Inspection on 24/11/05 for 1 Old Road

This inspection was carried out on 24th November 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 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 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

1 Old Road 09/11/07

1 Old Road 20/06/07

1 Old Road 10/08/06

1 Old Road 11/07/05

1 Old Road 11/11/04

1 Old Road 18/02/04

1 Old Road 02/12/03

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Scic - Old Road, 1 1 Old Road Southam Warwickshire CV33 0HD Lead Inspector Martin Brown (Unannounced Inspection 24th November 2005 14:00 Scic - Old Road, 1 DS0000004307.V266908.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 Scic - Old Road, 1 DS0000004307.V266908.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. Scic - Old Road, 1 DS0000004307.V266908.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Scic - Old Road, 1 Address 1 Old Road Southam Warwickshire CV33 0HD 01789 298709 01789 296724 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) Stratford & District Mencap Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Scic - Old Road, 1 DS0000004307.V266908.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th July 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 DS0000004307.V266908.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is of the second unannounced inspection of the year at this home, and should be read alongside the previous inspection report, for a fuller picture. Where key standards have been assessed on the previous inspection and have been seen to be met, these have not necessarily been inspected on this occasion. The inspection took place over two hours on a week day afternoon. The inspector was made welcome by the staff and service users. The manager was not present on this occasion, all service users were seen, as well as staff from two shifts. What the service does well: What has improved since the last inspection? What they could do better: Although working hard to support service users and meet their needs, staff were unsure how to effectively meet the needs of one service user who has a diagnosis of dementia and whose behaviours and life patterns have changed considerably in recent months. The home should seek specialist support and advice to help those needs to be better met. The home must ensure it is able to adapt to meet the changing needs of the people living in the home, both by accessing relevant training and professional support, and by being able to make adaptations to the home either in anticipation of, or in direct response to, age-related changes, such as dementia, or physical frailty. Scic - Old Road, 1 DS0000004307.V266908.R01.S.doc Version 5.0 Page 6 In struggling to meet the needs of service users who are the most challenging, the service may have been paying less attention than it should have to those who are less forceful in making their case. It must ensure that everyone’s wishes and aspirations are heeded. 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 DS0000004307.V266908.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 Scic - Old Road, 1 DS0000004307.V266908.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): EVIDENCE: These standards were not inspected on this occasion. There have been no new admissions since the previous inspection. Scic - Old Road, 1 DS0000004307.V266908.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 Changing needs of people living in the home makes it important that individual plans ensure that staff have the guidance and support to fully and consistently meet these needs. There is a danger of inconsistency if individual care plans and guidelines are either not detailed enough, fully up-to-date, or are not clearly followed. The service has apparently not taken action in respect of at least one service user’s expressed wishes in the past. It is unclear if wishes regarding day services are currently being heeded. Person-centred plans should help service users’ wishes to be fulfilled. EVIDENCE: These standards were seen to be met during the previous inspection. There was a recommendation that the home works on development plans for individual residents. All those living in the home currently have changing needs, which are mostly age-related. Plans looked at showed that these were being reviewed and updated to reflect and inform these changes. Scic - Old Road, 1 DS0000004307.V266908.R01.S.doc Version 5.0 Page 10 Staff spoken to had good individual strategies for managing difficult situations; because some of these were relatively new experiences, they had not necessarily been shared. Staff also commented that, since doing double shifts, they realised how much they did things differently to each other. One service user had responded to a questionnaire by saying he had wished to move. When I spoke to him, he talked of wanting to live ‘somewhere on his own’. One staff spoken to advised that this was something he had wanted for years, but, although asked about, had never been achieved, because there was ‘no-one pushing for him’. The service user concerned presented as very easy-going; the staff member suggested that this was a factor in his wishes never being realised. He also felt it was now too late for him to achieve this level of independence, because of factors discussed. The service user was happy with elements of his life, such as the facilities in his room, but also indicated that he was not happy with his day care. Scic - Old Road, 1 DS0000004307.V266908.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): 12,16 There continues to be a variety of activities available, but these may no longer meet individual wishes or needs. Outside help and advice may help in ensuring worthwhile and meaningful activities are available for all. Being the ‘hub’ of a number of services operated by the organisation locally may have a detrimental effect on people living at Old Road, if not managed appropriately. EVIDENCE: Two service users returned from a day service later in the afternoon; one service user continues to have a home–based service provided by another agency. One service user has stopped going to a day service, or, indeed, almost anywhere other than the back garden. Staff advised that they are having difficulty supporting him in occupying his time. Much of the time he appeared to be wandering in and out the back of the house with little apparent purpose. When one of the other residents returned, he appeared more settled, spending time just sitting with her. Scic - Old Road, 1 DS0000004307.V266908.R01.S.doc Version 5.0 Page 12 One service user said he had not enjoyed his day service that day, because a named person had been annoying him. Staff believed that this day service was not perhaps ideal for this person, but knew of no alternatives. When two of the people living at the home returned from a day service, one other person, residing elsewhere, also arrived at the home for a short while, before going home. Something similar happened on the previous inspection. In neither case did it appear that those living at the home had any say in this; on this occasion, it may have been a factor in one service user retiring to his room. Scic - Old Road, 1 DS0000004307.V266908.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 Service users are currently going through a variety of age-related changes, which are providing challenges for the home to meet. To meet these challenges, the home needs to ensure staff have the appropriate training and guidance, and that environmental changes can be made when necessary. EVIDENCE: One service user recently had a ‘mini-stroke.’ This caused initial difficulties with personal care, resolved by the temporary use of the downstairs en-suite walk-in shower, which staff informed that the service user in that room had agreed to. Two service users have a diagnosis of dementia, although there is still some uncertainty in both cases over its extent, and the role of other factors. One service user is now reluctant to go out, and has been aggressive towards another service user, to whom he is, most of the time, very fond. Staff advised that they were finding it difficult to find ways of usefully occupying this person, although they did acknowledge that 1:1 contact was still something he responded to. Scic - Old Road, 1 DS0000004307.V266908.R01.S.doc Version 5.0 Page 14 The other service user has an outside agency involved in providing a 1:1 day service. Staff advised that this, combined with routines that better enabled him to combine privacy with living in a group setting, had resulted in him being more settled. It was noticeable that when I arrived, he was happily listening and singing along to music in the dining room, but went to his own room when more people arrived later. Scic - Old Road, 1 DS0000004307.V266908.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 The home’s duty of care should include it effectively pursuing instances where it suspects a resident is being financially abused outside the home. EVIDENCE: These standards were met during the previous inspection, and were not fully assessed on this occasion, other than to note service users’ finances being appropriately recorded. It was noted that one service user was not receiving Disability Living Allowance, (mobility component) although he should be entitled to it. I was advised by staff that enquiries concerning this had been made, but that the money was being paid to a person of whom they were unaware. Scic - Old Road, 1 DS0000004307.V266908.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26. The home continues to provide a small-scale, homely environment for the residents. The home will need to plan for likely and continuing age-related changes in the future, to maintain health and safety and to continue to meet the residents’ needs. There is a potential risk of burns from hot radiators. EVIDENCE: The home was clean, tidy and homely on this unannounced inspection. Service users continue to be at ease in all parts of the house. Bedrooms are pleasantly furnished, and reflect individuals’ personalities and interests. Two service users were particularly pleased with their new, large, televisions. The bath panel on the upstairs bathroom was missing two screws, and consequently loose. There is now a rail in place at the front of the house, to ease access for those who require additional support with mobility. It was pleasing to be informed that new living room chairs, chosen by those living in the home, but previously rejected by the organisation on the grounds of cost, are to be purchased, after all. Radiators in the home do not have protective covers on. Scic - Old Road, 1 DS0000004307.V266908.R01.S.doc Version 5.0 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 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): 33,35 More training in specific areas such as the management of challenging behaviour and dementia care would better enable staff to meet the current needs of service users. EVIDENCE: Two staff were on both shifts. This arrangement is now in place in response to the increased needs of particular service users. Prior to this, staff tended to work singly. The need for this level of cover was evidenced by one staff being available to anticipate or calm potentially disruptive behaviours, whilst another was busy elsewhere. Discussion with staff, and examination of the training matrix, demonstrated ongoing training throughout the home. The majority of staff have now undertaken initial dementia training. Staff spoken to expressed the wish for further training to enable them to relate that learning to the support currently needed by those living in the home. In relation to this, staff spoken to also agreed that training in Challenging Behaviour would be very beneficial in helping them better support service users. Staff were seen to be working effectively in key worker roles. Scic - Old Road, 1 DS0000004307.V266908.R01.S.doc Version 5.0 Page 18 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 Service users benefit from being in a home that strives to meet their needs. It must ensure it keeps pace with changing needs, and pays heeds to people’s choices. While fire safety procedures are appropriate for physically able and mentally alert service users, they will need revising with the increase in age–related frailties. EVIDENCE: Responses from service users and relatives to questionnaires sent out prior to the inspection were generally positive. Service users were supported by day service staff to fill these in. Downstairs firedoors now have alarm activated closure devices on them, to allow them to be safely remain open in the day. Upstairs bedroom doors remain closed when not in use. Scic - Old Road, 1 DS0000004307.V266908.R01.S.doc Version 5.0 Page 19 Staff were not clear whether these doors were fire doors, not could any documentation be found to show whether they offered a minimum period of protection against fire or smoke. Policy up until now has been for all residents to evacuate the building upon the sounding of alarms. Staff agreed that whilst people living in the home may be able to evacuate the building quickly at present, this ability is becoming increasingly compromised by age-related factors. The lounge has a gas fire. Staff spoken to were unaware of a risk assessment to cover its safe use. Scic - Old Road, 1 DS0000004307.V266908.R01.S.doc Version 5.0 Page 20 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 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 2 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 4 4 2 X X X LIFESTYLES Standard No Score 11 X 12 2 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X 3 X 2 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Scic - Old Road, 1 Score 2 2 X X Standard No 37 38 39 40 41 42 43 Score 3 X X X X 2 X DS0000004307.V266908.R01.S.doc Version 5.0 Page 21 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 YA6 Regulation 15 Requirement Care plans must cover individual needs in sufficient detail as to ensure service users can be confident that their changing needs are being supported by staff in a consistent manner. The home must plan as far as possible for environmental improvements to be made to meet the anticipated changes in needs of individual residents. The home must ensure that a service user receives any mobility money that is an entitlement. The bath panel requires attention. In order that service user needs are better met, there should be greater input for staff by specialists in Dementia Care and Challenging Behaviour The home must risk assess the radiators in the home, and have protective covers put on as appropriate. A risk assessment is required for the lounge gas fire.(This is outstanding from the previous inspection) DS0000004307.V266908.R01.S.doc Timescale for action 28/12/05 2. YA24 23 28/01/06 3. YA23 13(6) 28/01/06 4. 5. YA27 YA35 23(2) 18(1)(c ) 28/12/05 28/01/06 6. YA24 23(2) 28/12/05 7. YA42 23(2) 28/12/05 Scic - Old Road, 1 Version 5.0 Page 22 8. YA42 23(2) 9. YA7 12(3) The home must check whether bedroom doors are appropriate for service users in the event of a fire, and take any necessary action to ensure that they are. The home must ensure it acts on valid choices made by residents concerning issues of importance to them. 28/12/05 28/12/05 Scic - Old Road, 1 DS0000004307.V266908.R01.S.doc Version 5.0 Page 23 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. 5. Refer to Standard YA12 YA7 YA18 YA24 YA16 Good Practice Recommendations The home should ensure, with outside specialist help as necessary, that service users are able to have appropriate activities that are stimulating and enjoyable. It is recommended that all service users have person centred plans that promote their wishes and ensure that they are met. The home should plan for environmental improvements to be made as necessary to meet the anticipated changes in needs of individual residents. It is recommended that the gas fire is replaced. It is recommended that the home takes steps to ensure that the rights of people living at Old Road are not compromised by the effects of the organisation’s wider service. Scic - Old Road, 1 DS0000004307.V266908.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Leamington Spa Office 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 DS0000004307.V266908.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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