Inspection on 15/01/08 for 109 Higham Road

This inspection was carried out on 15th January 2008.

CSCI found this care home to be providing an Good service.

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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

109 Higham Road 21/01/09

109 Higham Road 05/03/07

109 Higham Road 13/01/06

109 Higham Road 26/04/05

109 Higham Road 12/10/04

109 Higham Road 05/05/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 109 Higham Road Rushden Northants NN8 3AA Lead Inspector Irene Miller Unannounced Inspection 15th January 2008 09:15 109 Higham Road DS0000012808.V355253.R01.S.doc Version 5.2 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 109 Higham Road DS0000012808.V355253.R01.S.doc Version 5.2 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. 109 Higham Road DS0000012808.V355253.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 109 Higham Road Address Rushden Northants NN8 3AA 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) 01933 358429 01933 358606 www.caremanagementgroup.com Care Management Group Ltd (trading as CMG Homes Ltd) Mrs Hilary Jennifer Watt Care Home 6 Category(ies) of Learning disability (6) registration, with number of places 109 Higham Road DS0000012808.V355253.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To include 2 service users over the age of 65 years LD (E) Date of last inspection 5th March 2007 Brief Description of the Service: 109 Higham Road is a care home providing accommodation and personal care for six adults with a learning disability, owned by Care Management Group Ltd. It is situated close to Rushden and to Higham Ferrers town centres and is in close proximity to all local amenities, with good transport links by bus to Wellingborough and Northampton. Higham Road is a detached house in a residential street with a pleasant rear garden. All residents are accommodated in single bedrooms. Communal areas consist of a lounge, a pleasant dining room overlooking the garden, and a kitchen. The garden is enclosed and used during the summer for barbecues and other outside activities. Current fees range from £565.32 - £1,055.50 per week and exclude the cost of chiropody, hairdressing, clothing and personal items such as toiletries. 109 Higham Road DS0000012808.V355253.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is based upon outcomes for people living at the home and their views of the service provided. This visit was unannounced and focused on the ‘key standards’ under the National Minimum Standards and the Care Standards Act 2000 for homes providing care for younger adults (18-65) years. Prior to the visit the Commission for Social Care Inspection sent out to the home the Annual Quality Assurance Assessment (AQAA) for the home to self assess their performance, the AQAA was returned to the Commission for Social Care Inspection prior to this visit taking place and provided information on the homes management and administration processes. The care needs of two people living at the home were looked at in depth this involved looking through written information available on their care, such as their care plans (a care plan sets out how the home aims to meet the individuals personal, healthcare, social and spiritual needs). Time was spent with the people living in the home, during which time the views on the quality of care of the residents were sought and discussion took place with the residents and staff that were present. In addition observations of staff and residents interactions were made with an aim to establish how residents were supported. Sample checks were carried out on the homes policies and procedures and records in relation to staff recruitment, complaints, and general maintenance and upkeep of the facility were viewed. During the visit the residents and staff were given the choice of completing a satisfaction survey produced by the Commission for Social Care Inspection called ‘have your say’ the aim of completing the survey is to assess the level of satisfaction about the quality of the service that Higham Rd, provides for those living and working at the home. The quality rating for this service is 2 stars. This means the people who use this service experience good quality outcomes. 109 Higham Road DS0000012808.V355253.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Risk assessments need to be conducted to manage the risk associated with exposed radiators and the steps to the main entrance. Having a training plan in place would aid in identifying when refresher training is due. 109 Higham Road DS0000012808.V355253.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. 109 Higham Road DS0000012808.V355253.R01.S.doc Version 5.2 Page 8 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 109 Higham Road DS0000012808.V355253.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2 Quality in this outcome area is good. The pre- assessment system identifies the needs and aspirations of people living at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The resident’s physical and emotional needs had been identified within their care plans, and there were records of the residents being involved in their care reviews. There were records available to demonstrate that health and social care professionals had been involved in the needs assessments. The Service Users Guide is provided to residents before they are admitted and available to residents and visitors upon request. 109 Higham Road DS0000012808.V355253.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6,7 & 9 Quality in this outcome area is good. The people living at the home are supported in making their own choices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents said that they liked living at the home and that they felt fully involved. They confirmed that they are consulted on what happens within the home, and that residents meetings take place to discuss matters such as meals and menus, holidays and anything else that they wish to discuss. Staff said that the home operates a flexible approach, and that residents can choose what they want to do. The comments within the residents survey cards indicated that the residents were encouraged to maintain their independence according to their level of capability. There were comments such as, ‘I like to learn new things and be independent’. ‘I like to tidy my own room’; ‘I like doing the housework’. 109 Higham Road DS0000012808.V355253.R01.S.doc Version 5.2 Page 11 The care plans contained sufficient detail to inform the staff on the level of support required by each resident, and the care plans contained the details of the individual likes and dislikes of the residents in terms of their personal, social and cultural preferences. However not all the care plans seen had been signed by the resident or their representative. The risk assessments viewed addressed the hazards that present through the activities chosen by the residents. These included safety in the community, household tasks such as cooking and cleaning and managing personal finances. In discussion with the staff it was evident that they know the residents very well, and feel competent to provide the correct level of support for each person living at the home. The residents are encouraged to be as independent as possible and take it in turns to help with cooking, one resident said that they had made Spaghetti Bolognaise the prior evening. The staff were observed to show respect for the residents and to promote their rights to make choices and make their own decisions. 109 Higham Road DS0000012808.V355253.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,15,16 & 17 Quality in this outcome area is good. The people living at the home are supported in leading fulfilling lifestyles. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans evidenced that residents have access to a range of activities during the day, such as music and movement and arts and crafts. There were personalised activities programmes in place. On the day of the visit a group of residents were observed having a game of bingo, and residents that did not wish to take part in the bingo were provided with another activity, one resident was colouring in a picture, but also observed to show an interest in the game of bingo and staff ensured that they were fully included. 109 Higham Road DS0000012808.V355253.R01.S.doc Version 5.2 Page 13 Activities are planned on a weekly basis for residents that do not attend external day care provision. Residents were asked what they do in their leisure time and they talked of visiting the local shops, going bowling, visiting a local coffee shop and going to a local supermarket restaurant for a cooked breakfast on a Saturday morning. Residents confirmed that they are able to maintain links with their families and friends and to receive visitors at the home. The registered manager confirmed that all residents are provided with a main holiday abroad each year, together with long weekend breaks throughout the year. The main holiday last year was to Greece there were photographs of the holiday and residents spoke of having a ‘great time’ on their holidays. The minutes of the residents meetings demonstrated that the residents had been consulted about where to go on their main holiday and short breaks. The registered manager confirmed that the menus were being reviewed to ensure that a health balanced diet is offered to residents. The residents were taking an active part in selecting what meals are to be included on the menus, and this was confirmed verbally by the residents and supported in the minutes of the latest residents meeting. Comments received from the staff satisfaction surveys were: ‘We need more materials to work with, and routine so the residents know what is going on’, ‘the staff work well together here there is a relaxed atmosphere’, ‘we could do with more staff to allow more one to one with residents’ and ‘the home provides a happy atmosphere for the residents, and we aim to meet all of their needs’. The Annual Quality Assurance Assessment stated that the service has requested a bigger vehicle from the company as a result of residents saying it is not comfortable enough for them when full. 109 Higham Road DS0000012808.V355253.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18,19 & 20 Quality in this outcome area is good. People living at the home receive the individual support they require to ensure that their physical and emotional health needs can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There were records available within the care plans of residents having contact with their general practitioner, dentist, podiatrist and optician and of other heath care professionals being involved in their care that specialise in mental health care. Risk assessments were in place that addressed areas such as, falls, burns, and use of household cleaning agents and kitchen equipment. Assessments were in place to monitor the physical and emotional needs of the residents, such as records of weights to monitor nutrition, and emotional states/moods, and behaviour patterns to indicate signs of well or ill being. 109 Higham Road DS0000012808.V355253.R01.S.doc Version 5.2 Page 15 The medication systems were reviewed and seen to be in good order and the medication administration records (MAR) sheets were well maintained. 109 Higham Road DS0000012808.V355253.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 & 23 Quality in this outcome area is good. The people living at the home are encouraged to raise any concerns or complaints if they are dissatisfied with the service provided. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents said that they could approach any member of staff if they had any worries or concerns, and were fully aware of which member of staff was assigned to be their keyworker. Since the last inspection visit one complaint had been raised with the provider and due to the nature of the concerns the investigation involved referrals to the Northamptonshire County Councils Safeguarding Adults Team and the Commission for Social Care Inspection. The provider took the complaint seriously and conducted a full investigation. The Commission for Social care Inspection are satisfied that the provider fully investigated the complaint. Staff training had been provided on adult protection and responses from the staff surveys demonstrated that the staff are aware of the whistle blowing policy and safeguarding adult’s procedures. Comments received in the staff survey were “ I am aware of the whistle blowing policy, I would report any abuse to my manager or the regional manager”. 109 Higham Road DS0000012808.V355253.R01.S.doc Version 5.2 Page 17 Observations of staff and resident interaction demonstrated that the staff treated the residents with respect and their rights to privacy and dignity maintained. 109 Higham Road DS0000012808.V355253.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 & 30 Quality in this outcome area is good. The people living at the home are provided with a comfortable, clean and safe environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A limited tour of the building was carried out and the communal areas were pleasantly furnished and decorated. The residents rooms viewed were individually decorated and furnished, and items of personalisation were evident, such as pictures, ornaments, and electrical items. The bathrooms were seen to be in good order with adequate facilities including hot water and shower facilities. 109 Higham Road DS0000012808.V355253.R01.S.doc Version 5.2 Page 19 All of the radiators within the house had thermostatic control valves fitted, although none had protective covers in place. Therefore to identify where radiators may pose a high risk, such as bathrooms and individual bedrooms the company should carry out risk assessments, taking into consideration the individual risks to residents living at the home. In areas identified, as high-risk protective covers should be fitted to minimise the risk of a residents being harmed should they fall against a hot radiator. The registered manager confirmed that she has been obtaining quotes for the fitting of radiator covers. To the front of the building there was a flight of steps leading to the front door in discussion with the registered manager it was established that the steps should be risk assessed to identify and minimise the risks of slips, trips and falls, for residents, staff and visitors to the home. 109 Higham Road DS0000012808.V355253.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 33, 34 & 35 Quality in this outcome area is good. People living at the home are protected through having robust recruitment and selection procedures in place. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the morning of the visit there was sufficient staff on duty to meet the needs of the residents, however comments in the staff surveys indicated that the staff feel that residents would benefit from having more one to one time. Staff recruitment records were sample checked and found to be in order with records of the new staff members having obtained clearance through the Criminal Records Bureau (CRB) and the necessary pre employment checks having been carried out. There was evidence of staff having undergone induction training within the first six weeks of employment, and taking up training to achieve a National Vocational qualification (NVQ) in care at levels 2 & 3. 109 Higham Road DS0000012808.V355253.R01.S.doc Version 5.2 Page 21 Comments received in the staff surveys were “ we are kept up to date with new ways of working” and “we work to a high standard”, “The staff work well together there is a relaxed atmosphere”. In addition staff training had taken place in fire safety awareness, health and safety, basic food hygiene, first aid, moving and handling, challenging behaviour, protection of vulnerable adults (safeguarding) and the safe administration of medication. 109 Higham Road DS0000012808.V355253.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39 & 42 Quality in this outcome area is good. People living at the home can be assured that their views are listened to and their health safety and welfare is promoted and protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Registered Manager was available on the day of the visit and time was spend going through the company’s detailed action plan, that addressed all areas of the care provided for the residents living at the home. The registered manager has worked at the home for a number of years and has the necessary skills and experience to manage the home, and is currently undertaking further training to achieve the registered managers award. 109 Higham Road DS0000012808.V355253.R01.S.doc Version 5.2 Page 23 A representative of the company carries out regular health and safety audits, and in addition carries out monthly unannounced visits (under regulation 26 of the Care standards Act 2000). In discussion with the residents they confirmed that they meet with the registered manager on a regular basis to discuss issues within the home and to give feedback about the services provided. 109 Higham Road DS0000012808.V355253.R01.S.doc Version 5.2 Page 24 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 2 X 109 Higham Road DS0000012808.V355253.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Yes 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 YA42 Regulation 13 (4) Requirement Risk assessments must be carried out on all radiators, based upon the capability and vulnerability of risk to service users. All radiators identified, as high risk must have protective covers put in place. (This requirement has been carried forward from the previous inspection) The steps at the front entrance to the home must be risk assessed to ensure the safety of service users, staff and visitors to the home. Timescale for action 30/04/08 2 YA42 13 (4) 28/02/08 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 registered manager should put a staff training and development programme in place to ensure that all staff receive mandatory and vocational training to meet the aims of the home and the changing needs of service users. 109 Higham Road DS0000012808.V355253.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Text phone: 0845 015 2255 or 0191 233 3588 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 109 Higham Road DS0000012808.V355253.R01.S.doc Version 5.2 Page 27 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!