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Inspection on 11/07/05 for 1 Old Road

Also see our care home review for 1 Old Road for more information

This inspection was carried out on 11th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service provides a small, homely environment where four people for live together in a relaxed, easy going atmosphere, with an emphasis on people helping and enhancing their social and living skills.

What has improved since the last inspection?

Improvements in practice and policies have been made following requirements at the previous inspection. An increase in staffing required to manage the needs of one service user has also meant an improvement in the quality of care for the other service users as well.

What the care home could do better:

The home needs to ensure that staff training equips staff to meet all identified needs of service users, and that all major risks are assessed and managed.

CARE HOME ADULTS 18-65 Scic - Old Road, 1 1 Old Road Southam Warwickshire CV33 0HD Lead Inspector Martin Brown Unannounced 11 July 2005 2.30pm 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. Scic - Old Road, 1 E53 s4307 Old Road v238201 110705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Scic - Old Road, 1 Address 1 Old Road Southam Warwickshire CV33 0HD 01789 298709 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) Stratford & District Mencap Rachel Sass(pending approval) PC Care home only 4 Category(ies) of LD Learning Disability (4) registration, with number of places Scic - Old Road, 1 E53 s4307 Old Road v238201 110705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 17 March 2005 Brief Description of the Service: 1 Old Road is a semi-detached house, which provides accommodation for four adults who have learning disabilities. The ground floor has the communal accommodation, with a lounge that leads into a large open plan dining area and kitchen. There is a small utility room off the kitchen. The ground floor also has one bedroom with its en-suite WC and shower. There are three bedrooms on the first floor in addition to a bathroom and staff sleep in/office. The house has a rear garden and parking for cars at the front. Shops and village amenities are available locally. The property is owned by a Warwickshire housing association and held on lease by the care provider. Scic - Old Road, 1 E53 s4307 Old Road v238201 110705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection lasting approximately four hours, on July 11th, 2005. Staff and service users were welcoming and co-operative. Six members of staff and management and all four residents were seen and spoken to during the inspection. What the service does well: 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. Scic - Old Road, 1 E53 s4307 Old Road v238201 110705 Stage 4.doc Version 1.40 Page 6 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 Scic - Old Road, 1 E53 s4307 Old Road v238201 110705 Stage 4.doc Version 1.40 Page 7 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) 5 Service users are protected by the provision of individual contracts, that are updated as required. EVIDENCE: A sample of contracts were seen to be in place in individual service user files. Other standards were not looked at in this section, as there have been no new service users for a number of years. Scic - Old Road, 1 E53 s4307 Old Road v238201 110705 Stage 4.doc Version 1.40 Page 8 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) 6,7,8,9 Service users’ changing needs and goals are reflected in their individual plans. Clarification of these goals might be helped by further development of individual, user-friendly and user-centred plans for everybody. Risk assessments should be proportionate, in that greatest concentration is paid to the highest risks and their management. Clarification with the organisation over the financial implications of service users’ decision-making would reduce disappointment in future. EVIDENCE: Some service users had ‘life story’ books, full of photographs, and ‘about me’ books. The manager advised that the home is in the process of developing these further, with other service users. Individual care plans detailed guidelines for personal care, and managing any risks associated with these, or the failure to follow them. Risk assessments were seen to be recorded, reviewed and dated, enabling service users to take managed risks. The manager acknowledge that some risks had a higher priority than others, and that these ought to be highlighted and contain more detail. Staff were able to give many examples of service user decision-making and choice, such as service users choosing plants for the garden, and being Scic - Old Road, 1 E53 s4307 Old Road v238201 110705 Stage 4.doc Version 1.40 Page 9 involved in choosing a new carpet for the lounge. A further example given by the manager involved service users going with staff to try out and select a new three-piece suite. The manager advised that a strong preference was shown by service users for a particular set of chairs, which was later vetoed by the organisation on the grounds of cost. Scic - Old Road, 1 E53 s4307 Old Road v238201 110705 Stage 4.doc Version 1.40 Page 10 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. Service users are supported in a variety of activities, all of which help support the development of their living and social skills. An increase in staffing, brought about for other reasons, has also had the beneficial effect of enabling greater support to enable service users to develop and widen their skills and experiences. EVIDENCE: Service users have a variety of activities. Three people attend regular day services, one person has a home-based day service provided by another agency, for twenty hours a week. Current staffing levels enable individual activities to take place more frequently at weekends and in the evenings, so that activities such as swimming, the cinema, going shopping or to the pub can take more frequently than has previously been the case. Service users are supported to visit friends and take part in social events in the locality. A variety of holidays and trips out are planned for the rest of the year. Staff were seen to be respectful of service users in interactions during the inspection. Scic - Old Road, 1 E53 s4307 Old Road v238201 110705 Stage 4.doc Version 1.40 Page 11 Menus, and the stocks of food available indicated that a varied and healthy diet was enjoyed by the people living at the home. Service users enjoyed a relaxed evening meal together, which they had helped prepare and which they helped clear away afterwards. Scic - Old Road, 1 E53 s4307 Old Road v238201 110705 Stage 4.doc Version 1.40 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 standard(s) 18,19,20 Guidelines assist in ensuring service users are supported in ways that meet their needs and wishes. Further training in relevant areas will assist in meeting current and anticipated needs. EVIDENCE: Guidelines are in individual care files, detailing personal care, and responses to particular needs, where appropriate. Specialist support from appropriate professionals is available and recorded where relevant. Guidelines are reviewed regularly, to reflect changing needs. Medication is administered and recorded appropriately. The home uses its own Medication Administration Record Sheets. Most medications are in blister packs. Scic - Old Road, 1 E53 s4307 Old Road v238201 110705 Stage 4.doc Version 1.40 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 standard(s) 22,23 The culture in the home is one in which service users’ views are listened to, and which helps protect against abuse. EVIDENCE: The home has a copy of the organisation’s abuse policy; service user guides contain a user-friendly complaints procedure, but thus still leaves a reliance on staff or other parties to support a service user if he or she has a complaint. Staff were observed paying due attention to service user’s views and concerns. Staff are currently in the process of undertaking abuse training, with approximately half of them having undertaken it. The manager was able to show examples of service users’ concerns being raised and being responded to. Service users spoken to expressed no concerns in respect of their care. There had been a recent complaint to the home which has been investigated and actioned appropriately. Scic - Old Road, 1 E53 s4307 Old Road v238201 110705 Stage 4.doc Version 1.40 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 standard(s) 24,28,29,30 The house is comfortable and homely in nature. The provision of some support rails, under Occupational Therapy guidance, would help increase people’s confidence, and reduce falls. EVIDENCE: The home is an ordinary semi-detached house, in a row of similar, and is homely, comfortable and domestic in scale. Service users were equally at ease in all parts of the house, some choosing to spend time in their bedrooms, whilst others used the dining room, kitchen, and back garden. The home was clean and hygienic on this unannounced inspection. There were some items occupying communal space when they could have been stored more appropriately, such as a ‘zedbed’ and a wheelchair. The lounge has a gas fire. Scic - Old Road, 1 E53 s4307 Old Road v238201 110705 Stage 4.doc Version 1.40 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 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 service users benefit from the support of sufficient and competent staff who are familiar with their needs and wants. Specific training for all staff, particularly in dementia-related issues, will help staff meet anticipated needs of service users. EVIDENCE: The home has a large staff team, enabling the home to operate with very little reliance on agency or bank staff. There is a planned programme of training, showing staff are being trained in core skills, progressing in NVQ and LDAF training. Very few staff have had training in dementia care. The file of the most recent recruit was seen, and demonstrated that appropriate procedures were being followed. The manager advised that she views all Criminal Record Bureau checks, and will in future sign, date and record the reference number to verify this. Supervision records demonstrated that regular, recorded supervision takes place. Scic - Old Road, 1 E53 s4307 Old Road v238201 110705 Stage 4.doc Version 1.40 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 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) 39,42,38 There are systems in place for ascertaining the views of service users and significant others regarding the home. Service users safety in the event of a fire is compromised by the use of wedges on a number of doors in the daytime. EVIDENCE: The manager advised that the home regularly meets with parents of service users, holds regular service user meetings, which are recorded, and has userfriendly questionnaires for service users to respond to, with support as necessary. The manager discussed issues that were frequently raised, and the service’s response to these. The home carries out regular fire drills, all based on a day time, waking alarm. The last fire inspection report, which was satisfactory, in 2003, was seen. There were wedges on some doors. The manager advised that these were not in place at night, and that certain doors were locked, effectively blocking the lounge, dining room and kitchen from the rest of the house. The manager has not yet completed the registration process. Scic - Old Road, 1 E53 s4307 Old Road v238201 110705 Stage 4.doc Version 1.40 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 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x 3 3 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 3 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Scic - Old Road, 1 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x 2 3 x x 2 x E53 s4307 Old Road v238201 110705 Stage 4.doc Version 1.40 Page 18 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. Standard 42 Regulation 23(4) Requirement The home must consult with the fire officer regarding the most suitable way of ensuring access without compromising fire safety through the use of door stops. Outdoor access must be fully risk risk assessed Dementia training must be accessed by all staff. Appropriate storage must be found for items such as zedbeds as wheelchairs. A full fire assessment must be carried out in respect of fire safety and fire evacuation at all times of the day. The armchair in the dining room requires replacing. Acess to the front of the house is to be improved. (I was advised that this is underway) A risk assessment is required for the lounge gas fire. The manager is to complete the registration process. Timescale for action 15/8/05 2. 3. 4. 5. 42 35 24 42 23(2) 18(1)(c) 23(2) 23(4) 15/8/05 15/9/05 15/8/05 15/8/05 6. 7. 8. 9. 24 24 42 38 23(2) 23(2) 23(2) 9 15/8/05 15/8/05 15/8/05 15/9/05 Scic - Old Road, 1 E53 s4307 Old Road v238201 110705 Stage 4.doc Version 1.40 Page 19 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. 3. 4. Refer to Standard 29 6 24 24 Good Practice Recommendations It is recommended that the home seek outside professional advice regarding mobility aids to ease access for service users all round the house It is recommended that the home works on development plans It is recommended that the chairs in the lounge are replaced. It is recommended that the gas fire is replaced. Scic - Old Road, 1 E53 s4307 Old Road v238201 110705 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection Imperial Court Holly Walk Leamington Spa CV32 4YB 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 Scic - Old Road, 1 E53 s4307 Old Road v238201 110705 Stage 4.doc Version 1.40 Page 21 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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