted. The service users bedrooms and some furniture are due to be redecorated and replaced as well as new flooring. A new light is due to be fitted in the toilet. The kitchen was clean. Damage to a broken door has been reported. A rusty chopping board stand. The laundry and arrangements for infection control are appropriate. Bedrooms are personalised and decisions about decoration and furnishing is discussed with service users Warwick Road, 2 DS0000000353.V249529.R01.S.doc Version 5.0 Page 15 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): 32 & 33 were assessed. 34 & 35 were assessed and met at the last inspection. Staffing numbers are appropriate to the assessed needs of the residents, size, layout and purpose of the home, at all times. Service users are cared for by staff who are trained to NVQ Level 2 & 3. EVIDENCE: The home maintains the level of staffing in accordance with previous agreements with the local authority and this reflects the size and layout of the building and the needs of the residents currently living in the home. The current levels of staffing are a minimum of 3 care staff on duty during the day and 1 waking night staff with 1 person sleeping in. Over 50 of staff are qualified to NVQ Level 2 and to Level 3. Warwick Road, 2 DS0000000353.V249529.R01.S.doc Version 5.0 Page 16 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 & 42 were assessed. 39 was met at the last inspection July 2005. Service users live in a home with robust management arrangements. Systems are in place to protect service users from health and safety hazards. EVIDENCE: The Registered Manager has nearly completed her Registered Managers Award and NVQ 4 in Care. Maintenance checks and records are in place and risks are managed. Checks include the fire log, training and maintenance of equipment. Gas and electrical testing, hot water and Legionella prevention is in place. Moving and handling equipment is serviced at the required time. Electrical servicing is in place. Warwick Road, 2 DS0000000353.V249529.R01.S.doc Version 5.0 Page 17 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 x x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 x x 3 x Standard No 24 25 26 27 28 29 30
STAFFING Score 3 x x x x x 3 LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score x 3 3 x x x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Warwick Road, 2 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 x x x x 3 x DS0000000353.V249529.R01.S.doc Version 5.0 Page 18 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. Standard Regulation Requirement Timescale for action 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 YA6 YA30 Good Practice Recommendations Update photograph on Missing Persons Form Replace rusty chopping board stand Warwick Road, 2 DS0000000353.V249529.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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